key: cord-023157-0lqlx2rv
authors: nan
title: Poster Sessions
date: 2013-04-18
journal: J Diabetes
DOI: 10.1111/1753-0407.12032_1
sha: 
doc_id: 23157
cord_uid: 0lqlx2rv

nan

Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy in women before menopause, The purpose of this study was to determine the effects of a diet and physical activity trial for improving PCOS clinical and laboratory findings in obese women. This semi-experimental single-blind controlled trial was conducted among 50 women with PCOS (25 cases and 25 controls). Initially, all the patients′ information was evaluated in terms of: demographic, menstrual status, clinical characteristics of hyperandrogenemia, as well as biochemical, hormonal and abdominal ultra-sonography. The intervention plan consisted of a 12-week exercise and diet program for the experimental group. All baseline assessments were repeated in both groups within 3 months after beginning of the trial, and the results were analyzed. The comparison between the two groups revealed that in the experimental group, the interventions have been effective for the following variables: follicle stimulating hormone (P = 0.01), the luteinizing hormone (P = 0.01), total testosterone (P = 0.005), free testosterone (P = 0.004), estradiol (P = 0.03), selfglobulin band sex hormone (P = 0.001), triiodotyronine (P = 0.001), thyroxine (P = 0.001), TSH (P = 0.001), hydroxy progesterone (P = 0.03), triglycerides (P = 0.03), total cholesterol (P = 0.05), body mass index (BMI; P = 0.03), the ultrasound exam (P < 0.001), oligomenorrhea (P < 0.001), of hirsutism (P < 0.001), acne (P < 0.001) and alopecia (P = 0.01).

It seems that regular exercise and dietary intervention are effective to improve PCOS among obese women.

A series of studies have recently demonstrated that the oxidative stress, nuclear factor-kappa B (NF-jB) activation and the subsequent coordinated inflammatory responses played an important role in the pathogenesis of urate nephropathy (UN). Polydatin has been suggested to have the properties of anti-oxidative, anti-inflammatory and nephroprotective effects. However, the possible protective and beneficial effects of polydatin on UN are not fully elucidated. Therefore, we investigated the potential beneficial effects and possible mechanisms of polydatin on UN. In this study, polydatin showed inhibitory activities on xanthine oxidase to repress the level of serum uric acid in vivo and in vitro. Further investigations revealed that polydatin displayed little toxic effects and significantly ameliorated the renal function in fructose-induced UN mice. The nephroprotective activities of polydatin was not only due to the effects on remarkably attenuating the oxidative stress induced by uric acid, but also on markedly suppressing the oxidative stress-related inflammatory cascade, including decreasing the expressions of NF-jB p65, COX-2 and iNOS proteins and inhibiting the productions of TNF-a, PGE 2 and IL-1β. These findings elucidated that polydatin exhibited prominent nephroprotective activities and low toxic effects.

Drug Discovery, ObeTherapy, Evry, France Many obesity related genes have been proposed as targets for the treatment of obesity. However, these obesity genes did not provide efficient drug therapy for obesity treatment. This is mainly due to the redundancy of the biochemical pathway involved in obesity and the lack of specificity of the gene targets. It is therefore a challenge to identify crucial gene(s) targets involved in energy metabolism associated with "lean or starvation phenotype".

Congenital Enteropeptidase defficiency is an extremly rare pathology which answer to all these criteria. Enteropeptidase catalyzes the conversion of inactive trypsinogen into active trypsin via the cleavage of the acidic propeptide from trypsinogen.

We have generated knock out transgenic mice for enteropeptidase which shows the same phenotype like in human. These data and in vivo preclinical data using per os small molecule for long term treatment (9 weeks) will be presented.

F. Nasiri Amiri 1 , F. Ramezani Tehrani 2 , M. Simbar 2 1 Babol Medical Sciences University, Babol, 2 Shahid Beheshti University of Medical Sciences, Tehran, Iran Polycystic ovary syndrome (PCOS) is the most common chronic endocrine disorder with a prevalence estimated at 4-25% depending on the diagnostic criteria used. It has significant and diverse clinical consequence including reproductive, metabolic, psychological morbidity and some cancer. It is unclear how PCOS symptom influences such women's experiences of their bodies. This study aimed to explain women's experiences of their health concerns when living with PCOS. This research is a qualitative study. semi-structured opened interviews were conducted with 20 women aged 18-39 years who were diagnosed with PCOS. Interviewing the participants were continued to reach data saturation. All the interviews were recorded and transcribed. The data were analysed using content analysis. Four closely intertwined themes were disclosed: physical consequences of PCOS, fear of future, economic burden of desease and coming to Terms with a chronic condition. Our findings suggest that healthcare professionals working with PCOS patients should consider providing peer support groups as a means to alleviate patients concern and to promote self management activities such as lifestyle modification. Ideally, groups should be designed to meet patients support needs and expectations, and should be evaluated regularly.

M. Kidron 1 , E. Arbit 2 1 Oramed Pharmaceuticals, Jerusalem, Israel, 2 Biomedical Engineering, NYU -Oramed Pharmaceuticals, Englewood, NJ, USA Introduction: The major cause of hyperglycemia in T2DM is inappropriate, non-suppressible hepatic glucose production due to hepatic insulin resistance (HIR)) and elevated glucagon levels. HIR is a result of fat deposition in the liver which in turn begets a local inflammatory process, a common thread observed in T2DM, the metabolic syndrome and obesity which are all known risk factors for morbidity. The only antidiabetic drug that addresses specifically HIR, up to now is metformin and its effects wanes over time. There is an unmet need for other drugs that target the liver specifically. Insulin has a direct effect on hepatocytic receptors and thus has shown to be capable to reduce hepatic steatosis and improve glycemic control, as well as reduce hepatic insulin resistance. Insulin administered orally is absorbed into the portal-hepatic vein and reaches the liver at high concentrations. This route of administration may confer physiologic advantages over systemic insulin administration and lower the risk of hypoglycemia.

Results: BMI, HDL and Cu levels were found to be significantly higher in women compared to men (P < 0.001). _ It was established that blood copper levels, similar to hsCRP, predicted MS and MS parameters, but predicted different MS parameters at different sensitivities and specifities. We obereved that there was a more significant correlation between TG level, blood pressure and Cu, compared to hsCRP (Tables 1, 2 and 3). Conclusion: Based upon these results, it may be stated that Cu predicts MS and MS parameters as well as hsCRP does and that it is even a better predictor for MS and atherosclerosis since it is less influenced from inflammatory events than CRP.

short-chain fatty acids which then up regulate proglucagon (precursor to GLP1) and PYY gene. These gut hormones are collectively known as "incretin" and they primarily regulate insulin level after eating. Very recently, two new classes of drugs based on incretin action have been approved for lowering blood glucose levels in type 2 diabetes milliets. One is exenatide, long-acting agonist of the GLP-1 receptor and other is incretin enhancer known as sitagliptin, a DPP4 inhibitor. However, GLP-1 agonist reduces body weight (anti-obesity therapy) and leads to hypoglycemia. Similarly, liraglutide, DPP-IV-resistant GLP-1 receptor agonists is also synthesized using GLP-1 sequence with prolongs half-life. In conclusion, polysaccharides might be a way to decrease the hurdle in diabetes managements and special attention should be paid to naturally derived polysaccharides. MS is often associated with inflammation caused by latent infections or SIBO. We investigated whether treatments of such items may help to control MS.

Method: We prospectively studied 17 patients presenting with MS and three concomitant causes of inflammation [Helicobacter pylori (HP = 17 cases); oral papillomavirus virus (HPV = 9) or EBV (5); SIBO (H2 or CH4 breath tests: 17 cases)] who were all successfully treated for HP, HPV or EBV, and SIBO (decrease of H2 or CH4 > 50% and decrease of circulating TH17 cells >50% which are correlated with intestinal chronic inflammation). Patients were followed-up 6 months. Conclusion: Treatment of latent infection and SIBO benefits mainly to patients younger than 60, without methanogenic flora and with few circulating TH17 cells.

and increases the gastric emptying time, Intestinal transit time, gastric acid secretion in the MS bark juice treated group. There was significant (P < 0.001) decrease in the T max , T 1/2 and increase in the C max of MET in MS bark juice treated group as compare to diabetic group. Present study suggests that the bark juice of MS shows significant effects in the treatment of gastroparesis and it improves the pharmacokinetic of MET compared to Diabetic Group of rat. Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder. Its prevalence is expected to increase exponentially around the world. Insulin resistance, inflammation and dysregulation of adipokines play a major role in the pathogenesis of T2DM. Among the huge growing adipose secretome, nicotinamide phosphoribosyl transferase (Nampt) and vaspin emerged as novel interesting adipokines having insulinmimetic and -sensitizing effects, respectively. However, their role in T2DM is still controversial. Accordingly, this study was designed to investigate their levels in T2DM patients compared to healthy control subjects, and to study the correlation between these two novel adipokines and the correlation between each of them with anthropometric parameters, insulin resistance, hyperglycemia, dyslipidemia, and also the inflammatory marker interleukin-6 (IL-6). The levels of these two novel adipokines and other parameters were measured in non-obese and obese T2DM patients together with matched healthy non-diabetic control subjects. The Nampt, vaspin and IL-6 levels were measured by ELISA while insulin levels by chemiluminescence technique. The Nampt and vaspin levels were found to be significantly elevated in non-obese (25.9 AE 3.4 and 1.6 AE 0.2 ng/ml, respectively) and obese T2DM patients (45.4 AE 4.6 and 2.8 AE 0.4 ng/ml, respectively) compared to control subjects (9.4 AE 2.0 and 0.4 AE 0.05 ng/ml, respectively) at P < 0.01. Furthermore, Nampt as well as vaspin were found to be significantly correlated with one another and with various metabolic parameters.

In conclusion, Nampt and vaspin are potential candidates to play important role in the development and progression of T2DM. 2. to compare insulin resistance in sub-clinical and overt thyroid hypo-function.

Methods: One hundred eighteen patients with the diagnosis of hypothyroidism based on their clinical and thyroid function test profile were included in this cross sectional hospital based descriptive study with their informed consent. HOMA-IR as an index of insulin resistance was calculated for each subject from their fasting plasma glucose and serum insulin levels. Autoimmunity against thyroid was evaluated by estimating anti TPO antibodies.

Results: HOMA-IR as an index of insulin resistance was comparable in overt (5.8 AE 3.24) and subclinical hypothyroidism (6.27 AE 3.87) but was above the reference range for this population. Hypothyroid anti TPO positive cases has high TSH compared to negative cases in both overt hypothyroidism and subclinical hypothyroidism.

Conclusions: Hypothyroidism induces insulin resistance but the degree of insulin resistance is not dependent on severity of thyroid hypofunction however is associated with autoimmunity against thyroid. .86 AE 0.35 in smoker and 3.95 AE 0.16 in non-smoker, insulin: 4.44 AE 0.95 and 2.0 AE 0.1 (P < 0.05), control: glucose level was 4.37 AE 0.14 in and 4.55 AE 0.16 mmole/l, insulin level: 3.1 AE 0.64 and 3.7 AE 0.65 mkIU/ ml, respectively.

Both growth in height and weight gain are accelerated during puberty. They are mainly affected by sex hormone, growth hormone and IGF-1, and influenced by various factors either directly or indirectly. The aim of this study is to find out the association of various cytokines with obesity and early-or precocious puberty in female children.

Twenty-eight female children with breast budding before 9 years old, who underwent the LHRH stimulation test as well as cytokine analysis in their blood, were included in this study. The height, weight, and BMI were measured. We defined obesity when the BMI was 95 percentile or more, and puberty when the maximum LH level was 5 IU/l or more during LHRH stimulation test. Adiponectin, leptin, ghrelin, IL-1β, IL-6, IL-10, resistin, and TNFa levels in the blood were analyzed by Luminex multiple bead technology (Milliplex; Millipore Co., Billerica, MA, Bio-plex; Bio-Rad laboratories, Hercules, CA).

Nineteen out of 28 children were categorized as having early-or precocious puberty. Their mean IL-6 level was lower in pubertal children than that in prepubertal state (4.48 AE 4.77 vs. 19 .56 AE 20.26, P = 0.057). The leptin and resistin levels were significantly higher in obesity group (n = 6) than in non-obesity group, while the ghrelin was significantly lower in obesity group (P < 0.05).

In conclusion, the female children younger than 9 years of age in early-or precocious puberty did not show the increment of leptin or resistin comparing with the female prepubertal children, although the obesity group showed significantly higher levels of leptin and resistin. Aims: Arterial stiffness is independent risk factor of cardiovascular events. Suggest that the statins benefit associated with improvement in arterial stiffness parameters beyond lipidslowering effects. To evaluate changes in pulse-wave shape in obese high risk patients with AH and dyslipidemia treated with rosuvastatin compared with atorvastatin.

Methods: Eighty-two obese patients (age 61.5 AE 10 years) with AH, dyslipidemia were randomized to Atorvastatin group (n = 41) or Rosuvastatin (n = 41). ACEi and thiazide diuretics added blood pressure control. Pulse-wave characteristics measured before and after 5 weeks of treatment using finger photoplethysmographic device. Stiffness index (SI), reflection index (RI), augmentation index (AIx), systolic BP in aorta (SPa), digital pulse amplitude augmentation (PAA) were accessed.

Results: Before the treatment impared SI, elevated RI, AIx, Spa were shown. Lipids and BP goals were achieved in all patients validating further analysis. Decrease in SI (D SI, м/c À0.87 Atorva and À0.89 Rosuva), RI (DRI, % À7.89 Atorva and À7.21 Rosuva) were revealed in both treatment arms (P > 0.05), whereas significant trends towards AIx decrease were demonstrated only in Rosuvastatin-treated patients (DAI, % À1.88 Atorva and À1.92 Rosuva, P < 0.05) Rosuvastatin group demonstrated better increasing in PAA than Atorvastatin group (PAA (Atorva): before treatment 1.58 AE 0.42 and After 5 weeks: 1.82 AE 0.51, P = 0.06 vs. PAA (Rosuva): before 1.68 AE 0.22 and After 5 weeks 1.95 AE 0.23, P < 0.05).

Conclusions: Pulse-wave analysis in obese AH patients demonstrated increasing vascular stiffness. Both Atorvastatin and Rosuvastatin treatment resulted in arterial stiffness parameters, whereas only Rosuvastatin treatment was significantly associated with trends in AIx and PAA improvement in short-term follow-up.

Z. Wang 1 , M. Xu 2 1 Methods: Four thousand two hundred and twenty-six adults above 60 years of age and 3145 adults under 60 years from a cohort investigated in 2010-11 at the medical examination center of Zhongnan hospital were recuited. Cases of FLD was identified through ultrasound imaging. The risk factors measured were BMI, and plasma concentrations of ALT, AST, TC, TG, HDL, LDL and serum uric acid (SUA). The probability of steatohepatitis with advanced fibrosis was calculated according to the body mass index, age, ALT, and triglyceride (BAAT) and AST/ALT ratio (AAR).

Results: The prevalence of FLD was higher in elderly (26.7%) than in non-elderly (22.8%) and similar in elderly between men and women (26.6% vs. 27.0%, P > 0.05). Multiple regression analyses showed that obesity, high TC, TG, SUA, low HDL, and elevated ALT, AAR < 1 were closely related to the elderly FLD The prevalence of steatohepatitis estimated as BAAT index ! 3 was 2.4% in all subjects, and was higher elderly FLD patients than in the non-elderly FLD patients.

Conclusion: The prevalence of FLD is higher in the elderly, and is broadly related to the same metabolic risk factors as in the nonelderly. However, female-sex is no longer protective with increasing age, and the prevalence of steatohepatitis with advanced fibrosis is estimated to be considerably higher in the elderly FLD patients than in the non-elderly FLD controls.

Vanderbilt, Nashville, TN, USA Bariatric surgery improves glucose tolerance and may be a viable strategy to prevent the progression from obesity-induced insulin resistance to overt diabetes; however, the recurrence of diabetes is significant following the surgery. We sought to determine whether gastric bypass surgery protected pancreatic beta cells and prevented disease progression to overt diabetes. Gastric bypass (Roux-en-Y gastric bypass, RYGB) was performed in young (6 weeks old) prediabetic BLKS db/db null (BKS-db) mice, young (6 weeks old) New Zealand Obese (NZO) male mice that were fed high-fat diet (HFD) post-surgery, C57BL/6 db/db null (B6-db) mice that developed insulin resistance, and streptozotocin (STZ)-induced diabetic mice. RYGB resulted in sustained normoglycemia and improved glucose tolerance in pre-diabetic BKS-db mice and HFD-fed NZO mice. Remarkably, RYGB preserved beta-cell mass and increased plasma insulin with reduced beta-cell apoptosis which was independent of weight loss and body fat reduction. RYGB neither reversed hyperglycemia when performed in diabetic BKS-db and NZO mice nor resulted in resolution of diabetes in STZ-induced diabetic mice. The results demonstrate that gastric bypass prevents beta-cell failure if performed prior to onset of severe beta-cell damage in genetic obese mice.

L. Ruzic 1 , G. Sporis 2 , M. Prasek 3 1 Sport and Exercise Medicine, 2 Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, 3 Vuk Vrhovac University Clinic, Zagreb, Croatia

The aim of the study was to examine the influence of strength training program on pre-and post workout glycemia. Twelve able-bodied diabetic patients using insulin pump (mean age 31.4 AE 4.44, 3M/9F) were enrolled into gym programs 39/week (15 min warm-up aerobic workout, intensity at 70% HRmax plus 8 strength training exercises involving different muscle groups) for 3 months. No other interventions were introduced.

We were interested in effects of the programe on pre-and post workout glycemia, so the comparisons between the first 2 weeks and the last 2 weeks of the study were performed. Also the subjects were asked about hypoglycemic episodes. There was a great variability observed in pre-and post glucose concentration within and between subjects. The mean pre-workout glucose concentration in the first 2 weeks of the program was 7.98 AE 3.91 vs. 7.57 AE 3.08 mmol/l in last 2 weeks of the program and the difference was not significant (P = 0.523). Nevertheless, the mean glucose decrease after workout was higher in the last 2 weeks of the program (deltaGLU: 2.52 AE 0.73 vs. 3.62 AE 1.38 mmol/l; P < 0.05). No hypoglycemic episodes were reported.

The 3 months strength training program did not influence large variability in glucose levels before the workout as it depends on many other factors. The only observed effect were larger pre-to post workout glucose differences. It seems that over the time, the strength training may stimulate the body to use more glucose during the workout, which might be explainable with the expected increase of lean body mass. Aim: The aim of this study was to evaluate the level of C-reactive protein in gestational diabetes mellitus.

Materials and methods: Sixty-five healthy pregnant women aged 29.75 AE 5.59 years between the 20th and 25th weeks of gestation were studied. All women referred for a 75-g oral glucose tolerance test following an abnormal result on a screening. The demographic data, waist circumference, height, and weight of the participants were recorded. Fasting levels of insulin, triglycerides (TG), C-reactive protein (CRP), fasting blood glucose (FBG) and HbA1c were measured.

Results: Based on oral glucose tolerance testing participants were divided into two groups: normal glucose tolerance (NGT; n = 17) and gestational diabetes mellitus (GDM; n = 48). The mean CRP level was highest in GDM group (9.67 AE 5.57 mg/l), followed by NGT (2.56 AE 1.73 mg/l), (P < 0.0001). The mean FBG (4.98 AE 0.51 vs. 4.48 AE 0.58 mmol/l, P < 0.05), HOMA-IR (3.14 AE 1.63 vs. 1.83 AE 0.62, P < 0.05) and TG levels (1.95 AE 0.65 vs. 1.35 AE 0.58 mmol/l, P < 0.05) in the women with GDM were significantly higher than those in the NGT group.

Methods: In 2010, an observational, prospective study started in France on request of the Health Authorities (HAS). One thousand seven hundred and two type 2 diabetic patients treated by vildagliptin were recruited through a national representative sample of GPs and diabetologists. We report the data of interim analyses after 18 months of follow-up.

Results: One thousand four hundred and sixty-three patients are included in this interim analysis: 60% males, aged 63 AE 11 years, with mean BMI of 30 kg/m 2 . HbA1C was equal to 7.8 AE 1.2% at vildagliptin initiation, then 7.1 AE 1.0%, 7.0 AE 1.1% and 7.0 AE 0.9%, while mean weight decreased from 86 to 86, 85 and 84 kg at 6, 12 and 18 months respectively.

Vildagliptin, rarely prescribed when not recommended, was well tolerated: ASAT and/or ALAT were >120UI in 0.5% at initiation of vildagliptin then 0.2% at 18 months, with a slight decrease for mean ASAT and ALAT. Mean GFR was 82 ml/mn at initiation of vildagliptin then 83 ml/mn at 18 months, with a stable percentage of GFR < 60 ml/mn (14%) and <30 ml/mn (0.3%). Six severe hypoglycemic episodes occurred in six patients (incidence = 0.30/100 patient-years), all treated by insulin and/or sulfonylurea in addition to vildagliptin. The proportion of patients still treated by vildagliptin at 18 months was 89.3%.

Conclusions: Over 18 months, in real-life conditions of care, vildagliptin showed a sustained effectiveness in terms of HbA1c reduction, a good tolerance, very few severe hypoglycemic episodes, rare treatment discontinuations and was most often prescribed as recommended. Background: HDL lipoproteins are known to play a causative role in atherosclerosis and its clinical manifestation-coronary artery disease (CAD). Carotid intima media thickness (IMT) is considered as a marker of atherosclerosis and in prediction clinical coronary events.

Aim: To determine the associations between plasma lipids and subclinical atherosclerosis measured by the common carotid intimamedia thickness (IMT) in CAD patients.

Methods: HDL subclasses were separated with 3-31% PAG Electrophoresis, and IMT was determined using high-resolution B-mode ultrasound in 92 CAD patients, with normal levels of traditional lipid risk factors.

Results: Mean value of left and right carotid artery measurement was selected as value for correlation with HDL subclass size in each patient. The mean HDL size was 9.34 AE 0.74 nm, and the mean IMT in all patients was 0.89 AE 0.13 mm (0.6-1.2 mm). HDL size was not correlated with IMT (r = À0.03; P > 0.05). By univariate analyses, carotid IMT was the most closely related to systolic pressure (r = 0.510, P < 0.001), followed by diastolic pressure (r = 0.480, P < 0.001) and age (r = 0.25, P < 0.05). Stepwise multiple linear regression analysis revealed that diastolic pressure (β = 0.322, P < 0.016), systolic pressure (β = 0.237, P < 0.067) and age (β = 0.192, P < 0.037) were independent predictors of determining carotid IMT (adjusted R 2 < 0.290, P < 0.001).

Conclusion: These results indicate that diastolic pressure, systolic pressure and age are an important, independent determinants of carotid IMT in CAD patients. No other traditional risk factors imparted IMT. Objective: Antinuclear antibodies (ANA) are present in approximately 20-40% of patients with non-alcoholic steatohepatitis (NASH). A recent study implied the relationship between obesity and autoimmunity. The purpose of this study was to investigate the relationship between seropositivity for ANA and metabolic abnormalities including insulin resistance, obesity and hepatic steatosis in patients with NASH.

Methods: The severity of hepatic steatosis and fibrosis was scored by the NAFLD activity score system. Seropositivity for ANA was defined as titers of 1:40 or higher by an indirect immunofluorescence method using HEp-2 cells. Insulin resistance and obesity were evaluated by the value of HOMA-IR and BMI, respectively. The diagnosis of autoimmune hepatitis (AIH) was based on the simplified scoring system.

Results: Nine (45%) of 20 patients with NASH had ANA. Overall BMI in NASH patients with ANA was higher than that in those without ANA. Laboratory analyses revealed significantly higher mean IgG level (1904 AE 440 vs. 1358 AE 236 mg/dl, P = 0.0056) and the mean value of HOMA-IR (7.43 AE 3.33 vs. 4.15 AE 2.79, P = 0.0348) in NASH patients with ANA than those in those without ANA. Histological examinations exhibited that NASH patients with ANA had higher scores in hepatic steatosis (2.44 AE 0.73, vs. 1.91 AE 0.83, P = 0.1448) and fibrosis (2.33 AE 1.00 vs. 1.64 AE 1.12, P = 0.1535) than those without ANA. However, none of NASH patients fulfilled the criteria for "definite" AIH.

Conclusion: NASH patients with ANA had clinical characteristics of significantly higher serum IgG levels and severe insulin resistance, and they tended to have more severe obesity, hepatic steatosis and fibrosis than NASH patients without ANA.

R.F. Alponti 1,2 , P.F. Silveira 1 1 Pharmacology, Instituto Butantan, 2 Physiology, Instituto de Biociencias/Universidade de Sao Paulo, Sao Paulo, Brazil Introduction: Although IRAP (EC3.4.11.3) is well-known, the existence of other aminopeptidases (APs) related to energy homeostasis remains unclear.

Objectives: To search a diverse array of APs in high (HDM) and low (LDM) density microsomes and in plasma membrane (MF) of retroperitoneal adipocytes from healthy control (C), monosodium glutamate (MSG) obese and food deprived (FD) rats with their in vitro responses to insulin (IS), vasopressin (AVP), angiotensin (ANG)-II and ANG-IV.

Methods: Ultracentrifugation and spectrofluorometry.

Results: Dipeptidyl-peptidase-IV (DPPIV) and APs basic (APB), neutral puromycin-sensitive (PSA) and -insensitive (APM), and methionyl (MetAP) were found. Compared with non-stimulated, these APs were unaffected by IS; AVP increased APB/APM (LDM) and DPPIV/PSA (HDM) of MSG-FD and MetAP/PSA (HDM) of C; ANG-II increased APM (FM-LDM) of C, DPPIV (FM) of MSG and PSA (FM) of FD; ANG-IV increased APB (FM) of FD, APM (HDM) of MSG and DPPIV (FM) of C and MSG. APs were modulated by AVP in HDM-LDM, by ANG-II in FM-LDM and by ANG-IV in FM-HDM. Compared with LDM, MetAP decreased in FM of C and increased in FM of MSG-FD without peptide stimuli; and only diabetes-related enzyme DPPIV exhibited peptide-mediated intracellular translocation, which was from LDM to HDM (stimulated by AVP) in MSG-FD, and from LDM and HDM to FM in MSG and MSG-FD (stimulated by ANG-II) and in C and MSG (stimulated by ANG-IV).

Conclusion: Novel peptide-modulated APB, APM, PSA, MetAP and DPPIV are found in adipocyte, this last with altered subcellular trafficking under metabolic distress.

Supported by Fapesp, CNPq and Capes.

Nutritional and Environmental Sciences, University of Shizuoka, Shizuoka City, Japan

Previous studies have suggested that (-)-epigallocatechin-3-gallate (EGCG) exerts antioxidative and anti-inflammatory actions in various tissues, which might be beneficial for reducing risks of development of diabetes. However, an optimum intake level of EGCG is unknown. In this study, we have examined the effect of a diet containing EGCG on the expression of inflammation-related genes in various tissues including visceral adipose tissue and the muscle of non-obese type-2 diabetes animal model, Goto-Kakizaki (GK) rats. GK rats at 9 weeks of age were fed a control high-fat diet (45 energy% as fat) or the high-fat diet containing 0.1%, 0.2% or 0.5% EGCG for 25 weeks. The mRNA and protein levels of IL-1β, IL-18, MCP-1, CD11s, IL-6, TNF-a, resistin and PAI-1 were significantly reduced in the adipose tissue of rats fed a diet containing 0.1% EGCG, but not in those fed diets containing 0.2% or more EGCG, as compared with control. The mRNA levels of TNF-a, IFN-g, IL-1b, IL-6 and IL-18 in the Muscle of rats fed a diet containing 0.1% EGCG were also significantly lower than those in the control. These results suggest that there is an optimum range of intake of EGCG, which may suppress the expression of genes involved in inflammation in the adipose tissue and the muscle. Diabetes and hypertension are the most relevant factors leading to vascular disease and cardiovascular problems. Since both pathologies are greatly increasing nowadays, there is a need to detect at early stages the occurrence of target organ damage associated with them. This is the relevance of identifying biomarkers that can detect or predict the onset of cardiovascular and renal damage associated with diabetes and hypertension. Given that the role of osteoprotegerin in bone metabolism is well known, and some evidence of its putative relationship with diabetes-associated pathologies has been found, to this date there is no evidence linking this molecule with target organ damage associated with diabetes.

In this study, we analyze whether osteoprotegerin may be used to detect and evaluate cardiovascular and renal pathologies associated with diabetes in an in vivo model. We used normotensive and hypertensive rats, a subset of rats of each group receiving a single streptozotocin injection in order to induce diabetes. We performed an 8-month followup, periodically collecting blood and urine samples and monitoring both blood pressure and blood flow in the lower limbs.

Our results showed that osteoprotegerin was associated with the presence of diabetes, suggesting that it might be used as a biomarker for the occurrence of cardiovascular damage or to detect cardiovascular risk under these circumstances. Blood flow in the lower limbs decreased soon after diabetes onset, as osteoprotegerin levels increased.

Our data suggest the potential use of serum levels of osteoprotegerin as a biomarker for diabetes and hypertension-associated endothelial dysfunction. Purpose: This study examined whether breakfast meal composition alters the incretin response and glycemic control following both the breakfast and lunch meal.

Methods: Seven subjects with T2D completed two conditions where they consumed either a 500 kcal high protein (PRO: 40% carbohydrate, 40% protein, 20% fat) or high carbohydrate (CHO: 65% CHO, 15% protein, 20% fat) breakfast for 6 days of acclimatization. On day 7, they underwent meal testing in which they consumed the respective breakfast followed by a lunch meal (500 kcal: 65% CHO, 15% PRO, 20% fat). Blood samples were collected over the 8-h period and analyzed for glucagon, insulin, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) concentrations. Incremental area under the curve (iAUC) for the 4-h post-breakfast and 4-h post-lunch period was calculated.

Results: The iAUC for insulin, glucose and GLP-1 were not significantly different between conditions or between meals. The GIP response to the PRO breakfast (5485 AE 1369 pg/ml*min for 4-h) was lower (P = 0.049) compared to the CHO breakfast (7756 AE 759 pg/ ml*min for 4-h), with the opposite effect occurring in response to the lunch meal (PRO: lunch 9226 AE 2726; CHO: lunch 8174 AE 1105 pg/ ml*min for 4-h, P < 0.049).

Conclusion: Despite no differences in glucose and insulin levels, a PRO breakfast, compared to a CHO breakfast, resulted in lower GIP levels for the initial meal with a greater second meal effect after a lunch meal. However, a PRO breakfast potentiates GIP levels after a lunch meal. Further research is needed to determine the physiological role of changes in circulating GIP.

High Risk Pregnancy, Kasralainy University, Cairo, Egypt Background: Pregnancy tends to reset the glucose homeostasis in the direction of diabetes. About 1-2% of all pregnant women develop an abnormal glucose tolerance in pregnancy, but most often glucose tolerance returns to normal postpartum. This condition is called gestational diabetes mellitus (GDM).

Aims: Comparative study between gestational and pregestational diabetes in relation to glycemic control as regarding fetal and neonatal outcome.

Methods: This study was conducted in Kasralainy Maternity hospital from September 2011 to March 2012 and it included 60 pregnant women complicated by DM attending outpatient clinic or inpatient.

Patients were classified into two groups, Gestational Diabetes: 30 pregnant women complicated by DM which is diagnosed for the first time during pregnancy and Pregestational Diabetes: 30 pregnant women who have DM that has been diagnosed prior to pregnancy.

The two groups were compared according to fetal (macrosomia and intrauterine fetal death) and neonatal (respiratory distress syndrome and birth injuries) complications.

All patients were 18-40 years old, singltone pregnancy, with time of termination after completed 37 weeks.

Results: Fetal macrosomia occurred more with GDM, on the otherhand birth injuries and RDS occurred more with Pre-GDM. Macrosomia and RDS were commoner among poor glycemic control in pregnant diabetic females than birth injuries and IUFD.

Conclusions: Glycemic control started as early as possible (the best being preconceptional) is important to decrease the incidence of birth injuries, macrosomia, fetal mortality, the need for NICU admission (RDS). Adiponectin, an adipocyte-derived hormone, is implicated in type 2 diabetes and atherosclerosis. This study was designed to investigate whether serum adiponectin levels in coronary artery disease (CAD) patients with type 2 diabetes (T2DM) are lower than in patients with CAD alone and healthy controls.

We measured serum adiponctin levels in 198 subjects, 138 patients with CAD (72 subjects of whom had both CAD and T2DM), and also 60 healthy subjects were selected as controls. All patients were subjected to anthropometric indexes assessment and biochemical measurement of serum adiponectin, interleukin six (IL-6), insulin, lipid profile and glucose by standard methods.

The results revealed significant differences in serum adiponectin levels between CAD patients with T2DM and CAD patients without T2DM (3.80 AE 1.52 vs. 5.25 AE 2.35 lg/ml, P = 0.001), between patients with CAD and healthy controls (4.50 AE 2.54 vs. 7.04 AE 3.32 lg/ml, P = 0.000), and between men and women (4.62 AE 2.81 vs. 5.97 AE 3.15, P = 0.002). Serum adiponectin levels were correlated significantly with insulin, total cholesterol, low density lipoprotein, body mass index, glucose, HOMA-IR, IL-6 (r = À0.178, P = 0.013, r = À0.313, P = 0.000; r = À0.154, P = 0.016; r = À0.171, P = 0.016; r = À0.202, P = 0.006; r = À0.251, P = 0.001; r = À0.217, P = 0.042, respectively). Adiponectin was correlated positively only with high density lipoprotein (r = 0.422, P = 0.000).

Conclusions: We conclude that low serum adiponectin levels and insulin resistance coexist in CAD patients with T2DM. It is speculated that subjects who have very low levels of serum adiponectin may be at increased risk of developing both T2DM and CAD. Objective: To simultaneously examine the impact of self-reported and newly-identified hypertension upon subsequent type 2 diabetes (T2D).

Methods: Two community-based adult prospective cohort studies, with the same protocols, instruments and questionnaires, were conducted during 2004-2007 and 2007-2010 in urban areas of Nanjing, China. Data from these two cohorts were pooled and analyzed. T2D (outcome variable) was identified using the 1999 World Health Organization diagnosis criteria. Based on status of blood pressure (independent variable), participants were categorized into three groups: (i) people with normal blood pressure at baseline survey and during follow-up period (normal blood pressure), (ii) subjects with self-reported hypertension at baseline survey (self-reported hypertension) and (iii) those who did not report hypertension at baseline but were diagnosed having hypertension during follow-up period (newly-identified hypertension). All covariates were assessed at baseline and in the third-year follow-up survey.

Results: Among 4550 participants, the 3-year cumulative incidence of T2D was 14.1%, 6.5% and 3.2% for participants with newly-identified hypertension, self-reported hypertension and normal blood pressure, respectively. After adjustment for potential confounders, compared to people with normal blood pressure, participants with newly-identified (OR = 4.25; 95%CI = 3.04, 5.93) or self-reported (OR = 1.76; 95% CI = 1.25, 2.48) hypertension were more likely to develop T2D. Furthermore, subjects with newly-identified hypertension (OR = 2.53; 95% CI = 1.71, 3.73) were at elevated risk of developing T2D relative to their counterparts with self-reported hypertension. The similar associations of hypertension with T2D were also found in both men and women, separately.

Hypertension, either self-reported or newly-identified, is an independent risk factor for developing T2D among urban Chinese adults. Methods: A total of 60 patients with type 2 diabetes receiving standard glucose-lowering therapy were enrolled. Efficacy of the lowcalorie diet (1500 kcal/day) with inclusion of specialized Nutrison Advanced Diason product was assessed in two similar groups in during 2 weeks: main group patients (n = 30) received diet with Nutrison Advanced Diason in the amount of 1000 ml as the only food for the day twice a week for 2 weeks; control group patients (n = 30) received a low-calorie diet with the inclusion of a standard meal at 1000 calories twice a week.

Results: The average weight loss in the main group was 800 AE 70 g, in the control group -500 AE 40 g per day. According bioimpedance complex therapy with specialized product increased the content of lean mass by an average of 1.1 AE 0.4 kg and decreased fat mass by an average of 4.4 AE 0.3 kg. In main droup was a reduction of the basal level of glucose to 8.0 AE 0.7-6.0 AE 1.0 mmol/l (P = 0.01), in control groupfrom 8.0 AE 0.8 to 6.9 AE 0.9 mmol l (P = 0.01). Total cholesterol level in the main group decreased from 6.8 AE 1.0 to 5.9 AE 0.7 mmol/l (P = 0.01), in the control groupfrom 6.8 AE 0.8 to 6.3 AE 0.7 mmol/l.

The inclusion of the specialized product Nutrison Advanced Diason in the standard low-calorie diet allows to raise the efficacy of dietary therapy in patients with type 2 diabetes. Liver injury and regeneration involve complicated processes and are affected by various physio-pathological factors. This study was designed to investigate the mechanisms of steatosis-associated liver injury and impaired regeneration in a mouse partial hepatectomy model.

Male C57BL/6J and db/db mice were used as mice with normal and steatotic liver, respectively. Liver regeneration and injury were evaluated chronologically after hepatectomy.

Initial regeneration of the steatotic liver was markedly impaired after hepatectomy. Although hepatocyte proliferation was not significantly suppressed, intense liver injury with oxidative stress occurred immediately.

FasL/Fas expression was up-regulated in the steatotic liver, whereas the expression of anti-oxidative and anti-apoptotic molecules (catalase/Mn-SOD/Ref-1 and Bcl-2/Bcl-xL/FLIP, respectively) and p62/SQSTM1, a steatosis-associated protein, were down-regulated. Interestingly pro-survival Akt was not activated/phosphorylated in response to hepatectomy though it was sufficiently expressed/ phosphorylated even before hepatectomy.

Suppression of p62/SQSTM1 increased FasL/Fas-expression and reduced Nrf-2-dependent ARE activity and anti-oxidative responses in steatotic and non-steatotic hepatocytes. Exogenously added FasL induced intense cellular oxidative stress and necrosis/apoptosis in steatotic hepatocytes, only the necrosis being inhibited by pretreatment with anti-oxidants, suggesting that FasL/Fas-induced oxidative stress mainly leads to necrosis. Furthermore, p62/SQSTM1 re-expression in the steatotic liver markedly reduced liver injury and improved tissue regeneration.

In the steatotic liver, reduced expression of p62/SQSTM1 induced FasL/Fas expression and suppressed anti-oxidant genes through Nrf-2 inactivation, which together with hypo-responsiveness of Akt, caused post-hepatectomy necrotic and apoptotic liver injury in redoxdependent and -independent manners, respectively. p62/SQSTM1 may be a key molecule in post-hepatectomy acute liver injury and impaired regeneration in fatty liver in mice. Objective: Mastication can accelerate satiety sensation and lipolysis through activation of histamine neurons; however, the data on antiobesity effects of mastication are limited. We therefore examined the effect of chewing on postprandial satiety and energy metabolism in humans.

Methods: Satiety, energy expenditure, and fat oxidation were measured in 10 lean young women on separate occasions, before and 3 h after consumption of a solid meal with 30 chewing per bite or after swallowing the same mashed meal without chewing, in a randomized, crossover design. Each test meal consisting of 2510 kJ (60% of energy as carbohydrate, 25% of energy as protein, and 15% of energy as fat) was consumed between 20 and 25 min regardless of texture difference.

The thermic effect was greater after the solid meal (5.4 AE 0.6%) than after the mashed meal (2.7 AE 0.6%, P < 0.001). Time course of fat oxidation tended to be higher after the solid meal than after the mashed meal (P = 0.09). In addition, solid meal was more satiating than mashed meal (P = 0.005).

The results suggest that mastication contributes to postprandial satiety and thermic effect of meal. Chewing meal thoroughly could be a useful eating behavior for preventing weight gain. 

Introduction: Raven noted an association between insulin resistance and cardiovascular consequences and type 2 DM. Mathew prescribed the method of insulin resistance designation using mathematic model HOMA-IR.

Aim: To estimate insulin resistance HOMA-IR in adult population according to gender, assess selected parameters in people with HOMA-IR ! 2.5 (I group) and HOMA-IR < 2.5 (II group) and determine dependence between HOMA-IR and the above parameters.

Materials and methods: One hundred and fifty-four people medium age 52.5 years, from Tarnawa City constituted the material. BP was examined. Blood samples were obtained for plasma glycaemia, lipidogram and serum insulinaemia. All people were measured and weighed, BMI and HOMA IR were calculated, waist circumference was obtained. The cut-off point 2.5 for HOMA-IR was accepted.

Results: 24.7% of the examined population had insulin resistance without a difference between women and men. Significant differences between I and II group were observed according to TG and waist circumference. In women all examined parameters were significantly different except HDL. In men BMI, waist circumference and HDL were significantly different In I and II group. In the female group correlations between HOMA IR concerned all examined parameters, in the male group-HDL and waist circumference.

Conclusions: There was no significant difference between women and men according to insulin resistance in the whole study group. The difference between selected parameters in the two examinated groups were more strongly in women. Body mass was the main factor determining insulin resistance in the whole study group as well as in men and women. Background: The immune system is altered in obesity and diabetes, through changes in adipocytes, liver, pancreatic islets, vasculature and circulating leukocytes, with increased cytokine and leukocytes activation, suggesting inflammation participation in diabetes. Minocycline presents a potent anti-inflammatory activity, as evaluated in vivo and in vitro.

Objectives: Minocycline anti-diabetic effects were assessed in alloxaninduced diabetes through biochemical parameters measurements, histological and immunohistochemistry analyses.

Methods: Alloxan was injected to rats, blood collected 48 h later and after oral treatments (5, 10 and 30 days) for glycemia, triglycerides, cholesterol and transaminases measurements. Diabetic controls and diabetic plus minocycline (25 and 50 mg/kg) or glibenclamide (5 mg/ kg) were used. Furthermore, pancreas, liver and kidney were submitted to histological and immunohistochemistry (COX-2 and TNF-a) analyses.

Results: Decreases in glycemic and triglyceride levels, at the 5th and mainly 30th days after minocycline treatments, were observed. HE staining showed that minocycline partly reversed tissue alterations, and decreased expressions of COX-2 and TNF-a, as compared to untreated animals.

Conclusions: Beneficial minocycline effects in diabetes could be due to its anti-inflammatory and antioxidant properties and, by inhibiting microglial activation, it may be an important therapeutic strategy in diabetes where inflammation plays a significant role. Methodology: Forty-eight hours after alloxan-induced diabetes, blood from male Wistar rats was collected for biochemical measurements. Then, diabetic rats untreated or treated (1 week, 1 or 3 months) with pentoxifylline (5, 25, 50 and 100 mg/kg, p.o.) or glibenclamide (2 or 5 mg/kg, p.o., alone or associated to pentoxifylline) were divided into eight groups with 10-20 animals each. After treatments, biochemical measurements were repeated. Glycated hemoglobin determinations, and histological and immunohistochemistry analyses for iNOS were also performed.

Results: Pentoxifylline brought hyperglycemia and triglycerides towards normality. Glycated hemoglobin was improved. The use of diazoxide showed the mechanism of action of pentoxifylline partly related to ATP-dependent K + channels. Pentoxifylline improved histological alterations in pancreas, liver and kidney, and decreased iNOS cell expression.

Conclusions: Pentoxifylline effects are probably related to its action on oxidative stress and inflammation, decreasing pro-inflammatory cytokines. Thus, pentoxifylline is a potential candidate for diabetes mellitus therapy, since patients with vascular complications present beneficial effects, as shown in clinical practice. Recently, a close relationship between the development of adiposity and gut-derived hormonal dysregulation has been clearly established. For instance, studies of gut-derived peptides such as PYY 3-36 , GLP-1, oxyntomodulin, discovered more than 20 years ago and, later on ghrelin have significantly improved our understanding of mechanisms underlying ectopic lipid infiltration in organs and tissues. The etiology of non-alcoholic fatty liver disease (NAFLD) is intimately related to the capacity of hepatocytes to acquire an "adipocyte-like" phenotype. We previously reported that unacylated ghrelin (UAG) is more potent than acylated ghrelin (AG) to stimulate adipogenesis. The present study intends to investigate the relevance of UAG and AG as mediators of lipid accumulation in hepatocytes. HepG2 hepatocytes were treated with a control, UAG or AG (1 nmol/l and 1 pmol/l) in the presence or absence of oleate (50 nmol/l) to measure lipid droplet (LD) number and size. Gene expression analyses were performed for key mediators of pre-adipocyte differentiation or liver functions. In response to UAG or AG treatment in the presence or absence of oleate, LD number was markedly increased in HepG2 cells. Similarly, increased LD size was noted following the treatment of HepG2 cells with UAG or AG. However this effect could not be detected in the presence of oleate. Gene expression of PPAR-c and C/EBP-a was increased while that of PPAR-a was decreased in response to AG treatment. These results are first to describe mechanisms through which UAG and AG could promote the development of lipid infiltration in liver.

Deakin University, Melbourne, Vic., Australia

The World Health Organization believes that type 2 diabetes mellitus is an important public health problem in the world. However some statistics showed that only 2.8% of all world population had diabetes in 2000, but the health professionals argue, this amount will reach to 4% in 2014. Diabetes Australia -NSW estimates that almost 1 million Australians have diabetes and also around 2.1 million Australian populations are at risk of this disease and unfortunately, the number of Australian with diabetes will be approximately 4.5 millions in 2014.

Obviously, direct and indirect medical costs due to health care of diabetic's patients are very high and 2% of the Australian Government's health budget is spent on health care of type 2 diabetes. Therefore, the health professionals have tried to provide the optimal public health programs for control and management of type 2 diabetes. Many researchers and health professionals argue that control of weight by change diet habits and exercise are major keys in lifestyle programs for prevention of type 2 diabetes. In this case, the results of several studies like the Finnish study, American Study, the Swedish malmo study and Chinese study showed that the focus on diet and exercise programs are significant approaches in type 2 diabetes prevention, While some other studies claim that the change diet habits and exercise may not sufficient and some medicines for control of insulin sensitivity and energy expenditure may also be necessary. Therefore, lifestyle intervention programs and pharmacologic intervention programs are the major prevention programs. Objectives: Metabolic responses to acute endurance exercise may be affected by time of day because the nervous and endocrine systems have circadian rhythms clearly. The purpose of this study was to investigate the influence of acute endurance exercise in the morning and evening on metabolic responses in young men.

Methods: Ten healthy young men completed two trials in a randomized cross-over design:

1. morning (09:00-10:00) and 2. evening (17:00-18:00) trials.

In the morning and evening trials, participants walked for 60 min at 60% of maximal oxygen uptake on a treadmill. Pulmonary gas exchange was determined breath-by-breath by a gas analyzer. Blood samples were collected to determine hormones and metabolites at preexercise, immediately and 2 h after exercise.

Results: Plasma interleukin-6 and adrenaline concentrations were significantly higher immediately after exercise in the evening trial than in the morning trial (P < 0.01 and P < 0.05, respectively). Serum growth hormone concentrations were significantly higher immediately after exercise in the evening trial than in the morning trial (P < 0.01). Serum free fatty acids concentrations were significantly higher in the evening trial than in the morning trial at 2 h after exercise (P < 0.01). However, there was no significant difference in fat oxidation between the morning and evening trials.

Conclusion: These findings suggest that acute endurance exercise in the evening is more effective on lipolysis compared to that in the morning in young men.

Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil Background: The rs9939609 SNP of FTO (T>A) has been associated with obesity and its comorbidities. In A allele carriers, physical activity (PA) minimizes the deleterious impact on body weight, which could reduce cardiovascular risk.

Objectives: To investigate whether PA level and television viewing modulate the effects of A allele of FTO on adiposity and markers of inflammation in individuals at high cardiometabolic risk.

Methods: This cross-sectional study included 158 prediabetic individuals (103 women, 54.7 AE 12.5 years, BMI 30.5 AE 5.6 kg/m²). Physical activities were measured by the long-version of IPAQ; individuals were genotyped and stratified according to total PA (<150 or ! 150 min/week) and television watching (<15 or ! 15 h/week). Anthropometric, biochemical and inflammatory data were obtained. Subgroups of individuals with or without A allele were compared by student's t test.

Results: Among individuals who watched TV < 15 h/week, those carrying the A allele had significantly higher concentrations of total and LDL-cholesterol, apolipoprotein B (88.3 AE 27.0 vs. 96.8 AE 21.1 mg/dl) and interleukin-6 (2.37 AE 2.06 vs. 3.54 AE 3.07 pg/ ml), but did not differ regarding anthropometric measures. Among those who watched TV ! 15 h/week, no difference in any clinical data was detected comparing carriers and non-carriers of A allele.

Regarding PA, the presence of the variant allele did not influence the metabolic profile.

The presence of the variant allele at FTO gene seems to favor a deleterious metabolic and inflammatory profiles particularly for individuals less exposed to sedentary activities such as watching TV. For inactive individuals, the allele presence might not affect predisposition to adiposity-induced disturbances. Cardiovascular disease is the leading cause of death in Brazil and in the world and its development is directly related to lifestyles and habits acquired in childhood. The objective of this study was to evaluate the anthropometric data and blood pressure levels of schoolchildren to verify that the body mass index and waist circumference maintain a relationship with blood pressure. The descriptive study was conducted with 1074 schoolchildren of both sexes in schools of Cruzeiro do Oeste, a small town in southern of Brazil. The evaluations consisted of: measurement of weight (W) and height (E) to calculate the body mass index (BMI), waist circumference (WC) and blood pressure (BP). Associations between variables were determined using the chi-square test. We observed a high percentage of overweight, WC modified and high pressure measurements. Both BMI and WC showed significant association with the high pressure measurements. There is an association between increased blood pressure and increasing age. Increases in BMI and central adiposity are associated with higher risks of high pressure measurements, and consequently other chronic diseases in 6-10 years old children. This study, descriptive and cross-sectional, had as objective to evaluate the relationships between anthropometric measures and lifestyle habits with the lipid profile of Brazilian schoolchildren (n = 135). The variables obtained were: weight and height to calculate body mass index (BMI), waist circumference (WC), blood pressure (BP), physical activity and dietary habits, serum lipid profile and glycemia. The results were analyzed by the Mann-Whitney test, the chi-square test and a relative measure of effects odds ratio. The significance was set at 5% (P < 0.05). Anthropometric variables showed 19.3% of schoolchildren are overweight, 59.3% showed elevated levels of total cholesterol. There was no significant association between nutritional status and lipid profile. This evidence suggests that an appropriate BMI is not indicative of the absence of changes in lipid profile components. The risk factors associated with the development of cardiovascular disease among the children evaluated were: absence of mean meals, lack of daily physical activity, physical activity <4 times a week, and the consumption of salty snacks more than four times a week. The physical activity was negatively associated with dyslipidemia, suggesting that physical activity may Underlying mechanisms by which zinc and magnesium influence glucose metabolism involved oxidative stress and inflammation. This crosssectional study investigated whether intakes of zinc and magnesium are useful to indicate oxidative stress, inflammation and insulin resistance in individuals at cardiometabolic risk. Two hundred and five individuals (55.2 AE 12.6 years) with pre-diabetes were evaluated regarding dietary (24-h food recalls) and clinical variables and compared according to zinc and Magnesium intake tertiles by ANOVA. Multiple linear regression analysis was employed including adjustments for age, gender and BMI (model 1), and saturated fat acid intake, smoking status and physical activity (model 2). Stratified according to tertiles of magnesium intake, no significant differences in anthropometric, plasma glucose, lipid variables, superoxide dismutase (SOD), oxidized LDL, inflammatory markers and HOMA-IR were found. Mean values of fat mass (35.9 AE 8.7 9 34.6 AE 9.0 9 31.8 AE 9.4%) and HOMA-IR (2.3 AE 1.8 9 2.1 AE 2.0 9 1.6 AE 1.8) were significantly lower in the highest tertile of zinc intake; significant trends to decrease fat mass, HOMA-IR and C-reactive protein were also observed (P-trend < 0.05). In linear regression models, intakes of both micronutrients were inversely associated with HOMA-IR but not with inflammatory markers. Direct associations were found between magnesium intake and SOD concentrations in adjusted models. Our findings suggest that assessment of zinc and magnesium intakes may indicate oxidative stress, inflammatory status and insulin resistance in at risk individuals. Our design does not allow establishing cause-effect relationship. Longitudinal studies are needed to clarify if increased consumption of these micronutrients would ameliorate these pathophysiological processes.

A. Cezaretto, B. Almeida-Pititto, C.R. Barros, A. Siqueira-Catania, S.R.G. Ferreira Nutrition, School of Public Health/University of Sao Paulo, Sao Paulo, Brazil Introduction: Lifestyle changes remain a major challenge for reducing cardiometabolic risk. Psychological disorders coexist with risk factors such as unhealthy life habits, decreasing quality of life (QoL) and favoring dropouts during interventions.

Objectives: To compare clinical and psychological characteristics of individuals who dropped or not from 2 lifestyle interventions, traditional or interdisciplinary.

Methods: One hundred and eighty-three prediabetic individuals (54.7 AE 12.3 years; BMI 30.8 AE 5.8 kg/m²) were allocated to 18month interventions on diet, physical activity and stress management. Traditional intervention was based on quarterly medical visits, while participants of interdisciplinary intervention also had psychoeducative group sessions. Depressive symptoms were assessed by the Beck Depression Inventory (score ! 12) and QoL by the SF-36. Independent t-test was used to compare dropouts and non-dropouts.

Results: Body adiposity, blood pressure, fasting glycemia, lipids, depression and QoL improved in both interventions, but, in general, improvements were greater in the interdisciplinary intervention. Comparing baseline data of dropouts and non-dropouts at the 18th month, dropouts of traditional intervention had higher BMI (32.4 vs. 28.9; P = 0.024), depression score (18.2 vs. 8.7; P = 0.002) and lower QoL (59.0 vs. 74.0; P = 0.013) than non-dropouts. However, no difference between individuals who dropped or not was found in the interdisciplinary intervention.

Conclusion: Interdisciplinary approach may be more effective to improve clinical features and QoL. In addition, this intervention avoids dropout of individuals with worse risk profile concerning adiposity, depression and QoL when compared with those having only medical visits. Interdisciplinary approach may favor the retention of a subset of individuals at higher risk, which may result in long-term cardiovascular protection. Aims: Consumption of high fat diet (HFD) leads to accumulation of intramuscular bioactive lipids: long-chain acyl-CoA (LCACoA), diacylglycerols (DAG) and ceramides (Cer) which are implicated in induction of muscle insulin resistance. The aim of this study was to elucidate the role of HFD, myriocin (an inhibitor of ceramide de novo synthesis) and metformin on skeletal muscle LCACoA, DAG, Cer and acyl-carnitine content and their impact on proteins of insulin pathway.

The experiments were performed on male Wistar rats: 1-fed standard rodent chow (control), 2-fed HFD, 3-fed HFD treated with myriocin, (HFD/Myr) and 4-fed HFD treated with myriocin and metformin (HFD/Myr/Met). Muscle bioactive lipids were analyzed by LC/MS/MS and plasma glucose and insulin concentration by standard assays. Content and phosphorylation of Akt and glycogen synthase (GS) was measured by Western Blot.

Results: Compared to control, all measured lipids were elevated in HFD group. These changes were accompanied by decreased phosphorylation of Akt and GS and impaired glucose disposal. Myriocin caused a decrease in Cer but an increase in the other lipids content as compared to HFD. Introducing metformin to HFD/Myr group attenuated levels of lipid metabolites known to interfere with insulin signaling (Cer, DAG, LCACoA) and increased acyl-carnitine content as compared to HFD/Myr. In HFD/Myr and HFD/Myr/Met groups insulin-sensitizing effects were accompanied by enhanced Akt and GS phosphorylation when compared to HFD.

Conclusions: Simultaneous treatment with myriocin and metformin redistributes fatty acids to β-oxidation which attenuates muscular content of bioactive lipids and improves glucose tolerance by promoting Akt phosphorylation.

pro-inflammatory state leading to abnormal production of hormones like leptin and adiponectin. The present study was designed to explore endocrine dysfunction of adipose tissue in metabolic syndrome.

The study included 170 subjects; 84 metabolic syndrome cases as defined by International Diabetes Federation and 86 age and sex matched controls. The blood samples were collected for estimation of serum triglycerides, HDL-C, insulin, leptin, adiponectin and fasting plasma glucose. Leptin and adiponectin were estimated by ELISA and insulin by Electrochemiluminescence immunoassay. Other biochemical parameters were estimated on Clinical Chemistry analyzer by standard methods. HOMA-IR as an index of insulin resistance was calculated from fasting plasma glucose and serum insulin levels.

Results: Serum leptin level was significantly higher in metabolic syndrome patients (26.45 AE 6.17 ng/ml) in comparison to control group (14.76 AE 6.42 ng/ml). Serum adiponectin was significantly lower in metabolic syndrome patients (6.75 AE 3.22 lg/ml) in comparison to control group (8.44 AE 3.90 lg/ml) levels. Significant difference of HOMA-IR was between metabolic syndrome cases and controls (P < 0.05).

Conclusions: It is concluded that altered endocrine functions of adipocytes are associated with metabolic syndrome and leptin and adiponectin has potential to be incorporated as components of diagnostic criteria of metabolic syndrome. Aim: To devise noninvasive method to diagnose NAFLD.

Methods: One hundred and eight patients were examined: biochemical blood analysis, endotoxin and nitric oxide in blood, shortchain fat acids (SFA) in faeces, biopsy of liver. Patients have been divided into two groups depending on activity of hepatitis:

1. steatosis; 2. steatohepatitis, and into three groups according to the therapy: 1. statin; 2. probiotic;

Results: We didn′t revealed direct correlation between biochemical parameters of liver function and heaviness of morphological changes in liver. However patients with steatohepatitis had increased level of endotoxin (0.37 AE 0.01) and nitric oxide (72.25 AE 2.22) in blood. Total quantity of SFA in faeces was also decreased in those patients. There was more effective decrease of lipids, endotoxin and nitric oxide in those patients, who received probiotic in combination with statin. If patient received only probiotic there was not any changes of lipids, but the level of endotoxin and nitric oxide became lower. If NAFLD progressed in steatohepatitis and there was high level of c-GTP and transaminases we didn′n notice such effective decrease of cholesterol.

1. The increase level of endotoxin and nitric oxide in blood is the marker of steatohepatitis.

2. Application of statin in combination with probiotic is more effective in achievement of target levels of lipids and decreasing endotoxin and nitric oxide.

3. If patient has steatohepatitis, effectiveness in the hypolipidemic therapy decreases (in comparison with steatosis), because the metabolism of drugs in liver decrease. Methods: One hundred and eight patients with NAFLD were examined: biochemical blood analysis, endotoxin and NO in blood, shortchain fat acids (SFA) in faeces, biopsy of liver (index of steatosis (IS) and index of histological activity (IHA)). Patients have been divided into two groups:

1. steatosis;

2. steatohepatitis.

Results: Total quantity of SFA in faeces was decreased in all patients, but there wasn′t difference between I and II groups. All patients with had increased level of endotoxin (0.37 AE 0.01) and nitric oxide (72.25 AE 2.22). There was correlation between ALT and GGTP with endotoxin and NO (AST/endotoxin r = 0.34; GGTP/endotoxin r = 0.88; AST/NO r = 0.34; GGTP/NO r = 0.88; P < 0.05). The biopsy of liver showed all signs of NAFLD including changes of tiny bilious ductules. We didn′t revealed direct correlation between biochemical parameters of liver function and heaviness of morphological changes in liver (appearance of morphological attributes of steatohepatitis precedes development of cytolytic and cholestatic syndrome). However there was reliable direct correlation between endotoxin and NO with histological parameters of NAFLD (IS and IHA): IS/endotoxin r = 0.81; IHA/endotoxin r = 0.84; IS/NO r = 0.72; IHA/NO r = 0.69; P < 0.05.

1. Endotoxin and NO may be used in diagnosing of NAFLD.

2. Increase of level of endotoxin and NO in blood in patients with NAFLD is associated with progression of inflammation in liver. Thereby blood analysis for endotoxin and NO can be used in diagnosing of NAFLD progression.

3. We also can judge about effectiveness of treatment of NAFLD by the level of endotoxin and NO in blood.

of this study was to analyze incidence obesity and insulin resistance in patients with fatty liver.

The study involved 130 patients with diagnosis non alcoholic fatty liver at the Clinical Centre Pristina. There were analyzed demographic and anthropometric characteristics of the examined patients. Of clinical characteristics, there were determined smoking habit, arterial pressure. Routine biochemical analyses were carried out by a standard laboratory procedure. HOMA-IR was used to evaluate insulin resistance.

Results: In the study group, fatty liver was demonstrated by ultrasound in 72 (55.38%) subjects and in the control group there were 58 respondents (44.62%) without pathological findings of ultrasound and with the level of P < 0.001. The values of BMI (34.56 AE 6.05 kg/m 2 vs.; P < 0.001), waist circumference (110.13 AE 11.22 vs. 88.63 AE 10.32 cm; P < 0.001) and glucose (6.23 AE 0.95 vs. 4.82 AE 0.38 mmol/l; P < 0.00), level of insulin (16.56 vs. 7.37 mU/I; P < 0.001) and HOMA-IR (4.16 vs. 1.6; P < 0.001) were significantly higher.

Conclusions: These results confirm that obesity and insulin resistance are associated with fatty liver infiltration. Background and aim: This study was designed to determine the impairment of the skin structure in experimentally-induced diabetes with injection of streptozotocin (STZ).

Material and methods: Experimental groups consisted of controls (group 1, N = 10) and diabetes groups (group 2, N = 10). Dorsal skin was removed for routine histological tissue procedures. Hematoxylene and Eosin (HE), Masson's Trichrome and Periodic Acid Schiff (PAS) stainings, immunohistochemical connexin 43 (Cx43) and type IV collagen stainings were applied. Morphometry of epidermal thickness were also determined.

Results: Group 2 revealed decrease in epidermal thickness with disintegration of epithelium and decrease of dermal collagen fibers. Stratum spinosum were morphologically abnormal for group 2. Measurements of epidermal thickness revealed statistically significant decrease (P0.000). PAS staining for group 2 revealed disruption of the basement membrane. Epithelial scar formation, deterioration of transformation in the polyhedral cells, degradation of epidermis and decrease in PAS staining for vascular structures were observed, whereas the reticular dermis and hair follicles were normal. Collagen fiber density in group 2 were found to be prominently decreased in dermis with Masson's Trichrome staining. Evident decrease in immunostaining of Cx43 and type IV collagen were also shown in diabetic group in comparison to the controls.

Conclusion: Diabetes not only induced impairment of the epidermal integrity and deterioration in the epidermis via loss of gap junctions (the most prominent cellular junctional complex), but also caused dramatically negative impact on the dermal collagen content, and integrity of the basement membrane. Background and aims: Obesity, a major obstacle in the improvement of human health, is associated with an increased risk of development of numerous diseases. On the other hand, plant metabolites showed various bioactivities on affecting food intake, lipase activity, energy expenditure and lipid metabolism that may have potential on preventing body weight gain. Therefore, this study aims to discover a new metabolite with anti-obesity efficiency.

Brief methods: Adipocyte differentiation was induced by dexamethasone, 3-iso-butyl-1-methylxanthine and insulin in 3T3-L1 preadipocyte. In vivo, male C57BL/6 mice were fed a normal diet (ND), high-fat diet (HFD), a lucidone-supplemented HFD in lower dosage of 250 mg/kg of diet (LSH/L) or in higher dosage of 1250 mg/ kg of diet (LSH/H) for 12 weeks. Record the changes of body weight and food consumptions. Physiological parameters in plasma were determined after sacrificed. Epididymal and perirenal adipose tissues were collected for further histological analysis.

Results: Lucidone at 40 mmol/l suppressed adipogenesis in 3T3-L1 cells by reducing transcription levels of adipogenic genes, including PPARg, C/EBPa, LXR-a, LPL, aP2, GLUT4 and adiponectin. LSH/ H mice showed lowered body and liver weights, decreased food efficiency, and lowered plasma cholesterol, triglyceride, glucose, and insulin levels. Dissection of adipose tissue from lucidone-fed mice showed reductions in the average fat-cell size and percentage of large adipocytes.

Conclusion: These results provided evidence that dietary intake of lucidone alleviates high fat diet-induced obesity in C57BL/6 mice and reveals the potential of lucidone as a nutraceutical on preventing obesity and consequent metabolic disorders under unhealthy eating habits.

Introduction and aim: Obesity and type 2 diabetes (T2D) are accompanied by intramyocellular lipid accumulation which might lead to mitochondrial dysfunction and insulin resistance. Our aim was to compare changes in peripheral insulin sensitivity and mitochondrial respiration after a diet-and subsequently a gastric bypass induced weight loss in obese patients with or without T2D.

Materials and methods: Sixteen subjects (4M/12F; 6 with (T2DM) and 10 (OB) without T2D) reported thrice to the lab after an overnight fast: Prior to weight loss (A), 2 mo later just prior to operation (B) and 4 mo after operation (C). At each visit tree tests were performed: Day1: DEXA scan for body composition and stationary graded bicycle test for VO 2 max.

Day2: Hyperinsulinaemic euglycemic clamp for peripheral insulin sensitivity. Prior to the clamp a vastus lateralis muscle biopsy for high resolution respirometry was obtained. Respiration protocol is shown in Fig. 2 .

Results: Anthropometric, body composition and VO 2 max data are shown in Fig. 1 .

Insulin sensitivity (GIR FFM ) and maximally coupled respiration (GMSO3) data are shown in Fig. 2 .

Conclusion: In spite of a marked difference in insulin sensitivity, maximally coupled mitochondrial respiration was similar in the two groups. Moreover, with marked improvements in T2DM insulin sensitivity, due to the massive weight loss, mitochondrial respiration remained unchanged. These results speak against an association of mitochondrial respiratory capacity and insulin resistance in skeletal muscle in obese and T2D patients. Introduction: Increased circulating levels of resistin was proposed as a possible link between obesity and insulin resistance. We investigated if increased resistin expression in adipose tissue affected age-related changes in insulin resistance of peripheral tissues, including brown adipose tissue (BAT), and oxidative stress parameters in the spontaneously hypertensive rats (SHR).

Methods: Sixteen months old male SHRs expressing the mouse resistin gene under control of adipose tissue specific Ap2 promoter (SHR-Tg) and age matched non-transgenic SHRs were used.

Results: Transgenic expression of resistin was associated with impaired glucose tolerance measured during OGTT (AUC 1429 AE 169 vs. 725 AE 14 mmol/l/2 h, P < 0.01); elevated serum insulin (0.34 AE 0.02 vs. 0.28 AE 0.03 nmol/l, P < 0.05) and triacylglycerols (2.00 AE 0.15 vs. 1.34 AE 0.12 mmol/l, P < 0.01) levels. SHR-Tg exhibited lower insulin sensitivity measured as insulin stimulated incorporation of 14 C-glucose into lipids in epididymal adipose tissue (621 AE 38 vs. 1654 AE 302 nmol gl./g/2 h, P < 0.01) and into skeletal muscle glycogen (P < 0.05). Glucose oxidation in soleus muscle (P < 0.05), and BAT (P < 0.05) were reduced. SHR-Tg displayed decreased 14 C-palmitate oxidation to CO 2 in BAT (37.6 AE 4.5 vs. 53.8 AE 4.9 nmol/g/2hod, P < 0.05). In adipose tissue of SHR-Tg rats was increased concentration of lipid peroxidation products (conjugated dienes and TBARS), reduced activity of antioxidant enzymes: superoxide dismutase (1.931 AE 0.187 vs. 3.023 AE 0.307 U/ mg protein, P < 0.05) and glutathione peroxidase (118 AE 6 vs. 163 AE 4 lmol NADPH/min/mg protein, P < 0.001).

Conclusion: Chronic transgenic expression of resistin gene might contribute to insulin resistance and associated metabolic disorders suggesting possible involvement of reduced BAT metabolic activity in age-induced prodibetogenic effect of resistin. Examination of 230 patients with type 2 diabetes mellitus (T2DM) revealed 83 patients (36.1%) with non-alcoholic fatty liver disease (NAFLD). NAFLD met more often in the patients with obesity (54.5%) and overweight (37.5%) and only in 20.8% patients with normal body weight. All the patients had abdominal type of adipose tissue distribution regardless of body weight. In patients with T2DM and normal body weight the NAFLD met more often in women, and in overweight and obesity in men.

In the examined patients with T2DM and NAFLD complaints peculiar to dyspepsia and asthenovegetative syndrome prevailed. The average level of HbA1c corresponded the state of subcompensated carbohydrate exchange (6.86%). These patients had marked dyslipidemia with predominance of II and IIb types of hyperlipidemia. Cytolytic, cholestatic, mesenchymal-inflammatory syndromes were marked out as well as syndrome of hepatic-cellular insufficiency.

Increased level of immunoreactive insulin IRI (17.65 AE 2.56) mU/ml and index of HOMA IR (8.30 AE 1.50) mU/ml testified the presence of expressed insulin resistance in the patients with T2DM and NAFLD. The patients revealed the increase of free fatty acids level (2.19 AE 0.10) mmol/l/ml, that meaningfully differed from such indexes in the control group (P < 0.001) and low level of adiponektin (3.70 AE 0.70) mg/ml that confirms their role in development of NAFLD even for persons with normal body weight after the presence of abdominal type of adipose tissue distribution. Study object: Diene (DC), triene (TC), oxydien (ODC), tetraen (TRC) conjugates, malondialdehyde (MDA), aspartate aminotransferase (AST), alanine aminotransferase (ALT).

The study involved 37 patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease (NAFLD) -14 men and 23 women among them and 10 diabetes women without NAFLD. All subjects are representative on age and diabetes duration. Correlation analysis has been conducted with the calculation of Spierman rank correlation coefficient.

Study results: The increase of TC and ODC levels has been marked in type 2 diabetes men with NAFLD vs. women -(46.71 AE 3.15); (113.37 AE 8.32) and (38.86 AE 2.66); (91.54 AE 5.52), respectively, P < 0.05, as well as AST and ALT levels -(0.87 AE 0.1); (1.46 AE 0.2) and (0.61 AE 0.08); (0.93 AE 0.2), respectively, P < 0.05, P < 0.001. The positive correlation of AST, ALT with ODC and TRC has been found among type 2 diabetes women with NAFLD (r = 0.38, r = 0.4, P < 0.05) and (r = 0.36, r = 0.37, P < 0.05) unlike women without NAFLD -(r = À0.002) between AST and TRC and (r = 0.32) between ALT and TRC.

AST, ALT are in positive correlation with CT in men (r = 0.56, r = 0.57, P < 0.05).

In type 2 diabetes men with NAFLD the oxidative stress displays are more clearly seen. It is expressed in increasing of TC and ODC combined with AST and ALT hyperactivity. TRC levels are increased in women group with AST and ALT increasing vs. type 2 diabetes women without NAFLD. The above mentioned can serve as a diagnostic marker of NAFLD in type 2 diabetes women.

I. Kara, B. Bonardo, F. Peiretti UMR 1062, Inserm, Marseille, France Gamma secretase and the triggered Notch signalling are involved in the regulation of the differentiation/proliferation equilibrium of progenitor cells. Gamma secretase consists of four subunits: Presenilin 1 or 2, Nicastrin, Pen-2 and Aph1 (stoichiometry 1:1:1:1). In humans, there are two Aph1 proteins (Aph1A and Aph1B). In rodents there is an additional protein, Aph1C issued from a duplication of the aph1b gene.

It has been reported that inhibition of c-secretase improves insulin resistance and stimulates adipogenesis.

These data led us to study the impact of obesity in the regulation of the c-secretase composition.

Expression of c-secretase subunits was measured by quantitative PCR (tissues and cells) and western blot (cells).

The expression of Aph1B is significantly increased in the adipose tissue of obese mice whereas the expression of the other subunits of the c-secretase is not altered. The increased expression of Aph1B is not observed in muscles and liver of obese mice. The expression of Aph1B is also increased in visceral adipose tissue of human obese subjects. In addition, the expression of Aph1B/C increases during adipocyte differentiation of 3T3L1 cells.

In conclusion, the c-secretase composition is specifically altered in hypertrophied adipocytes. This result provides the first evidence of a pathophysiological regulation of Aph1B/C expression.

An approach to knockdown adipocyte expression of Aph1B/C is in progress. The analysis of the consequences of this manipulation on csecretase activity, Notch signalling and the biology of the adipocyte will help assess the importance of the alteration of c-secretase composition during adipocyte differentiation. Background and aim: Certain legumes and barley kernels may favorably modify metabolic risk parameters in semi-acute studies in healthy subjects. This investigation assessed the medium-term effect of a diet combining specific legume and whole grain barley products on markers associated with the metabolic syndrome (MetS) in mature women.

Design and methods: Randomized crossover intervention in 46 women (50-72 years-old, BMI 25-33, normal fasting glycemia), comparing a diet rich in kernel-based barley products, brown beans and chickpeas (D1) with a control diet (D2) of similar macronutrient composition but lacking legumes and barley. D1 included 172 g (as eaten)/day legumes, 58 g whole grain barley kernels and 200 g barley kernel bread. Both diets followed the Nordic Nutrition Recommendations and provided similar amounts of dietary fiber (46.9 g/day, D1; 43.5 g/ day, D2), with wheat-based products as main fiber supplier in D2. Each diet was consumed for 4 week under weight-maintenance conditions. Blood lipids, glucose, insulin, CRP, gamma-glutamyl transferase (GGT) and blood pressure were the measured outcomes.

Results: Both diets decreased serum cholesterol fractions, but D1 had greater effect (P < 0.01) on total and LDL-cholesterol (changes from baseline: À12% and À11%, respectively) than D2. D1 also reduced GGT (À8%, P < 0.05), diastolic blood pressure (À3%, P < 0.05) and the Framingham cardiovascular risk estimate (À11%, P < 0.05), while D2 had no effect. Methods: Group I (n = 70)women with MS were examined proinflammatory cytokines polymorphisms, group II (n = 52)testing for hereditary and acquired forms of thrombophilia. All subjects had the fetal loss syndrome, fetoplacental insufficiency, severe preeclampsia in previous pregnancies.

Results: Group Ipolymorphisms IL-1β -31T/C in 95.7%, IL-6 -174 G/C-in 68.6%, tumor necrosis factor-a -308G/Ain 27.1% of cases. In II group the multigenic defects were verified in 100% of cases; the feature of multigenic defects is that the 4G/5G polymorphism of plasminogen activator inhibitor-1 (PAI-1) gene was found in 92.3% of cases, the 4G/4G phenotype of the gene PAI-1 was verified in 61.5% of cases. The polymorphism in the tissue-type plasminogen activator I/D gene, in the angiotensin-converting enzyme I/D gene, in the fibrinogen 455G/A gene were found in 65.4%, 48.1%, 55.8% respectively. Acquired antiphospholipid antibodies were verified in 15.4% of cases. All women received antithrombotic therapy from the fertile cycle involved low molecular-weight heparin (Enoxaparin sodium, daily dose 0.4-0.8 ml), vitamins B, folic acid. Pregnancy was achieved in 100%. There were not recurrent fetal loss, severe pre-eclampsia, placental abruption in the study groups. Live births was in all cases.

Conclusions: We suggest that proinflammatory and thrombophilic status is an important pathogenetic factor of recurrent fetal loss, severe pre-eclampsia and other obstetric complications in women with MS. Timely antithrombotic prophylaxis may be a key of successful outcome of pregnancy. The prescription of an individualized rehabilitation program based on the crossover point of substrate utilization (COP) could be particularly relevant in patients with metabolic syndrome (MS). The aim of the study was to examine:

1. The effects of a 12 week rehabilitation program at an intensity corresponding to COP on the anthropometric characteristics of women with MS, and 2. These effects after a 2 month follow-up period without supervision.

Nineteen women with MS (54.8 AE 8.1 years; 89.0 AE 12.2 kg; BMI = 34.5 AE 4) performed an indirect calorimetry test to determine their COP and then participated in a supervised rehabilitation program (3 9 45 min/week at COP on cycle-ergometer over 12 weeks). Afterward, they were instructed to continue to practice a physical activity without supervision over 2 months.

The target exercise intensity at COP was 38.3 AE 15.3% maximal aerobic power. Mass, body mass index, waist and hip circumferences, waist-hip ratio, relative fat mass and fat-free mass were significantly decreased whereas energy balance was significantly increased after the rehabilitation program. There were no significant differences at the end vs. 2 months after the rehabilitation program. Two months after the rehabilitation program, only both circumferences, waist-hip ratio and energy balance were not significantly different from baseline values.

An individualized rehabilitation program over 12 weeks at COP allowed to improve the anthropometric characteristics in women with MS. However, although the energy balance remains unchanged during the 2 month follow-up period, only the effects on circumferences are maintained 2 months after the rehabilitation program. Objective: Hypoxia contributes to adipose tissue inflammation and fibrotic remodeling in obesity. We have recently shown that longchain n-3 polyunsaturated fatty acids (PUFA) ameliorate adipose tissue inflammation in obese subjects. Here we investigated, whether long-chain n-3 PUFA also reduce adipose tissue hypoxia and may prevent adipose tissue remodeling.

Patients and methods: In a randomized controlled clinical trial we treated 49 severely obese subjects (BMI > 40 kg/m 2 ) with either 3.4 g/ day highly purified long-chain n-3 PUFA or control for 8 weeks. At the end of the treatment we sampled visceral and subcutaneous adipose tissue (VAT and SAT) during elective bariatric surgery. We quantified gene expression of hypoxia and fibrosis markers in tissue specimen by real-time quantitative RT-PCR. Statistical analyses were performed by one-way ANOVA.

Results: Adipose tissue gene expression of HIF1A correlated positively with CD40 expression, a M1 macrophage marker and expression of both genes was significantly reduced after n-3 PUFA treatment in SAT (P < 0.05). Furthermore, HIF1A expression correlated negatively with the anti-inflammatory fatty acid index in the treatment group. n-3 PUFA significantly downregulated the pro-fibrotic markers TGFB, MMP3 and COL6A3 in SAT.

Conclusions: Mitigation of adipose tissue inflammation by n-3 PUFA is paralleled by the amelioration of hypoxia and prevention of tissue remodeling as estimated by marker gene expression. These data emphasize beneficial effects of high-dose n-3 PUFA in obesity. Biochemistry, University of Medicine and Pharmacy "Carol Davila", 2 Faculty of Medicine, University "Titu Maiorescu", 3 DELTA Hospital, 4 NIDNMD "N.C. Paulescu," Bucharest, Romania

Background and aim: The diabetes "epidemic" nowadays appeared at the same time with the obesity "epidemic", their relationship being a causal one. Weight gain cannot be conceived without a good sensitivity to insulin. All three paraoxonases have antioxidant properties. These protect vascular tissues from oxidative damage by modulating the effects of the main actors in the atherosclerotic process, namely the HDL and LDL particles and the macrophage. In this study we aimed to investigate the role of paraoxoanse2 (PON2) in the relationship between obesity and type 2 diabetes.

Materials and methods: Ten obese patients with type 2 diabetes mellitus were compared with 12 non-diabetic obese subjects. We determined the PON2 in preadipocytes cells obtained from bariatric interventions and in differentiated adipocytes (day 4, 8, 12, 16, 20) . ELISA method was used for leptin and adiponectin measurements.

Results: The obesity antropometric markers (waist and hip circumference, visceral fat index) were positively correlated with the value for leptin and negatively with the value for adiponectin (P < 0.001). The intracellular PON2 tented to be lower with the degree of diferentiation and these was associated with adipokines changes both in serum and cell lysates.

Conclusion: Resuming our data, we presume that PON2 is present in pre/adipocytes and could be implicated in prevention of type 2 diabetes obesity associated complications.

Acknowledgements: This work was supported by a grant of the Romanian National Authority for Scientific Research, CNCS-UEFISCDI, project numer PN-II-ID-PCE-2011-3-0429". Dr. Lixandru was supported by the postdoctoral program POSDRU/89/ 1.5/S/60746, from European Social Fund. 1. the effects of a 12 week individualized rehabilitation program (IRP) coached at an intensity corresponding to the crossover point of substrate utilization (COP) on HQRoL, peak of oxygen uptake (VO 2peak ) and power out peak (P peak );

2. the effects on HQRoL after a 2 month follow-up period without coach.

Nineteen women with MetSyn (54.8 AE 8.1 years; 89.0 AE 12.2 kg) performed a test to exhaustion to estimate the VO 2peak and P peak , and an indirect calorimetry test to determine their COP used during a IRP (3 9 45 min/week) on cycle-ergometer over 12 weeks. Afterward, they were instructed to continue their physical activity without coach over 2 months.

VO 2peak and P peak were increased after the IRP (P < 0.001). HRQoL were no different in every domain at the end and 2 months after the IRP. Only the question about their change of health compared to 1 year ago has improved but it was at the verge of significativity (P = 0.06).

Women with MetSyn undergoing IRP coached at COP improved VO 2peak and P peak, but showed no improvement in HRQoL after a 12 week coached IRP nor after the 2 month follow-up period without coach. Consequently, physical fitness seems not be associated with self-perceived quality of life in women with MetSyn.

T.B. Domagala 1 , K. Kotula-Horowitz 2 , R. Januszek 2 , M. Janczura 3 , J. Zagajewski 4 , J. Musial 2 micronized fenofibrate (215 mg/day) for 6 months. Fifty cardiovascular risk male volunteers (mean age 40 years) with no prior myocardial infarction or stroke were enrolled as the controls. Brachial FMD and homocysteine levels were measured at baseline and after 6 months.

The respective groups also differed in: BMI (P < 0.0001), plasma total (P = 0.0001), HDL cholesterol (P = 0.007) and triglycerides (P = 0.0001), but not in baseline plasma homocysteine levels (11.04 AE 3.69 vs. 9.98 AE 2.08 lmol/l; P = NS). At baseline, mean brachial FMD were lower in the subjects with metabolic syndrome (6.69 AE 2.41% vs. 8.56 AE 3.12%; P < 0.05). In those subjects fenofibrate therapy significantly improved FMD (6.69 AE 2.41% vs. 9.83 AE 3.31%; P < 0.0001) and increased plasma homocysteine levels (11.04 AE 3.69 vs. 9.98 AE 2.08 lmol/l; P < 0.0001). No such differences were noted in the controls, neither before nor after 6 months.

Conclusions: Fenofibrates improve endothelium-dependent FMD of the brachial artery, irrespective of the simultaneously induced hiperhomocysteinemia.

A. Picu 1 , L. Petcu 1 , D. Lixandru 2 , I. Stoian 2 , C. Cristescu 3 , E. Rusu 3 , C. Ionescu-Tirgoviste 1 1 NIDNMD "N.C. Paulescu", 2 Biochemistry, University of Medicine and Pharmacy "Carol Davila", 3 "Titu Maiorescu" University, Bucharest, Romania Background and aims: Oxidative stress leading to macrophage foam cell formation is the hallmark of the early atherosclerotic lesion. The aim of these study was to assess the relationship between clinical, biochemical and oxidative stress risk factors with obesity in newly diagnosed type 2 diabetes (N-DM).

Materials and methods: One hundred and forty-five patients with N-DM registered in the NIDNMD ambulatory, "N.C.Paulescu" and 30 healthy volunteers were included. The N-DM patients were divided into two subgroups according to the BMI (body mass index): group1overweight (BMI = 28.4-29.9 kg/m²) and group2-obese (BMI ! 30 40 kg/m²). In circulating monocytes, the ability to produce free radicals vs. their neutralizing capacity was determined by measuring NADPH oxidase activity (respiratory burst; RB) and intracellular activity of PON2. We also determined the serum leptin and adiponectine by ELISA, total antioxidant capacity (TEAC) and the concentration of non-protein thiols (SHneproteic) by spectrophotometric methods.

Results: In diabetic patients vs. normal subjects, leptin, proinsulin and RB were increased (P < 0.001), while adiponectin and PON2 decreased (P < 0.001). The differences were accentuated in the obese group. The strongest correlation was between proinsulin and leptin (r = 0.59, P < 0.001) and both contribute for the high cardiovascular risk in type 2 diabetes.

Our results showed imbalance pro/antioxidant of obese diabetic patients, low PON2 activity and increased RB being influenced by the degree of obesity.

Introduction: Cardio-protective role of human HDL-associated serum paraoxonase (PON1) is believed to be due, at least partly, to its antioxidative properties. PON1 activity is genetically determined by major polymorphism Q192R. Brachial flow-mediated dilation (FMD) is a non-invasive physiological measurement used to quantify endothelial dysfunction. Fibrates are known to exert hypolipidemic effects, while their effect on PON1 activity remains unclear.

Aim: To assess PON1 activity and FMD in the subjects with metabolic syndrome on fenofibrate treatment.

Methods: Forty male subjects (mean age 42 years) with hipertriglicerydemia, as well as metabolic syndrome, were treated with micronized fenofibrate (215 mg/day) for 6 months. PON1 activity in serum and brachial FMD were measured at baseline and after 6 months. PON1 Q192R polymorphism was determined by PCR amplification and restricted digestion; serum PON1 activity was assayed spectrophotometrically. Results There were 26 subjects with 192QQ genotype (Group A) and 14 carriers of 192R allele (Group B). At baseline both groups differed in PON1 activity only (102 AE 59 vs. 190 AE 39 U/l; P < 0.0001). Fenofibrate treatment reduced PON1 activity in all subjects, nonetheless significantly in those with 192QQ genotype (102 AE 59 vs. 93 AE 54 U/l; P = 0.001), unlike in the 192R allele carriers (P = ns). At baseline mean brachial FMD did not differ between Groups A and B. Fenofibrate therapy significantly improved FMD (7.12 AE 2.83% vs. 13.30 AE 1.72%; P = 0.001) in Group A subjects, unlike Group B (6.66 AE 2.50% vs. 9.61 AE 2.60%; P = NS). This study was to investigate the effect of nicotine on insulin sensitivity and explore the underlying mechanisms. Treatment of Sprague-Dawley rats with nicotine (3 mg/kg/day) for 6 weeks significantly reduced blood insulin level but had no effect on blood glucose level. Both insulin tolerance test and glucose tolerance test demonstrated that nicotine treatment enhanced insulin sensitivity. Pretreatment of rats with hexamethonium (20 mg/kg/day) to antagonize peripheral nicotinic receptors except for a7 nicotinic acetylcholine receptor (a7-nAChR) had no effect on the insulin sensitizing effect of nicotine. However, the insulin sensitizing effect of nicotine was totally abrogated in a7-nAChR knockout mice, indicating the involvement of a7-nAChR. Further, chronic treatment with PNU-282987 (0.53 mg/kg/day), a selective a7-nAChR agonist, significantly enhanced insulin sensitivity not only in normal mice but also in AMP-activated kinase-a2 knockout mice, an animal model of insulin resistance with no sign of inflammation. Moreover, PNU-282987 treatment enhanced phosphorylation of signal transducer and activator of transcription 3 (STAT3), a molecule involved in regulating insulin signaling, in skeletal muscle, adipose tissue and liver in normal mice. PNU-282987 treatment also improved glucose uptake in C2C12 myotubes and this effect was totally abrogated by STAT3 inhibitor, S3I-201. All together, these findings indicate that nicotine enhances insulin sensitivity in animals with or without insulin resistance, at least in part via stimulation of a7-nAChR-STAT3 pathway independent of inflammation. Our results not only contribute to the understanding of the pharmacological effects of nicotine, but also identify new therapeutic targets against insulin resistance and type 2 diabetes. Calorie restriction (CR) is one of the most reproducible treatments for weight loss and slowing aging. However, how CR induces these alterations is still unclear. This study was designed to understand whether nicotinamide phosphoribosyltransferase (NAMPT, also known as visfatin) plays a role in the beneficial effects induced by CR using a specific chemical inhibitor of NAMPT (FK866). Sprague-Dawley rats were treated for 8 weeks in four groups: ad libitum (AL), CR, AL + FK866 and CR + FK866 groups. AL and AL + FK866 animals were allowed unlimited access to standard chow, while the CR and CR + FK866 animals were restricted to 60% of the food intake consumed by AL and AL + FK866 animals. FK866 (1 mg/kg/ day) was given via drinking water. We found CR upregulated NAMPT mRNA and protein levels in rat skeletal muscle and white adipose tissue. Inhibition of NAMPT did not affect the SIRT1 upregulation by CR but suppressed the CR-induced SIRT1 activity and deacetylation of Foxo-1. Furthermore, inhibition of NAMPT not only weakened the CR-induced decrease of oxidative stress (ROS, superoxide O 2 À˙a nd MDA levels), but also greatly abolished the CRinduced improvements of anti-oxidative activity (total-SOD, GSH and GSH/GSSG ratio) and mitochondrial biogenesis. In addition, inhibition of NAMPT blocked the CR-induced insulin sensitization, Akt signaling activation and eNOS phosphorylation. Collectively, our data demonstrate that CR-induced beneficial effects in oxidative stress, mitochondrial biogenesis and insulin sensitivity require functional NAMPT. Background: The anti-diabetic effect of camel milk (CMK) gained increasing recognition in folk medicine and recent clinical and experimental studies. However, the mechanism(s) by which CMK influence the glucose homeostasis is yet unclear.

Objectives: To investigate the effects of CMK on the blood glucose regulatory mechanisms in control and diabetic animals.

Materials and methods: Experimental diabetes was induced by intrapertional injection of streptozotocin in 40 Wistar rats divided into (D & D-CMK) Groups. Two healthy (C& C-CKM) Groups served as control. Camel milk (50 ml/rat/day) was administered orally to the (D-CMK) and (C-CMK) Groups for 8 weeks. The (D) and (C) Groups received no treatment. The changes in body weight, blood glucose, glucose tolerance, serum insulin, blood lipids, incretin hormones (GLP-1 and GIP), TNF-a, TGF-β1, HOMA-IR and atherogenic index (AI) were investigated.

Results: The untreated diabetic animals (D-Group) exhibited significant hyperglycemia, hyperlipidemia, increased HOMA-IR and AI, elevated serum icretins, TNF-a and TGF-β1 levels. This was associated with weight loss and high mortality. Camel milk administration to the D-CMK Group inhibited the weight loss and mortality and caused significant hypoglycemia, hypolipidemia, insulin secretion, low HOMA-IR and AI. Serum GLP-1 and GIP levels show significant elevation but TNF-a and TGF-β1 were reduced.

Conclusion: Augmented insulin release and decreased insulin resistance together with enhanced incretin hormones release are anticipated to contribute to the anti-diabetic effect of CMK. Besides, the peculiar composition of CMK and its anti-inflammatory properties propose it as a valuable adjuvant anti-diabetic therapy. However large-sized clinical studies are still needed. Prediabetics reflect dysregulation in glucose homeostasis with obesity is known risk factor in western countries. Different degree of obesity contribution toward prediabetics is observed in lean populations.

Aim: To investigate the role of plasma leptin as a predictor of prediabetics in lean subjects.

Method: Plasma leptin were measured in 950 non-diabetic subjects aged 14-90 years old with BMI < 25. Prediabetes (N = 100) was defined based on fasting plasma glucose and 2-h oral glucose tolerance test. Plasma leptin were measured in all subjects using commercial ELISA kit. Binary logistic regressions were used to estimate the age and sex adjusted odds ratio of leptin and other metabolic parameters.

Results: Plasma leptin levels were significantly and positively correlated with BMI, percent total body fat, fasting plasma insulin and blood sugar and HOMA-IR values. Plasma leptin were significantly higher in lean prediabetics (31.04 AE 2.22) compared to euglycemic lean subjects (20.11 AE 0.62; P < 0.0001). Increase in plasma leptin value by one increases the risk of prediabetics with OR 1.019 (95% CI: 1.007-1.031).

Discussion: In a population of relatively lean and non-diabetic subjects, plasma leptin levels were associated with insulin resistance and prediabetes. Furthermore, plasma leptin levels increases risk of prediabetics in non-obese subjects independent of age and sex. Our data suggest that leptin as biomarker for screening individuals at high risk for prediabetes in lean population.

F. Al-Zadjali, R. Bayoumi

Latest update from the international diabetes federation shows that the prevalence of type 2 diabetes (T2DM) in the Arabian Gulf countries is among the top 10 worldwide. The rapid increase in T2DM prevalence in these countries suggests that psychological and behavioral factors, more than genetic factors, are primarily responsible for this trend.

Aim: To estimate heritability of plasma levels of adipocytokines in a large isolated Arab pedigree.

Method: Blood samples and anthropometric data were obtained from a large Arab pedigree of 469 individuals with high level of Consanguinity. Plasma levels of IL-6, IL-1b, Leptin, total adiponectin, sVCAM-1 were measured using commercial kits. Heritability parameters were measured using measured genotype analysis.

Results: Fout hundred and sixty-nine individuals were structured in a large pedigree which consisted of interrelated 148 nuclear families founded by 109 founders. The heritability values were adjusted using age and gender as covariates. Percentage of variation of plasma adipocytokines attributed to genetic factors were as following: leptin (41%), total adiponectin (19%), IL-1b (21%), IL-6 (38%) and sVCAM-1 (38%).

Discussion: Adipocytokines play central role in the development of T2DM. Our data shows high degree of heritability of leptin, IL-6 and sVCAM-1 indicating their production is under tight genetic control. Furthermore, our heritability values are different from previously reported heritability values of these adipocytkines studied in different ethnic populations. Therefore, our results suggests that Arab population are distinct and further genetic association and behavioral studies should be conducted for better understanding of the nature of T2DM and its increasing trend in Middle-East region. Results: All treatments were well tolerated and no subjects was withdrawn from the study. Compared to the baseline, the group treated with Chrome picolinate only experienced a mild but significant decrease in FPG (À1.8 AE 2.9 mg/dl). Compared to the baseline, the group treated with Chrome picolinate-Berberine experienced a mild but significant decrease in BMI (À0.1 AE 0.05 kg/m 2 ), TC (À19.1 AE 22.7 mg/dl), TG (À31.7 AE 45.3 mg/dl), non-HDL cholesterol (À18.6 AE 22.7 mg/dl), and FPG (À3.2 AE 7.2 mg/dl). Compared to the baseline, the group treated with Chrome picolinate-Berberine-Banaba experienced a significant reduction in BMI (À0.1 AE 0.1 kg/m 2 ), Waist circumference (À2.4 AE 1.4 cm), SBP (À3.0 AE 4.0 mmHg), TC (À25.1 AE 15.7 mg/dl), TG (À32.7 AE 15.8 mg/dl), LDL-C (À19.5 AE 13.4 mg/dl), non-HDL cholesterol (À26.1 AE 15.9 mg/dl), FPG (À5.3 AE 2.3 mg/dl), Insulin (À1.95 AE 1.47 mU/l), HOMA index (À0.72 AE 0.41) and HbA1c (À0.13 AE 0.25%), while HDL-C increased (+1.1 AE 1.2 mg/dl). Waist circumference, SBP, LDL-C, HDL-C, Insulin, HOMA index and HbA1c, also significantly improved when compared with other groups.

The tested combined nutraceutical appears to significantly improve insulin-sensitivity and a large number of related parameters in subjects with IFG and metabolic syndrome. Antioxidative mechanisms prevent human body from the damaging action of free radicals and reactive oxygen species. Glutathione and related to it enzyme systems detoxicate H 2 O 2 and hyperoxide and from there, reduced glutathione is a potential marker of oxidative stress level.

Purpose: To investigete glutathione of erythrocytes in patients with prediabetes (IGT and IFG) and type 2 diabetes.

Matherial and methods: We examined 25 patients with T2D and concomitant coronary heart disease (CHD) and atherosclerosis (group 1), 20 patients with prediabetes (IGT and IFG) newly diagnosed and the same co-morbidity (group 2) and 47 almost healthy person (group 3). Examinations included clinical laboratory evaluation, fasting glicose, HbA1c. Total glutathione (GSHt) and oxidized glutathione (GSSG) were measered by use of glutathione reductase reaction. Redox potential (E h ) of glutathione was evaluated by use of Nernst equation.

Results: Concentrations of GSHt and GSH were greater in group 2 to compare with groups 1 and 3 (by 4.2 times, P = 0.012 and by 3.1 times, P = 0.005 respectively). Inrease of concentration of GSSG in group 1 may change extracellular redox condition. Calculation of E h revealed its change to oxidized condition in group 1 to compare with group 2 (19.0 mV greater) and group 3 (15.4 mV greater).

Conclusion: Antioxidant defense in red-cells is overactivated during prediabetes (IGT and IFG) with concomitant CHD and atherosclerosis while in patients with T2D was noticed depletion of compensatory mechanisms with increased GSSG and E h . Reduction in 2GSH/GSSG suggests that intracellular antioxidant is lost; herewith cells become sensitive to oxidative stress. Clozapine increases meal size and meal duration, effects similar to the pharmacological blockade or congenital deficiency of CCK-1 (CCK-1R) receptor. We aimed to investigate the role of CCK-1R in clozapine-induced weight gain (WG) and insulin sensitivity (IS) in CCK-1R deficient, male Otsuka Long Evans Tokushima Fatty rats (OLETF). Long Evans Tokushima Otsuka (LETO) rats served as healthy control. Animals were orally treated with either clozapine or its vehicle over 25 days. Daily food intake was measured by means of metabolic cages. The IS was determined by hyperinsulinemic euglycemic glucose clamping (HEGC). Hypothalamic mRNA expression of CCK-1R and CCK-2R was measured by real-time PCR, plasma insulin was determined by radioimmunoassay. Clozapine failed to induce WG or increment in food intake in either OLETF or LETO rats. The fasting plasma insulin and blood glucose level was significantly higher in OLETF than in LETO rats, but clozapine failed to modify these parameters. The glucose infusion rate during the steady state of the HEGC was lower in OLETF than in LETO rats and clozapine did not modify it. The insulin sensitivity index (ISI) was lower in OLETF rats than in LETO and the ISI was further decreased by clozapine. The metabolic clearance rate of insulin changed parallel with ISI indicating the possible source of the surplus of insulin, which is responsible for the decrement in IS. Clozapine induced insulin resistance without hyperphagia and WG in male LETO and OLETF rats. Changes in CCK-1R and CCK-2R expression were inconsistent with the changes in the ISI.

Clinical Biochemistry & Immunology, Peterborough and Stamford NHSFT, Peterborough, UK The National Institute for Clinical Evidence has published guidelines for the treatment of prediabetes. These stress diet and exercise as shown by the DPP study a decade ago. However, recently published DPP follow-up data show how difficult it is for patients to follow that advice long-term. Metformin was also found to be effective and is cheap and generally well-tolerated. This study shows the long-term effectiveness of routine metformin use in patients with IGT.

All patients attending two rural lipid clinics from 2003 who were found to have IGT after a standard 75 g OGTT were offered metformin 500 mg bd or given diet and exercise advice if they did not wish medication. Metformin was preferred over diet and exercise despite being shown to be inferior in DPP because of the extra cardiovascular benefits shown in UKPDS. In 2011, after a mean (range) follow-up of 3.3 (0.4-7.0) years, it was decided to review the data to see if the (off-label) treatment was effective.

Metformin significantly reduced T2DM threefold after 6 years (18% v 55%). Further, it was possible to estimate that metformin could prevent 2/3 ever becoming diabetic (P = 0.014). The effect was due to restoring normoglycymia (FBG < 5.6 mmol/l) as the patients' weights and triglyceride levels did not change significantly.

Patients regularly present to lipidologists with fasting hypertriglyceridaemia. Those with IGT appear particularly likely to revert to normoglycaemia with metformin. Routine use of this inexpensive and well-tolerated drug reduces the lifetime risk of developing T2DM by over 70%.

K. Salehzadeh, M. Shirmohammad Zadeh Azarbaijan Shahid Madani University, Tabriz, Iran As a fermented drink probiotic Doogh [1] can help promote the health of the society. Studying CRP [2] changes as an important inflammatory index that predicts Coronary-Heart Diseases such as arteriosclerosis has received attention in medical and nutrition studies. The present study was carried out to study the effects of 10 week drinking different types of Dough (probiotic and plain) on the changes of liver CRP and other blood factors of male athletes with normal weight.

The research sample of this study included 30 healthy male athlete students with equal BMI characteristics that were divided into two testing groups (15 each) and were homogenized and randomly divided and went through some exercises.

The results of the paired t test showed that drinking plain Doogh resulted in significant reduction of blood's urea (12.5%) and CRP (66.87%) and significant increase of HDL (110.86%; P < 0.05). The probiotic Doogh also resulted in significant reduction of CRP (79.37%) and significant increase of HDL (75.67%). The comparison of the two groups showed that the only statistically significant difference was in the amount of CRP and the reduction effect of probiotic Doogh on CRP was more compared to the plain Doogh (P < 0.05). Also the amount of record changes in the probiotic group (À28 s) was significantly better than the plain Doogh (+2 s). Background and aims: Nutrition has significant effects on human health and diseases. Diabetes is a chronic disease that can be affect by nutritional status. Therefore, monitoring of nutritional status in these patients is one of the main components of prevention and controlling of complications. Therefore, in this study the nutritional status of patients that referred to health center in Songhor city was assessed.

Materials and methods: This descriptiveanalytical study was done on 300 patients with type 2 diabetes (56 AE 11 years old) with no insulin therapy. Anthropometric mesearments and dietary intake assessment were done. FFQ and three 24 recall quessionare were filled with face to face interview. N4 software were used for analysis. Mean AE SD of variables were reported. Background: The aetiology of type 2 diabetes and obesity may involve dysregulation of brain appetite control networks. We explored the impact of systemic insulin resistance, common to both conditions, on the effect of meal ingestion on brain responses to food cues.

Methods: Eight insulin resistant (IR, HOMA2-IR 1.81 AE 0.32) and 14 insulin sensitive (IS, HOMA2-IR 0.56 AE 0.16) non-obese non-diabetic right-handed men were studied twice, 16 min after consuming 50 ml water (fasted) or 630 kcal mixed meal (fed) in random order. Brain responses upon viewing high (HC) and low (LC) calorie food images vs. non-food object (NF) and Gaussian blurred (GB) images presented in a block design paradigm were measured using blood oxygenation level dependent functional magnetic resonance imaging.

Results: The meal reduced hunger (F 20 = 12.27, P = 0.002) and increased fullness (F 20 = 20.34, P < 0.001). Meal ingestion had no specific impact on responses to LC in either group. In contrast, on viewing HC, there were decreased precuneus responses (vs. GB and NF) and superior temporal gyrus/insula responses to HC (vs. NF) in IR subjects, whilst in IS subjects, meal ingestion increased responses to HC (vs. GB) in somatosensory cortex and to all food images vs. GB in putamen/insula, with a trend towards increased dorsolateral prefrontal cortex activity.

Conclusions: Meal ingestion augmented activity in brain regions involved in sensation, interoception and inhibitory control in IS subjects during food cue exposure. By diminishing activity in regions involved in imagery and interoception, insulin resistance may influence central appetite control networks to promote further eating after consuming a satiating meal. Methods: We examined 76 children with obesity in the endocrinological department of University hospital (Minsk) over the year 2011. The number of boys (B) 42 (55.3%), mean AE SD age 13.3 AE 2.5 years; girls (G) 34 (44.7%), mean AE SD age 13.7 AE 3 years (P = 0.6). Ultrasound (u/s) of the abdominal cavity; the levels of insulin (I); total cholesterol (TC); triglycerides (TG); high-density (HDLc), low-density (LDLc), very low-density (VLDLc) lipoprotein cholesterol; atherogenic coefficient (AC); standart oral glucose tolerance test (OGTT) with the calculation of HOMA-IR and CARO indexes; the levels of blood pressure (BP) and body mass index (BMI) were held to all patients.

Results: SDS BMI B was 6.24 AE 2.23, G 5.74 AE 2.35 (P = 0.7). BP more than 95th percentile was in 15 (35.7%) B and 17 (50%) G (P = 0.03). The signs of steatohepatosis were determined in 19 (45.2%)B, 16 (47%)G.

The average levels of TC and TG were in normal limits, gender differenses weren′t noted (P = 0.8), (P = 0.1). The concentration of VLDLc 0.76 AE 0.36 mmol/l (0.3-0.45), 0.73 AE 0.3 (P = 0.9). HDLc B and LDLc B didn′t exceed normal limits in boys and girls (P = 0.2), (P = 0.4). AC B 3.35 AE 0.79 (2-3), G 3.67 AE 0.92 (P = 0.3). Basal and postprandial plasma glucose levels didn′t exceed normal limits regardless of gender (P = 0.6), (P = 0.1).

The levels of I B 38.7 AE 5.5 mU/ml (2.1-22), G 33.3 AE 9.8 (P = 0.3).

HOMA-IR B 8.9 AE 5 (<2.77), G 7.1 AE 2 (P = 0.5), CARO 0.2 AE 0.15 (>0.33), 0.25 AE 0.13 (P = 0.8).

Conclusions: Obesity in children was accompanied with arterial hypertension, steatohepatosis and dyslipidemia. The development of insulin resistance with maintaining the basal and postrandial normoglycemia was noted by conducting OGTT in all patients regardless of gender. Objective: To evaluate the effect of short-term, moderately high-fat diets on body weight, lipid profile and serum leptin levels. The study was undertaken to create a model with an acute metabolic stress without marked obesity.

Design: The laboratory mice were fed either a moderately high-fat diet or control diet. Body weight, energy intake, body composition, and fasting plasma leptin were compared after 3 and 8 week of dietary treatment.

Results: After 3 week, abdominal fat mass was 10% greater in mice fed the high-fat diet than in those fed the control diet (P < 0.05). However, plasma leptin concentrations did not change much in animals fed the high-fat diet. From 3 to 8 week, animals fed the highfat diet gained weight twice the normal diet group and consumed 28 kJ/day more than controls (both P < 0.05). At 8 week, plasma leptin concentrations per unit abdominal fat mass were 20% lower in mice fed the high-fat diet (P = 0.058) and there was a significant negative association between leptin concentrations per unit abdominal fat mass and body weight (r = 0.46, P < 0.05).

Conclusions: Feeding for 8 weeks moderately high-fat diet is associated with lower than expected circulating leptin concentrations, which correlate with a higher body weight. A high-fat diet may therefore contribute to weight gain by reducing leptin secretion in adipose tissue. The significance of these findings will be discussed. Objective: To describe diabetes-related risk factors associated with lower respiratory tract infection (pneumonia) complications among children.

Methods: We obtained claims data on all hospital admissions to acute care hospitals for children patients with diabetes and pneumonia who were aged 1-15 years in Bosnia and Herzegovina and Sarajevo between November 1, 1995, and November 1, 2012 . These data are checked for accuracy and validity by the pulmologist and diabetologist pediatricians that oversee data collection. In both data sets, we linked diabetic kids patient charts to allow for calculation of previous admission and rehospitalization diabetic kids rates with complications of pneumonia in children. Children prescribed more than one antibiotic class contributed to determining the rates of each class. Objectives: To examine the extent to which adherence with multiple concomitant healthy lifestyle traits will be associated with the avoidance of the future development of T2D.

Methods: Five independent cohorts comprising 18,649 men and 20,052 women aged 25-74 and free of diabetes and CVD at baseline were examined in 1982, 1987, 1992, 1997 Objective: To investigate the effects of raloxifene on the insulin sensitivity and lipid profile in insulin sensitive and insulin resistant postmenopausal women.

Study design: This placebo-controlled, double-blind, randomized study involved 64 postmenopausal women aged between 45 and 55 years. All subjects were screened with the insulin resistance homeostasis model assessment (IR-HOMA) and those patients in the lowest quartile (n = 16) were assigned as insulin sensitive and those in the highest quartile as insulin resistant (n = 16). Patients in both groups received either raloxifene hydrochloride (60 mg/day) or a placebo, for a period of 12 weeks. Insulin sensitivity, the serum lipid profile, and anthropometric measurements were established before and after therapy.

Results: Women with the highest IR-HOMA scores were associated with a significantly higher weight, body mass index, waist, and waistto-hip ratio (P < 0.05). Raloxifene significantly reduced the IR-HOMA scores from 5.76 AE 2.91 to 1.93 AE 0.96 (P = 0.02) and modified the lipid profile in insulin resistant patients when compared to the placebo group and those patients receiving raloxifene in the insulin sensitive group.

Conclusion: Raloxifene reduced insulin resistance and modified the lipid profile in insulin resistant postmenopausal women. diseases, smoking, alcohol consumption, the use of sleeping pills and other potential confounders was also gathered. Statistical analyses were done by SPSS ver. 19.

The average age of the participants was 66.5 years old; 24% was reported current pet ownership. Mean HbA1c was 6.9%, BMI was 24, and systolic and diastolic blood pressure was 131 and 75 mmHg respectively. Pet owners were significantly younger and slightly more overweight; and dog owners were much younger and more overweight than cat owners. In unadjusted analyses, dog owners had a lower rate of taking sleeping tablets than cat owners (P = 0.047%), and dog owners were more likely to be smokers than cat owners (P = 0.044%). However, pet ownership was not associated with HbA1c, systolic or diastolic blood pressure, BMI, or the prevalence of diabetic complications.

Conclusions: Our results suggest that pet ownership may be associated with insomnia and smoking habits. However, pet ownership is not independently associated with control of diabetes, obesity and prevalence of diabetic complications. Objectives: To non-invasively assess the muscular oxygenation response using near-infrared spectroscopy (NIRS) and to determine the association between increasing levels of A1C and oxygenation response in subjects with type 2 diabetes.

Materials and methods: Forty-five subjects with uncomplicated type 2 diabetes were categorized into two groups: group I (A1C < 7) and group II (A1C ! 7). NIRS measurement of vastus lateralis was performed at rest and during a symptom-limited maximal treadmill exercise test to determine muscular oxygenation response. At rest and during peak exercise, deoxygenated hemoglobin (deoxy-Hb), oxygenated hemoglobin (oxy-Hb) and total hemoglobin (total-Hb)

were measured with characteristics of light absorptance from NIRS. Muscle saturation (%) was expressed as the ratio of oxy-Hb to total Hb volume, an index of tissue de-oxygenation.

Results: Group I subjects (n = 26 with 15 females, 60.3 AE 5.2 years) were older than subjects in group II (n = 19 with 13 females, aged 56.0 AE 5.9 years). The peak VO 2 was comparable between groups. Significant lower muscle saturation (54.0 AE 9.4% vs. 49.3 AE 11.8%, P < 0.05) and more decline (À8.5 AE 4.0% vs. À11.8 AE 6.1%, P < 0.05) at peak exercise, was noted in Group II. A significant correlation between A1C and decline of saturation (r = À0.361, P < 0.05) was noted in this study, whereas no other significance were demonstrated in deoxy-Hb or oxy-Hb.

Conclusions: This study provided evidence of imbalance of oxygen supply to exercising muscle in asymptomatic and uncomplicated diabetic subjects with elevated A1C levels. The insufficient perfusion occurred before vasculopathy and might develop metabolic impairments even myopathy in diabetic subjects with poor glycemic control. Study design and method: The lifestyle intervention was conducted as a cluster randomized trial (n = 190) in semi-urban setting in Sri Lanka. The intervention group (100) received a family centered lifestyle intervention package from family health workers while the control group (90) received a brief advice from a doctor. Duration of the study was 6-months.

Results: This study has shown effectiveness in reduction in fasting blood glucose (P < 0.01), systolic blood pressure (P = 0.03), diastolic blood pressure (P = 0.01), weight (P = 0.03), added sugar (P = 0.03) and fat consumption (P < 0.01) while improving physical activity (P < 0.01) and insulin sensitivity (P < 0.01) in the intervention group when compared with the control group at follow up assessment. This lifestyle intervention sessions (4) were carried out by family health workers during their routine house visits. Aim: We aimed to compare an experimental type 2 diabetic animal model generated by applying high fat diet combined with single shot of streptozotocin (STZ) at 40 mg/kg bw Sprague-Dawley (SD) rats.

Methods: We generated and selected rats based on fasting glucose, oral glucose tolerance, and %HbA1c. Once sever type 2 diabetic rats were identified, serum proteins were subjected to 2D-DIGE proteomics or comparative 2D-proteomics after phosphorylation or glycation.

Results: Seven protein targets differentially expressed in severe type 2 diabetic rats (sT2D) were identified as albumin, vitamin D-binding protein precursor, and transthyretin, respectively. In terms of serum proteins extracted by affinity columns for phosphorylation and glycation, the affinity of 14 phosphorylated protein targets and 23 glycated protein targets were modified under sT2D condition. Results of the Ingenuity Pathway Analysis (IPA) for those targets indicated that antigen presentation, humoral immune response, and inflammatory response are associated networks highly modified in sT2D group. Kidney and liver damages under those sT2D rats were proposed by IPA and validated by histopathology. polymorphism of patatin-like phospholipase-3 (PNPLA3) has been associated with susceptibility to non-alcoholic fatty liver disease (NAFLD); whereas genetic studies of NAFLD in Asian Indians are not investigated. We investigated the association of polymorphism rs738409 of PNPLA3 with clinical, anthropometric and biochemical profiles in Asian Indians with NAFLD.

Methods: In this case-control study, 162 cases and 173 controls were recruited. Abdominal ultrasound, clinical, anthropometry and biochemical profiles were determined. Fasting insulin levels and value of homeostasis model assessment of insulin resistance (HOMA-IR) was determined. Polymerase chain reaction and restriction fragment length polymorphism of PNPLA3 gene was performed. The associations of this polymorphism with clinical, anthropometric and biochemical profiles were investigated.

Results: Higher frequency of C/G and G/G genotypes of rs738409 polymorphism was obtained in cases as compared to controls (P = 0.04), as a consequence frequency of the minor allele G was significantly higher in cases (P = 0.003). The C/G+G/G genotypes was associated with significantly higher fasting insulin (P = 0.002), HOMA-IR (P = 0.05), alanine transaminase (P = 0.003) and aspartate transaminase (P = 0.04). Using a multivariate logistic regression model after adjusting for age, sex, body mass index and fasting insulin, subjects with G/G genotype showed higher risk of NAFLD (OR, 1.98, 95% CI: 1.43-2.73, P = 0.04). Results: Group 1; before diet: BG-4.3 AE 0.4 mmol/l; 3 months on diet: 6 AE 0.5 mmol/l (6.1-7.8 mmol/l) 4 months: 10.6 AE 2.4 mmol/l (8.6-12.6 mmol/l); histology: marked necrosis and destruction of Bcells on 30-35% islet's surface in 32 islets from 47 (68%); in 32% not marked necrobiosis or without changes; decreasing of insulin content in B-cells: IG-1.22 AE 0.03 (intact-1.89 AE 0.04); histology: without changes; group 2: before diet: BG-4.1 AE 0.5 mmol/l; 3 months on diet + vitamin B6: -BG-5.8 AE 0.6 (5.4-6.3 mmol/l); 4 months diet + vitamin B6: BG-6.2 AE 0.5 mmol/l (5.9-6.7 mmol/l); histology: partial necro-biosis on 15-20% islet surface in 18 islets from 54 (33%); in other 67% -without changes; IG-1.61 AE 0.04 (intact-1.86 AE 0.07).

Conclusions: 2.5 months prolonged administration of vitamin B6 result not marked decreasing of insulin content in B-cells of animals contained on diabetogenic diet and treated by pyridoxin but not protect B-cells of part islets of necrobiosis. Aim of this study: To determine the behavior of oxidative stress markers and mitocondrial dysfuncton in non-proliferative diabetic retinopathy.

Patients and methods: A cross-sectional study was designed with four groups:

Group 1: 5 healthy-volunteer subjects.

Group 2: 12 patients with mild-non-proliferative diabetic retinopathy (NPDR).

Group 3: 18 patients with moderate-NPDR.

Group 4: 22 patients with severe-NPDR.

Serum oxidative stress markers: lipid-peroxidation (LPO measured by malondialdehyde and 4-hidroxyalkenals), nitric oxide (NO metabolites measured by nitrites/nitrates), total antioxidant capacity (TAC), activities of antioxidant-scavenger-enzymes in erythrocytes (GPx glutathione-peroxidase and catalase), and mitochondrial dysfunction (expressed in erythrocyte/platelet membrane fluidity and platelet hydrolytic activity of adenosine-thriphosphatase enzyme; ATPase). The markers were quantified by colorimetric method.

Results: Patients with NPDR had a significant increased serum LPO and NO metabolites levels compared to the group 1. The TAC in patients with NPDR had a significant decreased compared to the control group. A significant increased in the activities of GPx, catalase and ATPase was shown in the experimental groups compared to healthy-volunteer subjects. A significant reduction was shown in membrane fluidity in patients with NPDR.

The results show that oxidative stress and mitochondrial dysfunction are associated to NPDR and its severity. Background: Weight loss after Rous-Y gastric bypass (RYGB) surgery is associated with alteration of body composition and visceral fat mobilization. We analyzed the amount of fat and fat-free mass reduction in order to identify factors that induce more favorable adiposity change.

Methods: Morbidly obese 40 patients (Age = 41 AE 11 years) underwent RYGB between September 2009 and July 2001. Anthropometry, Dual-energy X-ray absorptiometry (DEXA), computed tomography (CT), life style report, and Laboratory test results were registered prior to and 1 year after RYGB.

Results: Follow-up rate was 97.5%. DEXA demonstrated 27.6 AE 18.0 of %FFML (percentage of weight lost as fat-free mass) with reduction of 44% of total fat amount. CT demonstrated higher rate of visceral adipose tissue (VAT) reduction rather than subcutaneous adipose tissue with 2.1 of %dV/%dS (percentage change in VAT vs. SAT). Patients with diabetes mellitus preoperatively showed more favorable visceral fat reduction (%dV/%dS were 2.4 in DM and 1.5 in non-DM) even though they lost more fat-free mass. Objective: Prader-Willi syndrome (PWS), a genetic disorder characterized by childhood-onset obesity, is reported to have elevated levels of adiponectin. The actions of adiponectin are mediated by adiponectin receptors (ADIPORs) which include ADIPOR1 and ADIPOR2. Several cytokines such as adiponectin, TNF-a, and IL-6, have been known to be involved in insulin sensitivity.

Methods: Thirty PWS children (median age 7.1 year, 18 boys, 12 girls) who were being receiving growth hormone (GH) therapy and 32 obese children not receiving GH therapy (median age 9.1 year, 15 boys, 17 girls) were compared. The relative expression of adiponectin, ADIPORs, several proinflammatory cytokines including TNF-a, and IL-6 measured in peripheral blood mononuclear cells (PBMCs) using real-time PCR. Their correlation was analyzed by homeostasis model assessment insulin resistance index (HOMA-IR).

The PWS children showed increased expression of ADIPOR2 (P = 0.02) and decreased expression of IL-6 (P = 0.03) compared to the obese children. There was a significant positive correlation between the ADIPORs and TNF-a (ADIPOR1 vs. TNF-a: r = 0.66, P < 0.001 in PWS, r = 0.80, P < 0.001 in control group; ADIPOR2 vs. TNF-a: r = 0.69, P < 0.001 in obese group). The ADIPORs in the obese group showed significant negative correlation with HOMA-IR (ADIPOR1 vs. HOMA-IR; q = 0.41, P = 0.02, ADIPOR2 vs. HOMA-IR; q = 0.46, P < 0.01).

Conclusion: In result, inflammatory cytokine expression was closely associated with the expression of the ADIPORs in the PBMCs of both the children with PWS and the obese group. ADIPOR2 expression was highly expressed in the PBMCs of the children with PWS.

August to November 2012, homeostasis model assessment of insulin resistance (HOMA-R) were calculated. As a control, subjects were selected, who received oral glucose tolerance test (OGTT) between the same period showing normal glucose tolerance pattern. We used Mann-Whitney U-test and P-values <0.05 were considered statistically significant.

Results: There was no significant difference in sex, age (51.7 AE 13.6 vs. 45.3 AE 13.7), BMI (21.5 AE 2.01 vs. 21.4 AE 2.38), HbA1c (5.48 AE 0.29 vs. 5.31 AE 0.37) and fasting plasma glucose level (93.0 AE 6.99 vs. 90.7 AE 7.61) between the GD group (n = 6: two males and four females) and control group (n = 6: one male and five females). The GD group showed significantly higher HOMA-R than control group (1.49 AE 0.35 vs. 1.01 AE 0.25, P < 0.05).

Discussion: This study showed that GD patients with normal thyroid function had insulin resistance independent of BMI and HbA1c.

Conclusion: GD, even in euthyroid state, is associated with insulin resistance. Introduction: It is still remain uninvestigated the correlation of prebiotics and leptin and ghrelin level in frame of inflammatory process in liver.

Aims and methods: The aim of our study was investigation of nifuroxazide and prebiotic therapy influence on leptin and ghrelin levels in nonalcoholic fatty liver disease patients. Determination of leptin and ghrelin (ELISA), insulin, Il1-β, TNF-a were performed in all patients.

Results: N = 73 patients, 57 female, age 42 AE 7 years, BMI 32 AE 2 kg/m 2 . NAFLD in 97%, NASH in 33% and IR in 58%. Leptin was higher in women (24.0 AE 3.2 vs. 16.2 AE 2.2 ng/dl, P = 0.01), but ghrelin was similar (22.5 AE 2.1 vs. 21.1 AE 3.4 pg/ml). Leptin positively correlated with BMI (r = 0.48, P = 0.01) and ghrelin correlated (r = 0.25, P = 0.05). Ghrelin correlated with glycaemia (r = 0.245, P = 0.030) and correlated to HOMA (r = 0.52, P = 0.03). Both hormones positively correlated to Il1-β and TNF-a (ghrelin: r = 0.39, P = 0.01; r = 0.31, P = 0.01, respectively; leptin: r = 0.48, P = 0.04; r = 038, P = 0.02, respectively). Prebiotic (NPC BIC) consumption significantly decreased ghrelin, insulin, Il1-β, TNF-a level and had no influence on leptin level. The results of liver biopsy (histological examination) and Fibromax test showed, that in patients additionally treated by prebiotics, the progress of hepatic fibrosis was significantly slowly, then in CG (Fibromax test result: F1 vs. F3; P < 0.05).

Conclusion: Our data showed that nifuroxazide and prebiotic therapy decreased inflammation activity and ghrelin level in NAFLD. Cardiology, 2 Physiology, Medical University of Białystok, Bialystok, Poland Aim: Ceramide (C) is considered to be an important factor reducing insulin sensitivity. The aim of the present study was to investigate the effect of reduction of the sphingolipid synthesis in the solid tissues on the level of C, and other bioactive sphingolipids, namely sphingosine-1-pohosphate (S1P) sphingosine (SP), sphinganine (SA) and sphinganine-1-phosphate (SA1P) in different blood compartments.

The experiments were carried out on three groups of male Wistar rats, 230-250 g of body weight fed ad libitum on a commercially available diet: (i) control, (ii)treated with myriocin (an inhibitor of sphingolipid de novo synthesis) and (iii) treated with nicotinic acid (it reduces the level of plasma free fatty acids). The level of the above mentioned bioactive sphingolipis was determined with the use of mass spectrometry.

Results: Both treatments reduced profoundly the level of each of the examined compounds in the plasma. Treatment with nicotinic acid did not affect the level of either compound in erythrocytes but reduced it to a great extend in the platelets. Treatment with myriocin reduced the level of each compound, with the exception of SH, in erythrocytes. The compound reduced the level of each compound in the platelets to the level comparable to nicotinic acid.

1. The level of the examined sphingolipids in the plasma, erythrocytes and platelets depends thoroughly on their supply from solid tissues.

2. Short-term reduction in the plasma free fatty acids level very efficiently reduces the level of bioactive sphingolipids in different blood compartments.

Background: Maternal nutrition plays major role in fetal growth and development. Low birth weight and impaired early postnatal growth predispose the offspring to an increased risk for future chronic diseases such as metabolic syndrome. Stunting in South African children has previously been documented.

The study aimed to investigate effects of maternal nutrition on fetal and early postnatal growth in the population of 78 Black urban pregnant South African women, employing FFQ, ultrasound and anthropometry measurements.

Results: Based on the z-scores (at birth, 3 weeks and 6 month), babies in the current study were born lighter (À0.2) and shorter (À0.05) with larger head circumference (+0.38) in comparison with the 2010WHO child growth standards. The z-scores for both the weight and the lengthfor-age decreased after birth with subsequent increase at 6 months, being significant for length (À0.63, P = 0.003) after birth and for weight (+0.14, P < 0.001) at 6 months. Maternal intake of polyunsaturated fat in early pregnancy and of total protein in late pregnancy were found associated with the fetal head-to-abdomen circumference (β = À0.222, P = 0.048 and β = À0.366, P < 0.001 respectively) and with the lengthfor-age z-score at 3 weeks (β = 0.320, P = 0.010 and β = 0.316, P = 0.009 respectively). Early plant protein intake significantly correlated with fetal growth rate (β = 0.316, P = 0.004).

Conclusion: Low maternal pregnancy intake of protein, namely of plant protein, and of polyunsaturated fat affected fetal linear growth, and resulted in a possible "brain sparing effect" in fetus. Maternal dietary manipulation during pregnancy may therefore affect fetal and postnatal growth and thus modulate the risk of chronic disease later in life. Aims and methods: To assess the efficacy of HB in CP patients in a two centre randomised, double-blind, placebo-controlled, crossover trial.

One hundred and twenty-six patients with chronic pancreatitis were exposed to screening blood tests and test of elastase in stool before randomization to placebo or HB (Buscopan, Boehringer Ingelheim) for 6 weeks. All patients followed the basic treatment scheme include dietary and physical regimen.

Drug effect was optimized by dose titration during weeks 1-2 starting at 30 mg daily, increasing (max 60 mg t.d.s) or decreasing as required. Methods: Brown beans, or white wheat bread (WWB, reference product) were provided as evening meals to 16 healthy young adults in a randomized crossover design. Markers of glucose-and appetite regulation, GLP-2, and markers of inflammation were measured at a following standardized breakfast, i.e. 11-14 h after the evening meals. Colonic fermentation activity was estimated from measurement of plasma short chain fatty acids (SCFA) and breath hydrogen (H 2 ) excretion.

Results: An evening meal of brown beans, in comparison with WWB, lowered blood glucose (À15%, P < 0.01)-and insulin (À16%, P < 0.05) responses, increased satiety hormones (PYY 51%, P < 0.001), suppressed hunger hormones (ghrelin: À14%, P < 0.05), and hunger sensations (À15%, P = 0.05), increased GLP-2 (8.4%, P < 0.05) and suppressed inflammatory markers (IL-6 À35%, and IL-18 À8.3%, P < 0.05) at a subsequent standardized breakfast. Breath H 2 (141%, P < 0.01) and plasma SCFA (propionate 16% and isobutyrate 18%, P < 0.05) were significantly increased after brown beans. Results: The present study revealed significantly lower levels of adiponectin in diabetic children compared to the controls (10.1 AE 1.57 vs. 11.23 AE 1.14 lg/ml). It also showed significantly increased carotid intima media thickness (cIMT) in diabetic children compared to the control group (0.55 AE 0.08 vs. 0.43 AE 0.04 mm). There was also positive correlation between the mean cIMT and age of the patient, age of onset of Diabetes mellitus, HbA 1 C, and BMI measurements in diabetic children. There was negative correlation between mean cIMT and adiponectin level.

Conclusions: Subclinical microvascular disease in type 1 diabetes mellitus begins early in diabetic children, which emphasize the importance of early detection and control of vascular risks in diabetic children. The study also suggests that adiponectin may prove to be useful marker of cardiovascular risks, and potential therapeutic target for risk prevention in diabetics. in 22 overweight and obese individuals (7F/11M; age 33 AE 10 years, BMI = 30 AE 5 kg/m 2 ). An intra-venous glucose tolerance test, hyperinsulinaemic-euglycaemic clamp and circulating markers relevant to AGE signalling were performed before and after each diet.

Results: The high AGE diet was fivefold higher in AGE content than the low AGE diet. The high AGE diet reduced insulin sensitivity by À1.1 mg/kg/min (95% CI, À2.0 to À0.1; P = 0.03) while the low AGE diet improved insulin sensitivity by +1.0 mg/kg/min (+0.1 to +1.9; P = 0.03). The overall change in insulin sensitivity was 2.0 mg/ kg/min (1.0-3.1, P = 0.001). The change insulin secretion was correlated inversely with the change in plasma AGE (CML) concentration (r = À0.52, P = 0.02). To investigate the level of transforming growth factor (TGFbl) and basic fibroblast growth factor (bFGF), non-specific markers of inflammation: interleukin-6 (IL-6), tumor necrosis factor-a (TNF-a) in patients with coronary heart disease (CHD) depending on the presence of DM2.

The study involved 38 people: one group À18 patients with CHD without carbohydrate metabolism disorders, two group -20 patients with DM2 and CHD. Blood samples were taken from the cubital vein and the aorta during coronary angiography. .03)], as in arterial and venous blood in the presence of CHD and DM2 (P < 0.05).

1. Availability DM in patients with CHD was associated with significant increase in the level of TGFb1, IL-6. These observation reflect the effect of chronic hyperglycemia on the restructuring of the connective tissue and the vascular wall.

2. TGFb1 direct correlation with lipid markers confirms the relationship of connective tissue disorders and lipid metabolism in the pathogenesis of atherosclerosis. Obesity can be induced with high fat diets (HFD) and is associated with inflammation in white adipose tissue (WAT) and liver. The factors that control the early metabolic responses to HFD and that trigger inflammatory gene expression are only poorly understood. A time-resolved analysis of differentially expressed genes in expanding adipose tissue of mice (12 weeks HFD feeding) identified specific clusters of lipid metabolism-related genes and inflammation-related genes with similar time expression profiles. Subsequent promoter analysis of the clustered genes revealed that specific master regulators (among which Fos, Esr1, Hnf4a, Jun, Ppara, Pparg, Nr1 h2/Lxrb, Nfkb, Srebf1 and 2, Sfpi1, Smad2, Sp1) orchestrate metabolic adaptations and early inflammatory responses in WAT. Some of these transcription factors (Esr1, Jun, Fos, Pparg, Sp1) have a dual role and regulate the adjustment of lipid metabolism as well as expression of inflammatory genes such as Cxcl1/KC, Ccl5/Rantes, complement factors, ASC, granzyme A Ccl5/Rantes, Ccl6, Ccl7/Mcp3. Subsequent analysis of corresponding livers revealed comparable molecular responses on the level of transcription factors. More specifically, many master regulators identified in WAT were also involved in the liver response to HFD as demonstrated by analysis of hepatic target gene expression in conjunction with transcription factor binding activity analysis. Our findings support the view that metabolic and inflammatory processes are interlinked in WAT and liver, and that responses to HFD are controlled in a similar way on the transcription factor level. Distortions of the mechanisms which control metabolic homeostasis in these organs may thus also affect their inflammatory tone. Aim: To investigate the effects of iptakalim, a novel SUR2B/Kir6.1type ATP-sensitive potassium channel opener, on endothelial dysfunction induced by insulin resistance (IR) and to determine whether iptakalim improved IR associated with hypertension in fructose-fed rats (FFRs) and spontaneously hypertensive rats (SHRs).

Methods: The levels of endothelial vasoactive mediators and eNOS protein expression were determined usingELISAs or Western blot. In both FFRs and SHRs, hyperinsulinemic-euglycemic clamp was used to evaluate IR states.

1. Cultured human umbilical vein endothelial cells (HUVECs) incubated with the PI3-kinase inhibitor wortmannin (50 nmol/l) and insulin (100 nmol/l) induced endothelial dysfunction characterized by reduced release of NO and expression of eNOS protein, and increased production of ET-1. Pretreatment with iptakalim (0.1-10 lmol/l) could potently prevent the endothelial dysfunction by increasing NO production and inhibiting ET-1 release.

2. In FFRs, the levels of SBP, fasting plasma glucose and insulin were elevated, whereas the glucose infusion rate (GIR) and insulin sensitive index (ISI) were significantly decreased, and the endothelium-dependent vascular relaxation response to ACh was also impaired. These changes could be prevented by administration of iptakalim for 4 weeks. The imbalance between serum NO and ET-1 was also ameliorated by iptakalim.

3. In 2-4 month-old SHRs (IR was established at the age of 4 months), oral administration of iptakalim for 8 weeks significantly ameliorated hypertension and increased the GIR to the normal level.

Conclusion: Iptakalim could protect against IR-induced endothelial dysfunction, and ameliorate IR associated with hypertension, via restoring the balance between NO and ET-1 signaling.

M. Ste z pie n 1 , A. Ste z pie n 2 , R.N. Wlazeł 3 , M. Paradowski 3 , M. Banach 4 , J. Rysz 2

Material and methods: Patients (F 34, M 20) were divided according to BMI into three groups: A-obesity I 0 (n = 25); B-obesity II 0 (n = 14) and C-obesity III 0 (n = 15) and into other four groups: females and males and patients treated with statins or fibrates (n = 31) or untreated (n = 23).

Results: Leptin was significantly higher in group C compared to group A and B [57.2 (31.9-94.9) vs. 34.3 (12.5-49.0) ng/ml, P < 0.01 and vs. 30.8 (26.0-50.2) ng/ml, P < 0.05 respectively]; hs-CRP were higher in group C than in group A [3.6 (2.3-5.0) vs. 1.7 (1.1-2.6) mg/ l, P < 0.01]. Adiponectin and leptin were higher in females [18.0 (12.9-26.7) vs. 10.9 (6.4-14.6), P < 0.0001 and 49.6 (37.1-63.1) vs. 16.9 (7.9-30.4), P < 0.0001, respectively]. Resistin, hs-CRP and IL-6 were higher in untreated patients' group [1.04 (0.86-1.31) vs. 0.83 (0.70-1.04) ng/ ml, P < 0.05; 3.0 (1.8-5.0) vs. 1.7 (1.1-3.5) mg/l, P < 0.05 and 14.5 (10.3-19.9) vs. 8.9 (8.9-13.1) pg/ml, P < 0.01 respectively].

Leptin positively correlated with hs-CRP in the whole population (r = 0.318, P < 0.05), in treated patients' group (r = 0.434, P < 0.05) and with TNF-a in group C (r = 0.506, P = 0.05).

Conclusions: Leptin may be associated with chronic inflammation in obese hypertensive patients. Serum leptin and adiponectin levels are sex dependent. Hypolipemic treatment has impact on chronic inflammation and resistin. Lean body mass in genetically obese (ob/ob) or anorectic/cachectic subjects is severely reduced. Similar outcomes of two different pathological states prompted us to wonder if leptin, adipokine well known from its control of appetite interacts with myogenesis. Apparently, recombinant leptin (100 ng/ml) stimulated DNA synthesis in mononuclear myoblasts together with the increase of T 202 /Y 204 P-ERK1/2 protein expression levels. Additionally, leptin reduced cell viability and muscle fiber formation from C2C12 mouse myoblasts. Detailed short-and long-term examination with the use of metabolic inhibitors revealed that both JAK/STAT3 and MEK/MAPK but not PI3-K/AKT/GSK-3beta signaling pathways were stimulated by leptin, and that STAT3 (Y 705 P-STAT3) and MEK (T 202 /Y 204 P-ERK1/2) control these effects. In turn, insulin promoted PI3-K-dependent phosphorylation of AKT (S 473 ) and GSK-3beta (S 9 ) and insulin overruled leptin-dependent inhibition of myogenic differentiation in PI3-K-dependent manner. GSK-3beta might play dual role in muscle development. Insulin-induced effect on GSK-3beta (S 9 P-GSK-3beta) facilitated myotube formation. In contrast, leptin through MEKdependent manner led to GSK-3beta phosphorylation (Y 216 P-GSK-3beta) with resultant retardation of myoblast fusion. In summary, to some extent opposite effects of insulin and leptin on skeletal muscle development emphasize the importance of intercellular signaling between adipose tissue and skeletal muscle. Insulin and leptin determine how muscle mass is gained or lost, respectively.

Objective: Obesity is linked to both increased metabolic disturbances and increased adipose tissue macrophage infiltration. However, whether macrophage infiltration directly influences human metabolism is unclear. The aim of this study was to investigate if there are obesity-independent links between adipose tissue macrophages and metabolic disturbances.

Methods: Expression of macrophage markers in adipose tissue was analyzed by DNA microarrays in the SOS Sib Pair study and in patients with type 2 diabetes and a BMI-matched healthy control group.

Results: The expression of macrophage markers in adipose tissue was increased in obesity and associated with several metabolic and anthropometric measurements. After adjustment for BMI, the expression remained associated with insulin sensitivity, serum levels of insulin, C-peptide, high density lipoprotein cholesterol (HDL-cholesterol) and triglycerides. In addition, the expression of most macrophage markers was significantly increased in patients with type 2 diabetes compared to the control group.

Conclusion: Our study shows that infiltration of macrophages in human adipose tissue, estimated by the expression of macrophage markers, is increased in subjects with obesity and diabetes and associated with insulin sensitivity and serum lipid levels independent of BMI. This indicate that adipose tissue macrophages may contribute to the development of insulin resistance and dyslipidemia. Hp gene has been demonstrated to be a major determinant of susceptibility to CVD and in the development and progression of DN. Hp2 allele is defective in its ability to protect against oxidative stress CVD and DN. We decide to assess the intracellular localization of iron in the PCTcells and its potential toxicity in the development and progression of DN.

Methods: Wild type C57B1/6 mice have only an Hp 1 allele. We genetically engineered a murine Hp 2 allele and inderted it in the murine Hp locus by homologous recombinatiobn. We induced DM, by STZ for 5 days, at 10 weeks of age We assessed lysosomal membrane integrity, redox-active iron in kidney lysosomes.

1. Increased iron-rich deposits in lysosomes of PCT cells in Hp 2-2 DM vs. Hp 1-1 DM (65 AE 4% of all lysosomes) compared with Hp 1-1 DM mice (41 AE 4% of all lysosomes, P < 0.05).

2. Intralysosomal redox-active iron concentrations are markedly increased in Hp 2-2 DM mouse kidneys lysosomes of Hp 2-2 DM mice (0.56 AE 0.07 lmol/l) as compared with those from Hp 1-1 DM mice (0.23 AE 0.14 lmol/l, P = 0.036).

Lysosomal membrane lipid peroxides are increased in Hp 2-2 DM proximal tubule cell (P < 0.0001). Vitamin E supplementation resulted in a 45% reduction in lysosomal redox-active iron in Hp 2-2 DM mice (P < 0.04).

Conclusion: A novel mechanism whereby the Hp genotype may predispose to renal injury in the setting of DM Via increased Iron deposition in the lysosomes of PCT. Purpose: We aimed to use other less hazardous route of insulin injection to prevent pharmacokinetic problems of sc Insulin and find out response categories in diabetics and prediabetic patients. Besides, FBS and HbA1C are markers for treatment evaluation; we wondered whether AITT could be a marker of residual pancreatic activity regeneration or decelerating progression of type II diabetes.

Methods: Five hundred diabetic and 65 patients with impaired glucose tolerance were enrolled to this trial. Three hours after breakfast they receive 10-50 unit equivalents of Insulin into the external auditory cannel. Blood glucose level was measured every 15 min for 3 h. This was repeated 6 months later in both groups; while 35 prediabetic patients received some sorts of therapy while the other 30 patients remained on their previous lifestyle. AUC and best fit curve were evaluated by partial mathematical integration.

Results: Six different prototypic curves were extrapolated from diabetic patients with the possibility of excellent theoretic explanations about etiology and multifactoriality, lifestyle change, drug(s) of choice and prognosis. Parallel to this prediabetic patients showed comparable curves. The area under curve in treated prediabetics showed a small but significant reduction compared to untreated (217 vs. 226, P = 0.04).

Conclusions: As shown elsewhere the area under curve after an auditory insulin tolerance test is a nice marker in diabetes response evaluation and prognosis and an excellent marker for progression to diabetes and effectiveness of treatment in prediabetics (<215 compared to >235). Introduction: Type II DM is generally regarded as a progressive disease with control of BS becoming more difficult with time. We wondered whether optimal therapy with "mega-treatments" that can let the pancreas rest could reverse the disease.

Materials and methods: Thirty five patients received optimal doses of Insulin through the auditory channel for 6 months. Contributing factors such as obesity, anxiety, H. pylori infection and reduced physical activity were treated appropriately. At beginning and every month they were evaluated by way of auditory insulin tolerance test after 24 h of drug vacation. The general appearance of the curve, the partial integration of it and the overall area under curve were compared monthly.

Results: AUC declined from a mean of 289-257 from first to sixth month meaning reduced insulin resistance (P < 0.03). This decline was steady during the whole 6 months and minor variations in different patients were not significant. With mathematical calculation it seems very unlikely that this decline becomes asymptotic so that on extension of the curve for 3-5 years at least 30% of the patients eventually fall into the nondiabetic range with AUC under 450. (P < 0.1)

Although different definitions exist for DM, auditory insulin tolerance test might be functionally more illuminating. These results are in concordance with available literature that denotes early aggressive treatment might be better. We add to this notion that early aggressive treatment can possibly reverse type II diabetes. Physiology, Universidad de Guadalajara, Guadalajara, Mexico

Background: C-reactive protein (CRP) is an acute stage protein whose serum levels become raise by infection or because an undergoing metabolism disruption. Our group has found CRP variable serum levels in hypertensive patients that course with obesity and dyslipidaemia. The CRP polymorphism rs1205G>A has been associated to lowered CRP serum levels in autoimmune diseases. The role of C-reactive protein (CRP), a marker and mediator of inflammation, in the pathogenesis of metabolic syndrome and its complications such as non-alcoholic fatty liver disease (NAFLD) remains to be elucidate. In this study we investigated whether increased levels of human CRP itself can promote increase of glucose and lipid metabolism disorders associated with metabolic syndrome.

Materials and methods: Spontaneously hypertensive rats (SHR) with transgenic expression of human CRP gene under apolipoprotein E promoter (SHR-Tg) in age 1-year and age matched non-transgenic SHR controls were used. Both groups were fed a high fructose diet (60% cal fructose) for 2 weeks. Parameters of insulin resistance and oxidative stress were measured by commercially available kits.

Results: Transgenic expression of CRP was associated with significant increase of serum triacylglycerols (0.84 AE 0.05 vs. 0.64 AE 0.037 mmol/l, P < 0.05) and insulin levels (P < 0.05), markedly decrease in insulin stimulated 14 C-glucose incorporation into muscle glycogen (174 AE 8 vs. 278 AE 35 nmol/g/2 h, P < 0.05), reduced serum adiponectin (2.4 AE 0.3 vs. 4.3 AE 0.6 mmol/l, P < 0.05), and microalbuminuria (P < 0.005). Transgenic expression of CRP was associated with increased liver triglyceride concentrations (7.62 AE 0.9 vs. 4.30 AE 0.57 lmol/g, P < 0.05), decreased liver glutathione peroxidase activity (P < 0.01) and reduced glutathione concentration (P < 0.01). Liver lipidperoxidation were elevated in SHR-Tg rats: TBARS (P < 0.01).

Conclusion: Overexpression of human CRP induced insulin resistance, oxidative stress and liver steatosis in SHR rats. These finding indicate that chronically inflammation might directly contribute to the pathogenesis of metabolic syndrome and NAFLD. One of the most topical issues of modern pediatrics is obesity in children and adolescents, which has a tendency to doubling every three decades in almost all countries.

The aim of our research was to investigate the fatty acid composition of the blood in children with obesity.

Patients and method: We investigated 50 children aged from 7 to 15 years, divided into two groups: Group I -25 children (64% boys and 36% girls) who are overweight or obese (BMI 29.68 AE 1.21 kg/ m 2 ), group II -25 persons (85% boys and 15% girls) with normal body weight (BMI 19.45 AE 0.05 kg/m 2 ).

Research methods: Quantitation of omega-3 and omega-6 polyunsaturated fatty acids, determination of the total amount of fatty acids, the total content of eicosapentaenoic and docosahexaenoic acids by gas chromatography with mass selective detection and determination of the omega-3 index (the ratio of the sum of eicosapentaenoic and docosahexaenoic acids to total content of fatty acids in %).

Results: There was a direct correlation between the value of BMI and the increasing of omega-3 index and the omega-6 PUFAs in children with obesity, while for the children with normal body weight the connection of BMI with the change of the fatty acid composition of blood was not obtained.

Thus changes of the quantitative and qualitative fatty acid composition of blood in obesity children and adolescents had multidirectional nature and require further dynamic study.

A. Kopp, A. Schmid, M. Mü ller, A. Schä ffler Internal Medicine I, University Hospital Regensburg, Regensburg, Germany Introduction: Proteins secreted by adipocytes (adipokines) play an important role in the pathophysiology of type 2 diabetes mellitus and the associated chronic and low-grade state of inflammation. It was the aim to characterize the anti-inflammatory potential of the new adipokine, C1q/TNF-related protein-3 (CTRP-3), which shows structural homologies to the pleiotropic adipokine adiponectin. In earlier studies, recombinant CTRP-3 has been shown to inhibit LPS and lauric acid induced release of pro-inflammatory cytokines and chemokines dose-dependently in monocytes and adipocytes.

Methods: For in vivo analysis, male C57BL/6 mice were treated by intraperitoneal LPS administration for 2 h. Anti-inflammatory effects were tested by pre-treatment (30 min) with CTRP-3. After killing, epididymal adipose tissue was collected for cytokine mRNA expression analysis (real-time RT-PCR) and blood for measurements of circulating cytokine levels (ELISA).

The anti-inflammatory potential previously found in vitro is also seen in LPS-treated C57BL/6 mice. Animals pre-treated with CTRP-3 have lower levels of inflammatory cytokines such as Interleukin-6 (IL-6) and Macrophage Inflammatory Protein-2 (MIP-2).

Furthermore, mRNA expression of IL-6 and MIP-2 in the epididymal adipose tissue is significantly reduced by CTRP-3.

Conclusion: CTRP-3 acts anti-inflammatory in cells and tissues that are involved in obesity and type 2 diabetes mellitus. Therefore, it might be an interesting drug target in treating obesity-related chronic inflammation. Objective: The aim of the study was to assess the burden of some metabolic syndrome (MS) risk factors in Polish adolescents from two less-urbanized regions as well as the relationship between abdominal obesity, dyslipidemia and hypertension incidence.

The study involved 299 adolescents aged 13-18. All subjects lived in two less-urbanized regions of Poland (small towns and villages in the central and north-eastern regions). The concentration in blood of triglycerides (TG) and HDL-cholesterol (HDL-C), as well as systolic blood pressure (SBP) and waist-to-height ratio (WHtR) were determined. Using logistics regression, an odds ratio (OR) of the incidence of high WHtR ( ! 90 percentiles), high TG ( ! 150 mg/dl), high SPB (>90percentiles) and low HDL-C (boys: <40 mg/dl; girls: <50 mg/dl) was calculated.

Results: High WHtR was found in 4% of adolescents, high TG in 5%, high SPB in 11% and low HDL-C in 14%. Adolescents with abdominal obesity (WHtR ! 90 percentiles) had an OR rated as high SPB at 4.24 (95% CI = 1.19-15.14; P < 0.05), an OR rated as high TG at 3.31 (95% CI = 0.65-16.93; P > 0.05) and an OR rated as low HDL-C at 2.49 (95% CI = 0.72-8.62; P > 0.05) in comparison to adolescents with normal WHtR (between 10 and 90 percentiles). Adolescents from north-eastern Poland had an OR rated as high SPB at 0.08 (95% CI = 0.02-0.26; P < 0.05) and an OR rated as high TG at 0.06 (95% CI = 0.01-0.46; P < 0.05) in comparison with the central region (OR = 1.00).

Conclusions: Dyslipidemia and hypertension were the main metabolic syndrome risk factors in Polish adolescents from less-urbanized regions, especially in central Poland. The risk of hypertension rose over 4 times in adolescents with abdominal obesity. Objective and aims: As employment has become more sedentary in nature, there is a potential for more working individuals to be at risk of developing the metabolic syndrome (MetS). Physical activity (PA) is recommended for prevention of such chronic conditions. This study investigates self-reported PA and presence of MetS in the workplace as part of the established "Prosiect Sir Gâr" initiative in South Wales, UK.

Methods: Two hundred and twenty-one male steel workers (SW) and 92 male local health board (LHB) employees were screened and their data analysed. Anthropometric data, blood pressure and self-reported physical activity (GPPAQ) were all recorded alongside obtained blood samples which were subsequently analysed for high-density-lipoprotein cholesterol (HDL-C). Presence of the MetS was determined based on the following IDF criteria: central obesity (waist circumference: ! 94 cm), reduced HDL-C levels (<1.03 mmol/l) and either systolic ( ! 130 mmHg) or diastolic ( ! 85 mmHg) hypertension.

Results: The proportion of males diagnosed with MetS was comparable between worksites (SW: 25.8% vs. LHB: 26.1%; P = 0.96) despite the SW reporting being more physically "active" or "moderately active" than their LHB counterparts (92.8% vs. 67.3%; P < 0.001). Central obesity, reduced HDL-C levels and diastolic hypertension were comparable between worksites (P > 0.05), although systolic hypertension was higher amongst LHB employees (64.1% vs. 39.8%; P < 0.001). However, more SW were found to be clinically obese (33.2% vs. 25.3%; P = 0.02). Introduction: Diabetes mellitus is often a silent disease and its prevalence is increasing rapidly worldwide. Nonalcoholic steatohepatitis is certainly the less estimated complication of diabetes in frequency and severity. The aim of our study was to evaluate the prevalence of steatohepatitis and to identify its clinical and biological risk factors.

Materials and methods: The prospective transversal study was comparative between 120 type 2 diabetics (group 1) and 60 healthy people (group 2) with no chronic hepatopatic diseases, no alcoholism and no intake of hepatotoxic drugs. All have benefit from a clinical exam, biological assay and abdominal echography seeking for steatohepatitis.

Results: Group 1 has statistically a higher frequency of android obesity, insulin resistance, steatohepatitis, high blood pressure, hypertriglyceridemia, chronic inflammation and silent myocardial ischemia in comparison with group 2. The steatohepatitis was present in 69% of patients vs. 24.6% of healthy people; P < 0.001. Also, patients from group 1 with steatohepatitis (group 1a) had a body mass index (BMI), waist circumference, a percentage of fat mass, a level of triglycerides, of alanine aminotransferase (ALAT) higher than diabetics without steatohepatitis (group 1b), with a risk of metabolic syndrome multiplied by three. With multivariate analysis, we found that in group 1, ALAT and BMI were directly associated to steaohepatitis.

Our study notifies the frequency of steatohepatitis in diabetics. It could be prevented and treated by loss of weight and regular physical activity in order to reduce insulin resistance. Objectives: Vascular dysfunction and complications are the major cause of mortality in diabetic patients. Arterial stiffness has been known as a useful predictor of atherosclerosis and lipoprotein level is one of major risk factors of atherosclerosis. To investigate the association of lipoprotein level with arterial stiffness, we studied the vascular characteristics of patients with diabetes.

Methods: Fifty patients (male:female = 26:24, mean age 63.3 AE 11.3 years), with diabetes and without coronary artery disease, were enrolled and evaluated. All patients have been taking angiotensin receptor blocker or angiotensin converting enzyme inhibitor. Arterial stiffness was assessed by measuring the carotid-radial pulse wave velocity (PWV). The cardiovascular risk factors, including body mass index, lipid profile, pulse pressure, C-reactive protein, flow-mediated vasodilatation (FMD) were also measured.

The PWV was significantly higher in patients with metabolic syndrome than those without metabolic syndrome (1654 AE 127 vs. 1485 AE 131 cm/s, P = 0.03) in diabetic patients. Multivariate analysis revealed that HDL cholesterol level, body mass index and metabolic syndrome were highly associated with PWV (P = 0.01). Pulse pressure, CRP, HDL cholesterol level and metabolic syndrome were significantly associated with FMD.

Conclusion: In diabetic patients, metabolic syndrome and HDL cholesterol level were highly associated with arterial stiffness and FMD as in non-diabetic patients. Objective: Our goal was to compare a weight loss diet with high caloric intake during breakfast to an isocaloric diet with high caloric intake at dinner.

Research design and methods: Obese women (BMI 32.4 AE 1.8 kg/m 2 ) with metabolic syndrome were randomized into two isocaloric (~1400 kcal) weight loss groups, a breakfast (BF; 700 kcal breakfast, 500 kcal lunch, 200 kcal dinner) or a dinner (D) group (200 kcal breakfast, 500 kcal lunch, 700 kcal dinner) for 12 weeks. Anthropometric measurements, oral glucose tolerance test (OGTT) and meal tests were performed.

The BF group showed greater weight loss (À8.7 AE 1.4vs. À3.6 AE 1.5 kg) and waist circumference reduction (À8.5 AE 1.9 vs. À3.9 AE 1.4 cm) compared with the D group. Although fasting glucose, insulin and ghrelin were reduced in both groups, fasting glucose, insulin and HOMA-IR decreased significantly to a greater extent in the BF group. Mean triglyceride levels decreased by 33.6% in the BF group, but increased by 14.6% in the D group. After OGTT, the extent of reduction of AUCglucose and AUCinsulin was greater in the BF (À22% and À58%, respectively) compared with the D group (À15% and À30%, respectively). In response to meal challenges, the overall daily AUCglucose AUCinsulin, AUCghrelin and mean hunger scores were significantly lower, whereas mean satiety scores were significantly higher in the BF group.

Conclusions: An Isocaloric diet with switched caloric intake during breakfast or dinner differentially influences weight loss and metabolism. High-calorie breakfast with reduced intake at dinner might be a useful alternative for the management of obesity and metabolic syndrome. Centre for Biomedical Sciences, Cardiff Metropolitan University, Cardiff, UK Introduction: We have reported that exercise alters markers of monocyte/macrophage polarisation in peripheral polymorphonuclear cells, decreasing the M1:M2 marker ratio. Since the M2 phenotype is considered "anti-atherosclerotic", this may be beneficial in reducing cardiovascular disease risk. This study aimed to determine whether exercise specifically promotes M2 marker expression in purified monocytes, and to elucidate the molecular mechanisms involved in this process.

Methods: Twenty-six healthy, sedentary individuals (43 AE 10 years) participated in a low-intensity exercise programme (walking, 45 min, thrice weekly for 8 weeks). Peripheral monocytes were isolated using magnetic immuno-separation, and gene expression was determined by RT-PCR. Serum lipids, insulin and glucose levels were measured by standard biochemical methods. The presence of serum PPARc ligands was determined by gene reporter assay.

Results: During the 8-week exercise programme, PPARc ligand generation and COX-2 gene expression were increased [1.5 AE 0.6-and 3.9 AE 2.5-fold, respectively (P < 0.05)]. Similarly, PPARc-dependent genes (e.g. CD36) and M2 marker (e.g. Dectin-1) expression increased (2.5 AE 1.8-(P < 0.05) and 1.8 AE 0.7-fold (P < 0.1), respectively), while exercise-associated increases in pro-inflammatory M1 markers were blunted [e.g. MCP-1 0.7 AE 0.8-fold (P < 0. Conclusion: Low-intensity exercise may prime monocytes for differentiation into M2-polarised macrophages (possibly via PPARcdependent events) and contributes to improved insulin sensitivity. This data supports exercise prescription for the prevention and management of inflammatory-linked diseases such as atherosclerosis and diabetes. quantify and determine possible differences and their correlation with plasma leptin and ghrelin levels. For this study, 40 male rats were underwent a case control study. The fecal bacteria composition was investigated by PCR-denaturing gradient gel electrophoresis and realtime qPCR. In restricted eaters, we have found a significant increase in the number of Proteobacteria, Bacteroides, Clostridium, Enteroccoco and Prevotella and a significant decrease in the quantities of Actinobacteria, Firmicutes, Bacteroidetes, B. coccoides-E. rectale group, Lactobacillus and Bifidobacterium with respect to unrestricted eaters. We also found a significant positive correlation between the quantity of Bifidobacterium and Lactobacillus and plasma leptin levels, and a significant and negative correlation among the number of Clostridium, Bacteroides and Prevotella and plasma leptin levels in all the experimental groups. Furthermore, plasma ghrelin levels were negatively correlated with the quantity of Bifidobacterium, Lactobacillus and B. coccoides-Eubacterium rectale group and positively correlated with the number of Bacteroides and Prevotella. In conclusion, nutritional status and physical activity may have an impact on the gut microbiota composition affecting the diversity and similarity. The significant increase in the quantity of lactic acidproducing bacteria and butyrate-producing bacteria that would also implied an increase in their bacterial metabolites in the exercise rats without dietary restriction could be responsible of the plasma ghrelin levels decrease found in these rats which affect the food intake and the body weight. The aim of this study was to evaluate the relation between weight gain classified according to IOM recommendations and macronutrient intake.

Methods: A cross-sectional study was conducted on 400 women hospitalized in the maternity during August-September 2010. Prepregnancy weight was self-reported. Gestational weight gain and weight rate gain was determined by means of the weight registered in the maternity before delivery. Nutrient intake during pregnancy was evaluated with a 127-item food frequency questionnaire.

Results: On average, protein provided 15.79% (95%CI: 15.55-16.03), carbohydrate 53.75% (95%CI: 53.09-54.42) and fat 31.69% (95% CI: 31.11-32.28) of the total energy intake. There was a positive and consistent association between energy intake and maternal weight gain among the pregnant women (P = 0.041). The percent of energy from protein was associated with maternal weight gain rate (P = 0.022). Women with a weight gain higher then media + SD had a higher intake of protein compared with those with medium (P = 0.04) and lower (P = 0.03) weight rate gain. No significant differences regarding fats and carbohydrates intake was noted. Similarily, women with weight gain above the IOM recommendations had a significant higher protein intake compared with those with a lower weight gain (P = 0.019).

Conclusion: A strong association was found only between protein intake and weight gain in the studied sample. A dietary pattern analyses would clarify the relation with weight gain during pregnancy. Excessive weight gain and obesity before pregnancy was associated with large for geastational age newborns and prematurity. The aim of the study was to analyse the relation between maternal anthropometric indicators and Apgar score.

A cross-sectional study was conducted on 400 women hospitalized in the maternity during August-September 2010. Multiple pregnancy and obstetrical pathology represented exclusion criteria. Self-reported weight was used to estimate prepregnancy BMI. Gestational weight gain was determined by means of the weight registered in the maternity before delivery. Apgar score was determined by the neonatologist immediately after birth.

Results: In the sample studied, 5.4% newborn had an Apgar score lower than 8, thus indicating neonatal distress. There weren't noticed significant differences according to weight gain during pregnancy. Among the mothers with newborns which had an Apgar score lower than 8, 18.18% had a weight gain lower, 40.91% higher and 40.91% within the IOM′ s recommendations. However, excessive prepregnancy weight was associated with neonatal distress (P = 0.036): 9.37% of women with prepregnacy BMI ! 30 kg/m 2 ; 6.25% of the normal weight and 0% of the underweight gave birth children with low Apgar score.

Conclusion: Prepregnancy excesive weight was associated with neonatal distress, strenghtening the importance of achieving an ideal weight before conception. Patients and methods used: Six obese women (age 28.6 AE 5.4 years, BMI 39.2 AE 4.7 kg/m 2 ) had fasting metabolic measurements taken via indirect calorimetry before and after 8 weeks of a low starch diet. Respiratory gases were collected for 30 min using standard procedures in order to determine resting metabolic rate (RMR), respiratory exchange ratio (RER), and macronutrient oxidation (carbohydrate and fat). A paired sample t-test was used to evaluate significant mean differences from pre-to post-diet.

Results: After 8 weeks on a low starch diet, subjects lost an average of 9.1 AE 1.9 kg despite the fact that this was not designed as a weight loss diet. RER decreased from 0.86 AE 0.05 to 0.76 AE 0.02 (P = 0.007) from pre-to post-diet measurements. Further, carbohydrate oxidation decreased from 13.7 AE 5.3 to 5.5 AE 2.6 g/min (P = 0.009), and fat oxidation increased from 4.6 AE 1.7 to 7.5 AE 1.1 g/min (P = 0.013). Changes in RMR were not significantly different. Background: Weight loss improves insulin resistance and hyperandrogenism in obese women with PCOS but is unnecessary in lean women with PCOS; however, meal timing and composition may influence glucose metabolism and hyperandrogenism.

Objective: To investigate the effects of two isocaloric diets with different meal timing on insulin resistance and hyperandrogenism in lean women with PCOS.

Methods: Sixty lean women with PCOS were randomized to one of two 1800 kcal isocaloric diets with different meal timing: The number of young adults with MS is steadily increasing, but MS in children mainly incomplete according to the pediatricians' reports. So it was suggested that there are some flaws in the diagnostic criteria that lead to MS hypodiagnosis.

Hypothesis: Using the clarified criteria may improve quality of MS detection in children.

Methods: In 208 obese adolescents the MS components were analyzed by IDF and clarified criteria. Additionally abdominal obesity was analyzed by BMI SD and waist to height ratio; glucose intolerance by OGTT and HOMA-IR; dyslipidemia by fasting TG, LDL, HDL, TC (according to percentiles by NCEP for children); blood pressure by The Fourth Report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescents.

Results: The total number of detected MS components by IDF vs. clarified ones: "0" in 9.13 AE 3.96% by IDF; "1" in 40.87 AE 6.82% vs.

6.77 AE 3.48% (P < 0.001); "2" in 21.15 AE 5.65% vs. 6.77 AE 3.48% (P < 0.001); "3" -11.06 AE 4.33% vs. 20.83 AE 5.63% (P = 0.013); "4" in 12.98 AE 4.66% vs. 34.90 AE 6.61% (P < 0.001); "5" in 4.81 AE 2.97% vs. 30.73 AE 6.39% (P < 0.001).

Conclusion: Using clarified criteria improves the quality of MS detection in children, which corresponds to a MS global concept of identifying high cardiovascular risk group. 

Aim: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among women of reproductive age. PCOS is connected with ovulatory disorders, oligomenorrhea, hyperandrogenism, infertility, and an increased miscarriage rate, and is frequently associated with insulin resistance (IR). Multiple factors in the follicular fluid affect the fertilization and early embryonic development, including in women with PCOS. The aim of this study is to evaluate the predictive value of follicular adiponectine regarding pregnancy outcomes in PCOS vs. non PCOS patients who underwent in vitro fertilization.

Material/methods: We designed a prospective study. Group 1: (n: 59) non PCOS and Group 2: (n: 27) PCOS patients according to Roterdam criteria were included the study. Basal ovarian reserve parameters, endometrial thickness, follicular luid adiponectine levels, clinical and laboratory IVF outcomes, pregnancy rates were studied.

Results: There were statistically significant differences in used gonadotropine dose, total oocyte number, MII oocyte number in non PCOS vs. PCOS groups (P: 0.001). But there were no statisticaly significant differences between the groups according to follicular fluid adiponectine levels (P > 0.05). We evaluated the correlation with adiponectine and IVF outcomes as endometrial thickness, MII oocytes number, fertilization rates and pregnancy rates, but there were no statisticaly significant correlation (P > 0.05).

We could not find differences of follicular fluid adiponectine levels in the PCOS vs. non PCOS groups. Although we could not find correlation with adiponectine and pregnancy rates, further investigations with larger numbers of cases are needed to clarify this subject. Hypothesis: Using the clarified criteria may improve quality of cardiovascular risk (CVR) evaluation in pediatric group.

Methods: Comparative MS components detection in obese children by IDF and clarified criteria as well as prognostic value relative to the myocardial remodeling and diurnal blood pressure patterns. Results: It was established that the IDF criteria (>3) are highly specific (Sp = 0.96), but low sensitive (Se = 0.28) with deterioration negative predictive value (NPV = 0.29). Clarified criteria (sum score >4) correspond to higher sensitivity (Se = 0.86) without loss of specificity (Sp = 0.96).

Conclusion: Using the clarified criteria improves screening sensitivity and helps determine exact CVR. Obesity is a global problem associated with numerous health issues includes type2 diabetes. Bariatric surgery provides sustained weight loss and partial or complete diabetes resolution. MicroRNAs (approximately 22 nucleotides long) are post transcription regulators, which play important roles in conditions such as obesity and diabetes. The aim of this study is to investigate whether microRNA profile is changed by bariatric surgery in postprandial state and if the altered microRNA expression could contribute to long term post bariatric surgery benefits. Both bariatric and sham-operated rats were given 5 g of food 40 min before sacrifice. Total plasma and tissue RNA from post-operative bariatric and sham operated rats were isolated and the microRNA component was examined. Principle component analysis clearly showed that bariatric surgery dramatically changed circulating microRNA expression. Correlation between microRNA expression and metabonomics data indicated that certain plasma metabolites (for example, ketone bodies) are highly correlated. We also investigated liver microRNA expression, microRNA targeted mRNA and metabonomics profile. MiRNA regulated key metabolic enzymes and receptors involved in the TCA cycle, pentose phosphate pathway, gluconeogenesis and AMP-activated protein kinase pathway. Liver alanine, pyruvate and glucose levels were altered in bariatric compared to sham-operated rats. In summary, our data show that bariatric surgery changed both circulating and tissue microRNA expression. We suggest that these alterations contribute to post bariatric surgery benefits by regulating key metabolic enzymes and receptors. The purpose of the study was to investigate serum concentrations of the asymmetric (ADMA) and symmetric dimethylarginine (SDMA) and high sensitivity C-reactive protein (hs-CRP) in hyperuricemic adolescents.

Patients and methods: The study group consisted of 58 hyperuricemic patients aged median 16.15 years. The control group (C) contained 27 healthy individuals with normal serum uric acid (SUA) level. Serum ADMA and SDMA were measured by immunoenzymatic ELISA commercial kits and were expressed in lmol/l. Serum hs-CRP was determined using nephelometric method (Behring) and expressed in mg/l, SUA was measured on the Hitachi apparatus.

Results: Hyperuricemic patients showed increased SDMA (median: 0.54 Q1-Q3 (0.44-0.63) lmol/l vs. controls 0.51 Q1-Q3 (0.39-0.53) lmol/l, P < 0.01). Serum ADMA values did not differ between two estimated groups (P > 0.05). The positive correlation was observed between ADMA and SUA (r = 0.27, P < 0.01) and SDMA with SUA and hs-CRP concentrations (r = 0.37, P < 0.05; r = 0.48, P < 0.01, respectively).

We demonstrated that in adolescents with hyperuricemia increased serum SDMA, but not ADMA levels were observed. No significant differences for ADMA and SDMA between hypertensive and normotensive patients with hyperuricemia were found. The large, multicentre, prospective studies are needed to confirm if SDMA might play a role in chronic inflammation in patients with hyperuricemia. Objective and aim: Supplementation of n-3 polyunsaturated fatty acids expresses anti-diabetic effect by enhancing insulin sensitivity and improving lipid metabolism. In this study we wanted to assess whether supplementation of n-3 can improve antioxidant status, preferably PON1 level, in the serum of type 2 diabetic (T2DM) patients.

Subjects and methods: Twenty T2DM patients (12 females, eight males, age 53.15 AE 5.85 years, BMI 27.97 AE 1.61 kg/m 2 ) were randomized to intake 4 g marine oil (1.2 g EPA and DHA) during 12 weeks, after 6 weeks washout period. Anthropometry, blood pressure measurements and fasting blood samples for metabolic parameters (glucose, HbA1c, insulin, cholesterol, HDL-cholesterol, triglycerides), hsCRP, as well as oxidative stress enzymes [PON-1, catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)] were obtained before and after treatment period.

Results: Serum PON-1 activity response was increased by 123% from 22.07 to 49.43 (P < 0.05) as well as SOD from 39.56 to 48.20 (P < 0.05) by EPA and DHA supplementation. It was associated with serum n-3 PUFA increase by 152% (P < 0.01). There were no changes in anthropometry, glycemic control, insulin resistance index, the levels of total cholesterol, triglycerides and parameter of chronic inflammation (hsCRP). Only hdl-cholesterol increased after supplementation, from 1.04 to 1.25 mmol/l, with borderline significance (P = 0.05).

Conclusion: Supplementation with 1.2 g n-3 PUFA improves antioxidative status, PON1 activity and SOD level, and repairs dyslipidemia in T2DM patients. Aim of this study: To determine the behavior of endogenous antioxidants markers and metabolic profile in non-proliferative diabetic retinopathy Patients and methods: A cross-sectional study was designed with four groups: Group 1: five healthy-volunteer subjects. Group 2: 12 patients with mild non-proliferative diabetic retinopathy (NPDR). Group 3: 18 patients with moderate NPDR. Group 4: 22 patients with severe NPDR. Serum endogenous antioxidants markers (determined by UA and B), glycemic profile (measured by fasting plasma glucose and hemoglobin A1c), lipid profile (measured by total colesterol, triglycerides, high and low density lipoproteins-cholesterol), arterial pressure, renal profile (urea and creatinine analysis). Serum-markers were quantified using enzymatic-colorimetric methods.

Results: Patients with NPDR had a significant increased serum lipid profile, glycemic profile and renal profile levels compared to the control group. UA and B levels showed increased trend in retinopathy groups compared with group 1. Introduction: Bone tissue has been recognized as an endocrine organ. Recently it′s been found that levels of osteocalcin, a protein produced by osteoblast, is associated with glucose metabolism and lipids in human being. Experimental studies showed associations between adiposity and levels of osteocalcin, however in the adolescent population is not quiet elucidated.

Objective: To establish the association between adiposity indexes and serum levels of osteocalcin in children and adolescents.

Materials and methods: In this study we included 276 children and adolescents participants of the project "Health Worker Cohort Study" Adiposity index were establish through BMI, waist circumference and DEXA. The total concentration of osteocalcin was determined by chemiluminescence. Through multiple lineal regression we evaluated the association between osteocalcin levels and the adiposity index.

Results: Prevalence of overweight and obesity was 33.4% abdominal obesity 23.5%. It was observed a negative correlation between BMI, percentage of fat mass, waist circumference (P < 0.05). Independently of the adiposity index included in the model, have obesity increases the risk of presenting low levels of osteocalcin (OR: 2.09; 95% CI: 1.39-4.70, P < 0.05) and adolescents with higher percentage of fat mass have five times more risk than adolescents with less fat mass of present low levels of osteocalcin (OR: 5.12; 95% IC: 1.89-13.84, P < 0.05).

Conclusions: Adolescents with higher adiposity have more probability of have low levels of osteocalcin. Objective: To evaluate the association between physical activity (PA) with presence of burnout syndrome (BS) and its three dimensions: emotional exhaustion, despersonalization and low personal accomplishment in health workers and educational sector.

Methods: A sample of IMSS workers, INSP and UAEM was obtained. After signing informed consent subjects answer a lifestyle questionnaire that included a PA questions and the Burnout scale designed by Maslach. Anthropometric measurements were performed by previously standardized personnel (concordance coefficient of 0.83-0.9), with conventional stadiometer and calibrated scales previously Tanita brand. We determined body mass index (BMI) based on the criteria of the Center for Disease Control (CDC). PA was considered sufficient to perform 30 or more minutes of daily PA. The data analysis was performed in the Stata statistical package version 9.

Results: From the analysis of 1992 health workers and educational study participants′ Cohort Health Workers. "Female sex predominated by 67%. The mean age was 39 AE 9 years. Seven out of ten participants performed <30 min of PA per day. A trend of higher prevalence of BS in those performing <30 min of PA per day was showed, to perform ! 30 min of PA reduces the likelihood of developing BS in a 31% according to Grunfeld criteria and 65% according to the Ramı´rez's criteria.

Conclusions: To perform at least 30 min a day is a protective factor to avoid the presence of BS, but only three out of ten participants to perform AF. Aims: With research showing that more than one third of this current generation of Australian teenagers likely to become obese in adulthood, the need to arm our children with the skills to maintain a healthy weight has never been so urgent. The Need for Feed cooking program has been developed for teenagers to improve their ability to prepare and cook healthy food, and boost their knowledge about nutrition and support them to develop healthy habits for the future.

Methods: Need for Feed is delivered using school facilities and home economics teachers, but is delivered outside of school hours in an informal and engaging format. The program, which delivers 20 h of tuition, focuses on improving participants' food preparation and cooking skills, budgeting and meal planning, basic nutrition knowledge, and attitudes and behaviours associated with healthy eating.

Results: Evaluation demonstrates that participants improve in both skills and confidence in preparing and cooking healthy food, improve their knowledge of healthy eating guidelines and make tangible changes to their eating habits through increased consumption of fruit and vegetables, and reduced consumption of sugary soft drinks, cakes, chocolate and potato chips.

Conclusion: While the factors contributing to the obesity epidemic and growing rates of type 2 diabetes are complex, the importance of arming the community with skills and confidence in cooking at home is being increasingly recognised. This program has shown that teenagers can develop the necccessary skills to support healthy eating through a targeted and engaging cooking education program. Postprandial hyperglycemia is an early defect of type 2 diabetes and the one of primary antidiabetic targets. The therapeutic approach for the treatment of postprandial hyperglycemia can be achieved by inhibiting a-amylase and a-glucosidase, key enzymes for starch digestion and further glucose absorption. In this study, the inhibitory activities of microalgal fucoxanthin against a-amylase and aglucosidase were determined as well as antidiabetic effect to induce differentiation in 3T3-L1 preadipocytes using Oil Red-O staining. Fucoxanthin exhibited weak inhibitory activity against rat-intestinal aglucosidase, while strong inhibitory activity against pancreatic aamylase in a concentration-dependent manner with IC 50 values of 4.75 mmol/l and 680 lmol/l, respectively. Microalgal fucoxanthin significantly increased glucose uptake in 3T3-L1 cell by 31.3% at 5 lmol/l. Fucoxanthin inhibited lipid accumulation during adipocyte differentiation of 3T3-L1 cell and no cytotoxicity was recorded for preadipocytes up to 20 lmol/l. These results suggested that fucoxanthin may be useful approach for the prevention of type 2 diabetes by inhibiting carbohydrate-hydrolyzing enzymes. University of Vermont, Burlington, VT, USA Aims: We compared the effects of ad libitum low-fat, high-fiber and low-carbohydrate diets on caloric intake, anthropometry, and cardiometabolic risk markers in adults with the metabolic syndrome.

Methods: Twenty-three women and men (32-62 years) with the metabolic syndrome completed a randomized crossover comparison of two 4-week diets. All meals (Low-Fat, High-Fiber: 55-60% carbohydrate, 20-25% fat, 15-20% protein, 38-48 g fiber/day; Low-Carb: 15-20% carbohydrate, 55-60% fat, 25-30% protein, 9-11 g fiber/day) were prepared by a research dietician and consumed ad libitum.

Results: Caloric intake was lower on Low-Carb (2007 AE 383 vs. 2177 AE 398 kcal/day; P = 0.002). Only Low-Carb reduced body fat (À1.02 AE 1.57%; P = 0.006) and tended to produce greater weight loss (À2.7 AE 1.9 kg vs. À1.7 AE 1.6 kg; P = 0.068). Both diets reduced fasting insulin (À17.3% to À21.7%; P < 0.05) and non-HDL cholesterol (À5.0% to À5.6%; P < 0.05). Low-Fat, High-Fiber reduced serum cholesterol (À6.1%), while triglycerides (À34.1%) and VLDL cholesterol (À23.3%) were reduced on Low-Carb (all P < 0.05). Plasma FFA were elevated on Low-Carb (+16.7%; P = 0.018). Although flow-mediated dilation (FMD) was unchanged after Low-Fat, High-Fiber (9.5 AE 1.3% vs. 10.4 AE 1.5%; P = 0.609), a trend for reduced FMD was observed after Low-Carb (10.1 AE 1.4% vs. 7.2 AE 1.1%; P = 0.061), producing a significant diet interaction (P = 0.012). Introduction: Better insulin schedules are needed to prevent hypoglycemic attacks.

Materials and methods: BS/time curve was plotted in a series of 500 diabetic patients with and without treatment. The best fit curve was used by partial integration and mathematical extrapolation. The first and second derivatives of these curves were plotted by the use of special software and modified MATLAB. Points of major mathematical and lifestyle interest were marked within the curve for correlation. Daily variations were also registered. Based on mathematical results, 52 patients received auditory insulin and were compared with themselves and other patients under the same dose of insulin.

Results: Although the BS/time curve and its first derivative are completely chaotic due to daily activity and unplanned meal intake the second derivative has some regularities and in regard to cutting the X axis every Lambda minutes (37 min ( 51 min under 95% confidence interval. This shows that the innate glucose reducing potential of the body is exhausted after this time giving us the opportunity to treat with lower doses at these points. With this schedule patients needed less insulin and showed extremely better BS control.

Conclusion: Preventing superimposition of innate BS reducing potency and external drugs can give rise to smoother BS control and less hypoglycemic attacks. Besides, this can also be exploited in the management of prediabetic patients. Introduction: Type II DM is generally regarded as a progressive disease with control of BS becoming more difficult with time. We wondered whether optimal therapy of the disease with "megatreatments" that can let the pancreas rest could reverse the disease.

Materials and methods: Ten patients received optimal doses of Insulin through the auditory channel for 3 months. They were previously on oral hypoglycemic agents and relatively in good control. Their BS were measured daily for 2 months during the oral regimens before and after the auditory instillation. These two sets of measurements in addition to other subjective and objective parameters such as weight, sense of well being and HbA1C were compared.

Results: Insertion of a strict insulin regimen in the form of auditory insulin instillation between two intervals of the same oral hypoglycemic agents (sandwich effect) causes a significant improvement in glycemic control and possibly needed dose.

Conclusion: As fairly good controlled patients were selected there is probably no doubt that more strict control of BS can reverse type II diabetes progression. We have postulated that rest of the pancreas in the form of auditory insulin or strict diet can restore normal pancreatic response in a later occasion. Based on a mathematical model of extrapolation we suggested that strict BS control for 3-5 years with a mean BS of 80 mg/dl and possibly no attacks above 162 mg/dl can reverse type II diabetes in at least 30% of the patients. The diabetes epidemic could be controlled with effective prevention programs. These programs require accurate identification of subjects at risk. Unfortunately, current prediction models have several deficiencies and are not being used. We present results comparing a novel model using association rule mining (ARM) against three traditional models applied to data from the electronic medical record (EMR).

We used a cohort of 53,393 adults Olmsted County, MN, residents without diagnosis of diabetes who visited Mayo Clinic between 1999 and 2004. We collected 29 pertinent baseline characteristics available as structured data in the EMR. We assessed 5-year incidence of diabetes; a total of 2349 subjects developed diabetes during the follow up period. We used C-Statistic (mean AE SD) to compare risk of diabetes estimated by Framingham Score, San Antonio Index, FINRISK Index and our ARM model.

Results: Some variables used by traditional risk models were not available as structured data in the EMR. They were imputed as the mean of the variable as measured on the population in which the index was developed. With the exception of FINRISK, all indices preformed similarly. The C-Statistic for Framingham Score, San Antonio Index, FINRISK Index and ARM model was 0.75 AE 0.01, 0.76 AE 0.0.02, 0.68 AE 0.02 and 0.77 AE 0.02, respectively.

Conclusions: Our novel risk model using ARM compares favorably to traditional models and has the advantage that it does not depend on a limited number of risk factors. This model is implementable at the point-of-care or population-based care where EMR is in use, assuring universal utilization and improving implementation of preventive management. This study aimed to compare the effects of two types of interventions: diet vs. diet plus Sea buckthorn pulp oil intake, in childhood obesity. The results were focused on FMD and IMT values and risk factors for endothelial dysfunction.

Two groups of matched age, sex and BMI obese children (n = 36, 8-18 years old) and 30 controls were enrolled. The measurements in the obese children were done before and after interventions: diet (low caloric, lipid, sugar intake for 2 months) or diet plus Sea buckthorn pulp oil intake (800 mg/day for 2 months). Ultrasounds were used for FMD and IMT measurements and colorimetric and ELISA methods for biochemical parameters.

Obese children vs. lean ones had significantly increased values for IMT, leptin, apoB/apoA1 ratio, fasting C peptide, C reactive protein (CRP), and reduced values for FMD and adiponectin. In the obese group treated only with diet, a light reduction in weight was observed, but no modification of atherosclerotic markers or metabolic improvement. In the obese group treated with diet and Sea buckthorn pulp oil, FMD and adiponectin were unchanged, while IMT was significantly reduced (P < 0.03), together with the other atheroscleroric risk factors: fasting C peptide (P < 0.049), leptin (P < 0.05).

In conclusion, this study shows that Sea buckthorn pulp oil intake has beneficial effects by preventing atherosclerosis in obese children. 

Aims: As the rates of type 2 diabetes continue to skyrocket across the globe, public health measures to reduce obesity appear to have limited success. While social marketing campaigns for obesity prevention have their place amongst a suite of strategies, their impact can be limited due to the gap between the campaign messages and individual's ability to identify opportunities for change in their own life. In Queensland, a group of peak health agencies are working together to bridge that gap.

Methods: Swap It, Don′t Stop It is an Australian social marketing campaign promoting simple, everyday food and activity changes people can make to improve overall health. A multi channel health promotion and public relations strategy has been implemented to integrate the key messages of the Swap It Don't Stop It campaign with grassroots healthy lifestyle opportunities to support individuals to make changes. This has been achieved by harnessing the collective actions of the non-government health sector to promote clear and consistent obesity prevention messages and by implementing a communications strategy that has connected community and stakeholders with tangible opportunities for healthy lifestyle changes at the local level.

Outcomes: Through collaborative action amongst a broad network of service providers, the national campaign messages have been amplified through community events, radio, print and television stories that have highlighted examples of personal success and provided information that has inspired Queenslanders to make small steps towards better health and reduce the risk of type 2 diabetes and other chronic diseases. 

Background and aims: Proposed changes to GDM diagnostic criteria are anticipated to increase diagnosis rates leading to rising demand for support during pregnancy. Lack of awareness of risks associated with GDM acts as a barrier to healthy lifestyle adaptation and postpregnancy screening (1, 2) . The You2 program delivers a range of strategies to support women at diagnosis, facilitate behaviour modification (2) and re-enforce importance of post pregnancy screening.

Methods: Newly diagnosed women and their support networks are educated about GDM, risk reducing behaviours and the health care system through a purpose built website and a suite of print resources. Specific resources were developed for at risk groups including Indigenous Australians and women from non-English speaking backgrounds. Women are encouraged to join a national register to receive post pregnancy screening reminder letters and text messages in conjunction with regular newsletters containing family-friendly information on healthy lifestyle behaviours and screening. Nominated GP's are also sent screening reminders to prompt women to attend screening.

Results: Engagement with the website and newsletters is high, screening reminders evaluated positively with focus groups and participants indicated that they intended to attend their post natal screening.

Conclusion: You2 delivers a multi-strategy approach that engages and supports women at diagnosis and re-enforces the importance of screening and behaviour modification during and post pregnancy. Family members and peers were recognised as important sources of support and educated to encourage screening and behavioural changes. These low-cost interventions can help reduce prevalence or morbidity in women affected by GDM associated type 2 diabetes. 

However Smoking cessation has many benefits for smokers, but the most important challenge for smoking cessation is withdrawal symptoms during the first days and months of cessation which can be an important reason for unsuccessful in the smoking cessation process.

However, many methods are available to help quit smoking, but Acupuncture is used for the treatment of nicotine dependency with the aim of reducing of withdrawal symptoms experience.

Therefore, the aim of this study is to determine the role of Acupuncture in success at quit smoking in the Iranian samples.

Methods: One hundred and thirty-two men smokers who were ready to quit smoking were participated in the study. The participants were divided to two groups by randomized sample method. One group was for acupuncture and another group was for acupuncture in shame points. The mean age of smokers was 42 AE 65 years. All participants followed for 1 year and the quit rate evaluated in 1, 6, 12 months of the study.

The results show, while 22.4% in case-control and 19.2% in control group could quit smoking in the first month of study; but in 12 the month of the study 14.8% in case-control and 8.6% in control group were at quit rate.

The quit rate short and long term in case group was higher than control group. Therefore, physicians should play an active rate in control of smoking by ensuring and counseling and use of various pharmacology and non pharmacology methods for increase quit rate. Panjab University, 2 PGIMER, Chandigarh, India Introduction: 1,2-dimethylhydrazine (DMH)-induced colon carcinogenesis in rats is a reliable model to explore molecular mechanism involved in progression of colorectal cancer from adenoma to carcinoma sequence.

Objective: To study the transcriptional and translational levels of various genes involved in tumorigenesis pathway of DMH induced rat model.

Methods: Two groups of chow-diet-fed, male Sprague-Dawley rats, aged 10 weeks (n = 12/group) were fed a normal diet and injected subcutaneously for two time durations of 10 and 20 weeks DMH at a dose of 30 mg/kg body weight/week or with Ethylene diamine tetraacetic acid (EDTA)-saline. Macroscopic and microscopic analyses were performed for confirmation of adenoma and carcinoma. mRNA expression of NFkB and Caspase-3 genes were determined by Real-Time PCR. Immunohistochemistry was also performed for expression of above genes.

Results: Gross examination of 10 weeks DMH treated colon showed polypoid lesions and multiple tumors were formed after 20 weeks DMH treatment. Histopathological studies confirmed the colon carcinogenesis from adenoma-carcinoma sequence by type of tumor, degree of differentiation and invasion of tumors. In adenomatous and carcinomatous colonic tissues, mRNA expression of NFkB was increased by 5.8 and 8.2 fold respectively, whereas expression of Caspase-3 was reduced by 13.2 and 4.5 fold respectively. Immunohistochemistry studies showed the increase expression of NFkB and reduced expression of Caspase-3 in colonic tissues of DMH induced rat model as compared to controls.

The observed data strongly implicates that DMH induced colon carcinogenesis altered the apoptotic machinery by modulating the expression of various genes involved in this pathway. Objective: Identify anthropometric indicators that present the greatest correlation in the diagnosis of some metabolic syndrome components in adolescents and its association with gender, age, and family history.

Methods: Cross-sectional study with 487 adolescents between 16 and 19 years of age of a public high school in the Mexico City. BMI was used to diagnose overweight and obesity according to cut-offs proposed by the International Obesity Task Force. Waist circumference (WC) and waist-to-height ratio (WHR) were used as fat distribution indexes.

Results: 52.9% of the students were male. The prevalence of overweight and obesity were 22.9% and 4.4%. There were association between overweight-obesity and the average values of WC, WHR, and blood pressure (P < 0.001). The correlation between Waist circumference and BMI and waist-height were the strongest (r = 0.823 and r = 0.845, respectively).

We recommend using WC and WHR in clinical practice as simplified indicators to predict risk of metabolic syndrome in Mexican adolescents.

C. Saely, A. Muendlein, A. Vonbank, K. Geiger, P. Rein, H. Drexel

Background: The novel adipocytokine chemerin has been suggested to be linked to insulin resistance and to the metabolic syndrome (MetS). Its association with coronary artery disease (CAD) is unclear. We hypothesized that chemerin is associated with both angiographically determined CAD and with the MetS.

We measured serum chemerin in 498 patients undergoing coronary angiography for the evaluation of established or suspected stable CAD; the MetS was defined according to NCEP-ATPIII criteria; significant CAD was diagnosed when coronary stenoses ! 50% were present.

Results: Chemerin was higher in MetS patients (n = 150) than in subjects without the MetS (184 AE 77 vs. 150 AE 62 ng/ml; P < 0.001). It did not differ significantly between patients with significant CAD (n = 250) and those without significant CAD (P = 0.327). When both, MetS and CAD status were considered, chemerin was higher in MetS patients both among those who had significant CAD (182 AE 80 vs. 152 AE 60 ng/ml; P = 0.002) and among those who did not have significant CAD (187 AE 73 vs. 148 AE 63 ng/ml; P < 0.001); it did not differ significantly between patients with significant CAD and subjects without significant CAD among MetS patients (P = 0.248) nor among subjects without MetS (P = 0.263). Analysis of covariance (ANCOVA) showed that a large waist circumference as well as elevated trigylcerides were independent predictors of elevated serum chemerin (F = 12.5; P < 0.001 and F = 8.5; P = 0.004).

We conclude that chemerin is significantly associated MetS but not with angiographically determined CAD. The overall association of chemerin with the MetS is carried by its association with visceral obesity and elevated triglycerides. Objective: Resistin is a novel adipocyte-secreted hormone proposed to link obesity with diabetes. The role of resistin gene polymorphism in insulin resistance and metabolic syndrome is controversial till date. The present study was attempts to investigate the relationship between resistin gene polymorphism with circulating resistin level, metabolic risk factor and insulin resistance in north Indian population.

Methods: This is a case-control study; total 455 healthy subjects were selected for the study. Out of which 225 (age 31.91 AE 6.05 years) were with metabolic risk factor and 230 age matched control (age 30.96 AE 7.01 years) were without metabolic risk factors. We estimated Homeostatic Model Assessment (HOMA) index, circulatory resistin, and lipid profiles. The genotyping of resistin-C420G were carried out using PCR-RFLP method digested with BbsI restriction enzyme.

Results: Homozygous mutant genotype (CC) (CC v/s CG + GG) (P = 0.03: OR = 1.61: 95% CI = 1.06-2.47) and mutant allele (G) (P = 0.01: OR = 1.53: 95% CI = 1.11-2.08) of the 420C/G polymorphism was significantly less frequently observed in the control population as compared to study group. Furthermore, on dividing the subjects into two groups according to the absence (Resistin -1) or presence (Resistin-2) of the mutant G allele, significantly high levels of resistin (P = 0.006, OR = 1.90, 95%CI = 1.22-2.98) and insulin resistance (P = 0.03, OR = 1.46, 95%CI = 1.22-2.98) were observed in resistin-2 group as compared to resistin-1 group.

Conclusion: Our results suggest that the 420 C/G mutation of the resistin gene is likely to play an important role in the development of metabolic syndrome and metabolic abnormalities. King George's Medical University, Lucknow, 2 RIMS, Saifai, Etawah, India Objective: Adiponectin has been shown to be an insulin-sensitizing hormone and negatively associated with components of metabolic syndrome. Present study was attempted to investigate the Adiponectin polymorphism in Metabolic syndrome and Insulin Resistance.

Methods: The Adiponectin T45G and G276T polymorphism has been studied in 305 females with Metabolic Syndrome and 310 control without Metabolic Syndrome according to NCEP ATP III criteria, 2001. Circulating Adiponectin and Leptin levels were determined by sandwich ELISA method and Insulin resistance by the homeostasis model assessment (HOMA) index. The polymorphism of Adiponectin 45 T/G and 276 G/T gene were determined by PCR-RFLP method.

Results: Significant difference were found for circulating leptin level except adiponectin level (20.21 AE 10.85 vs. 29.56 AE 13.46), and in metabolic risk factors among metabolic syndrome and without Metabolic syndrome females. Homozygous mutant genotype (GG) (TT vs. TG + GG) (P = 0.0169: OR = 1.55: 95% CI = 1.09-2.19) and mutant allele (G) (P = 0.0080: OR = 1.49: 95% CI = 1.12-1.99) of the -T45G gene and mutant allele (T) (P = 0.0278: OR = 1.36: 95% CI = 1.04-1.77) of the G276T polymorphism were significantly less frequently observed in the control population as compared to study group.

The results of the present study concluded that the mutation of the adiponectin 45 T/G and 276 G/T gene might play a important role in obesity associated metabolic syndrome and metabolic abnormalities except insulin resistance, glucose level and insulin levels in the north Indian women due to mutation of the adiponectin gene is associated with decreased adiposity which is protective one for metabolic syndrome Design: Cross-sectional study of patients with good (excess body mass index lost (EBL) >60%) and poor weight loss (EBL 50%) >12 months after RYGB.

Material and methods: Sixteen patients with good weight loss and 17 patients with poor weight loss were included in the study. The patients underwent dual energy x-ray absorptiometry scan, indirect calorimetry and a 9-h multiple-meal test with measurements of glucose, insulin, total bile acids (TBA), glucagon-like peptide (GLP)-1, peptide YY3-36 (PYY), cholecystokinin (CCK), ghrelin, neurotensin, and pancreatic polypeptide (PP) as well as assessment of early dumping and appetite.

Results: Suppression of hunger was more pronounced in the good than the poor weight loss group in response to the multiple-meal test (P = 0.006). In addition, the good weight loss group had a larger release of GLP-1 (P = 0.009) and a greater suppression of ghrelin (P = 0.037) during the test, whereas the postprandial secretion of CCK was highest in the poor weight loss group (P = 0.005). PYY, neurotensin, PP and TBA release did not differ. Early dumping was also comparable. Differences in resting energy expenditure between the groups were entirely explained by differences in body composition.

Conclusion: Favorable meal-induced changes in hunger and gut hormone release in patients with good compared to poor weight loss support the role of gut hormones in the weight loss after RYGB. Background: The objective of this study is to explore changes in the vascular tone over the endothelial, neurogenic and myogenic frequency ranges during a contralateral cold pressor test by performing the wavelet analysis of skin temperature fluctuations and to compare the results obtained in healthy subjects and in patients with metabolic syndrome (MS) and type 2 diabetes.

Methods: Thirteen adults with type 2 diabetes aged 45-65 years (average diabetes duration of 10.6 AE 1.3 years) and 14 adults with MS aged 36-62 years participated in this pilot study. The control group included practically healthy men and women aged 39-60. The lowfrequency fluctuations of skin temperature in the appropriate frequency ranges, registered during contralateral cold test, were used as a characteristic reflecting the mechanisms of vascular tone regulation.

Results: The response to cold pressor test in patients with type 2 diabetes and with MS differs essentially from that of healthy subjects. Patients with MS show changes in the amplitude of skin temperature fluctuations similar for patients with type 2 diabetes in the endothelial range.

The endothelial dysfunction occurs in the pre-clinical stage of diabetes and manifests, in particular, as a disturbance of the endothelial part of vascular tone regulation. With progression of the glucose metabolic disorders the pathological process is worsened due to violation of the neurogenic vasodilatation mechanisms. Fetal metabolic programming states that early life nutrition is implicated with the risk of later disease development and both underand overnutrition during gestation might predispose individuals to develop obesity or diabetes later in life. Obesity operations called "gastric bypass" operations have shown unexpected involvement of the small intestine in diabetes pathophysiology as it in most cases result in a complete resolution of the diabetes before weight loss. Therefore we hypothesize that the small intestine is a subject of metabolic programming and that this programming can predispose for diabetes development. Twin-pregnant ewes where fed a Normal, a Low or a High diet during the last 6 weeks of gestation and the twin lambs where fed either a Conventional or a High fat, High carbohydrate (HCHF) diet during the first 6 months of life. Feeding challenge tests were performed on all lambs and some were slaughtered with collection of intestinal tissue for qPCR. The HCHF diet increased the blood level of glucose, insulin and TG and increased the intestinal expression of a range of genes involved in growth, vascularization as well as digestion and absorption. The maternal Low and High diet had effects on gene-expression, however the results vary between genes. These observations suggest that small intestine function has been programmed by the late-gestation Low or High diet at gene expression level, whereas the physiological metabolic functions has mainly been affected by the HCHF diet at such a young age. Further investigations on the long-term effects of early nutrition are required. Background: Liposuction is considered as the treatment for the metabolic complications of obesity. The aim of this study was to evaluate the effect of abdominal liposuction on leptin and interleukin-6 (IL-6) expression in adipose tissue and serum concentration.

Material and methods: The study included 32 consecutive patients (25 females, seven males) aged 38 AE 10 years with BMI 25 AE 3 kg/m 2 , non-diabetic, apparently healthy, who underwent liposuction in Mandala Beauty Clinic in Pozna n, Poland. The patients were examined clinically and the blood was withdrawn for routine laboratory tests (hematology, glucose, lipids, coagulation). Leptin (R&D) and high sensitivity IL-6 (hsIL-6) (Abcam) were analyzed in the supernatant of adipose tissue homogenate and in serum, by means of ELISA.

Results: The expression of leptin in adipose tissue positively correlated with white blood cells count before liposuction (rS = 0.425, P = 0.0431). It was also higher (P = 0.0397) in patients with BMI ! 25.0 (0.64; 0.40-1.199 ng/mg protein; median, interquartile range) than in subjects with BMI < 25.0 (0.38; 0.26-0.67 ng/mg protein). Following liposuction, after 1 month, serum leptin levels were lowered in smokers (18.03; 10.22-22.28 ng/ml), when comparing with baseline (28.14; 17.00-34.87 ng/ml). Serum level of the adipokine, both before (rS = 0.535, P = 0.0048), and after (tau Kendall = 0.352, P = 0.0275) liposuction correlated with tissue expression of leptin. No differences in adipose tissue expressions and serum levels of hsIL-6 were observed 1 month after liposuction.

Conclusion: A count of circulating leukocytes, even presented within references, affects the increasing adipose tissue expression of leptin.

Smoking status favorably affected the influence of liposuction on serum leptin levels. Liposuction has no short-term effect on serum IL-6 concentrations.

R.A.L. Sertié , S.A. Sertié , A.R.G. Proenc ßa, T. Lima-Salgado, A.C. Oliveira, F.B. Lima

Introduction: All adaptations acquired through physical training are reversible during inactivity. Significant reductions in maximal oxygen uptake (VO 2Max ) are observed within two-four weeks of detraining. Conversely, the consequences of detraining on adipose tissue are poorly known.

Aim: To investigate the physical detraining effects on metabolism and cellularity of rat periepididymal adipose tissue.

Methods and results: Male Wistar rats, ageing 6 weeks, were divided in three groups: trained (T) for 12 weeks; detrained (D), (trained for 8 weeks and detrained for 4 weeks), and age-matched sedentary (S). Training consisted in treadmill running sessions (1 h/day, 5 day/week, 50-60% of the maximal capacity). The morphometric analysis of PE tissue disclosed significant differences between the groups. The adipocyte sectional area of group D was significantly bigger than T and S (3474 AE 68.8 lm 2 vs. 1945.7 AE 45.6 lm 2 vs. 2492.4 AE 49.08 lm 2 , respectively). Compared to T the cells of D animals showed 48% increased ability to perform: lipogenesis, either spontaneously or insulin stimulated and isoproterenol-stimulated lipolysis. Basal lipolysis did not change. A 15% reduction in apoptosis was observed in groups T and D in relation to S. Some gene expressions were changed in D vs. S: adiponectin (three-fold up) and PPAR-gamma (two-fold up). PREF-1 gene was three-fold higher in T vs. S.

Conclusions: These results suggest that adipogenesis was stimulated in this group. Detraining causes significant increase in adipocyte size and lipogenic capacity. As PE fat cell apoptosis was reduced in D and T. Background: Chronic red wine (RW) consumption has been associated with a decreased cardiovascular disease risk, mainly attributed to an improvement in lipid profile. RW intake is also able to change gut microbiota composition. High-fat intake has recently been reported to increase metabolic endotoxemia. The gut microbiota has been proposed as the main resource of plasma lipopolysaccharides (LPS) in metabolic endotoxemia.

Objective: To analyze the effect on LPS concentrations of chronic RW consumption and acute RW intake in relation to high-fat intake in middle-aged men.

Design: For the chronic study 10 middle-aged male volunteers were randomized in a crossover trial and after a washout period all received RW, dealcoholized red wine (DRW), or gin for 20 days. The serum LPS concentration and changes in fecal microbiota were quantified before and after the treatments. For the acute study, five adult men underwent a fat overload or a fat overload together with RW, DRW or gin. Baseline and postprandial serum LPS concentrations and postprandial chylomicron LPS concentrations were measured.

Results: Chronic RW consumption led to a significant decrease in LPS concentrations compared to baseline. In addition, LPS concentrations correlated negatively with Bifidobacterium and Prevotella levels. There were no differences in postprandial serum or chylomicron LPS concentrations between acute RW, DRW or gin intake together with a fatty meal. Postprandial chylomicron LPS concentrations correlated positively with the increase in triglyceride concentrations.

Conclusions: Chronic RW consumption decreases LPS concentrations, but it is not able to attenuate the postprandial LPS increase induced by a fat overload. Physical inactivity increases the risk of metabolic disease, associated with perturbations of muscle energy metabolism. The aim of this study was to assess the effect of exercise training on adiposity, physical fitness and muscle energy metabolism in obese individuals with attributes of MS.

Methods: Sedentary individuals (M/F 16/8; age 36.7 AE 5.5 years, BMI 31.8 AE 3.6 kg/m 2 ) completed 3-months endurance or strength (n = 11/13) training program (1 h, 3-times/week). Subcutaneous and visceral adiposity was measured by MRI. Phosphorus MR spectroscopy ( 31 P-MRS) was used to assess the energetic status of muscle in vivo by measuring phosphocreatine (PCr), ATP, inorganic phosphate (Pi) and maximal oxidative flux (Q max ), after exercise-or magnetic-induced equilibrium perturbation (n = 11). The samples of skeletal muscle were taken by needle biopsy (vastus lateralis). Cytochrome C oxidase (COX) activity of permeabilized muscle fibers was measured by oxymetry and maximal aerobic capacity (VO 2 max) by bicycle ergometry. Free-living ambulatory activity was monitored by accelerometers.

Results: Subcutaneous adiposity did not change with training. However, strength training decreased visceral adiposity (P < 0.05). Training increased physical fitness (VO 2 max, n = 24, P = 0.01) and in vivo muscle energy metabolism ( 31 P-MRS: Q max , PCr, ATP, n = 11, P < 0.05), without a significant effect on COX activity (n = 0.1). Depletion of muscle PCr was negatively associated with COX activity (P = 0.01). VO 2 max was not associated with muscle metabolism (P > 0.05). Free-living activity increased during training (P < 0.05).

Conclusions: Three months training of obese individuals was sufficient to increase both cardiorespiratory fitness and muscle metabolism, assessed by 31 P-MRS. Strength training was more efficient in decreasing visceral adiposity. Background: The amelioration of metabolic complications of excessive body mass by liposuction is intensively discussed, as the metabolic surgery is proposed for future diabetes therapy. We have undertaken the study on the short-term effect of liposuction on insulin resistance parameters.

Material and methods: We included in the study 32 consecutive patients (25 females, seven males) aged 38 AE 10 years with BMI 25 AE 3 kg/m 2 , who underwent liposuction in Mandala Beauty Clinic in Pozna n, Poland. The non-diabetic, apparently healthy patients were examined clinically, blood was withdrawn for baseline routine laboratory tests (hematology, glucose, lipids, coagulation). Insulin levels in serum and its content in adipose tissue were evaluated by means of ELISA (DIAsource, Sunrise Tekan). Insulin resistance/ sensitivity indexes: HOMA-IR, QUICKI and McAuley were calculated. One month observation included re-evaluation of glucose, lipids and insulin along with the indexes. Data are presented as mean AE SD or median; interquartile range.

We have observed the decrease in glucose concentrations (85 AE 8 vs. 91 AE 10 mg/dl, P = 0.0130) and insulin levels (19;16-22 vs. 21;18-25 mU/l, P = 0.0202) 1 month after liposuction, comparing to baseline. HOMA-IR (5.2 AE 1.6 vs. 4.3 AE 1.4, P = 0.0474) and

McAuley index (5.12 AE 0.97 vs. 5.73 AE 1.04, P = 0.0448) were improved 1 month after liposuction, however no effect on QUICKI has been found. Triglycerides concentrations 1 month after liposuction were lowered comparing to baseline (76;70-97 mg/dl vs. 108;91-155 mg/dl; P = 0.0110). In multiple regression analysis age was independent factor that affected insulin content in adipose tissue in males (B = 0.1779, P = 0.0451).

Conclusion: Liposuction causes beneficial effect on insulin resistance parameters in short-term observation of non-diabetic patients.

Background: A large number of studies showed that community-based health promotion is an effective way of preventing and treating chronic diseases. However, participation rate is very low for health education programs in Community Health Centers (CHCs); that of the program is not attractive, in part, because it is not individualized. Using diabetes risk assessment tool based on Electronic Health Records (EHR) data for diabetes risk prediction could help to early identify high-risk groups and reduce the incidence of diabetes through health education and lifestyle changes to control risk factors.

Objectives: To conduct community research to understand the situation of community diabetes prevention and control; to initially established prediction model of diabetes risk factors based on EHR data in CHCs.

The project randomly selects four districts in Shanghai, using a combination of quantitative research and qualitative research method. Get EHR data from each CHC, attempts to establish the predicted model for diabetes, and test the sensitivity and specificity of the model.

Outcome measures: The prediction model include age, gender, blood pressure, smoking, drinking, body mass index, family history of diabetes based on EHR data. As Pr(D) ! 0.5, the sensitivity is 69.6%, specificity is 67.4% and Area Under ROC Curve (AUC) is 0.7407.

The empirical results will contribute to a better understanding of how the diabetes management in CHC is important and provider the targeted self-management materials to improve health outcomes as well as evidences directly applicable in improving China's health policy reforms.

A. Schmid, A. Kopp, M. Bala, S. Leszczak, I. Ober, M. Mü ller, A. Schä ffler Internal Medicine I, University Hospital Regensburg, Regensburg, Germany Introduction: The adipokine chemerin has an important role in insulin sensitivity and insulin secretion. Elevated systemic chemerin concentrations correlate with obesity and insulin resistance. This study investigated chemerin serum levels of healthy volunteers undergoing an oral fat tolerance test (OFTT) and their correlations with gender and markers of insulin sensitivity and inflammation. We further tested effects of the sex hormones estradiol and testosterone on chemerin secretion from adipocytes in vitro.

Methods: Hundred overnight fasted healthy volunteers participating in the study underwent an OFTT. After oral uptake of lipid suspension, venous blood was drawn at 0, 2, 4 and 6 h. Subjects were characterized by anthropometric and standard laboratory parameters. Chemerin levels were measured by ELISA. Mature murine 3T3-L1 adipocytes were stimulated with estradiol and testosterone. Concentrations of secreted chemerin were measured by ELISA.

Results: While there were no significant changes in individual chemerin concentrations resulting from the lipid load, mean chemerin levels in sera of female probands were found to be significantly higher when compared to males (116.7 AE 37.9 vs. 97.1 AE 24.7 ng/ml, P = 0.004). The correlation of chemerin with insulin and C-peptide concentrations also was gender-specific. Along with these findings, chemerin secretion from mature 3T3-L1 adipocytes was shown to be affected by estradiol and testosterone treatment.

Conclusion: Human chemerin concentrations are higher in females and there is a gender specific regulation upon stimulation with sex steroids. Chemerin is not responsive to an oral lipid load.

Objective: To study the predictors of change in BMI with respect to time among physically active subjects.

Methodology: The present study was conducted among 14 physically active individuals in Delhi. Data was collected longitudinally with a monthly follow up of 12 months. Various anthropometric and physiological measurements were taken using standard protocol. The analysis has been performed with mixed effect modeling to assess subject's variation for parameters with respect to time. R 2.10.10 software with nlme package was used. An Akaike information criterion (AIC) was applied to find the consistency and measure the relative goodness of fit of a statistical model.

: BMI as an important factor was taken as dependent variable and using AIC, gender, blood pressure and weight were independent variables or fixed and random variables for 12 months of longitudinal study. Using generalized linear model (glm), BMI was dependent variable and other parameters i.e. gender, systolic blood pressure (SBP), diastolic blood pressure (DBP) and weight were independent variables. The regression coefficient obtained for gender with respect to BMI (as response variable) was À0.59. The estimated values for SBP, DBP and weight were À0.15, 0.05 and 0.05 respectively.

The reduction of BMI among females was more in comparison to males. The reduction rate of SBP, DBP and weight with BMI was very low with respect to time.

A.E. Andreazzi 1 , S. Grassiolli 2 , J.C. de Oliveira 2 , R. Torrezan 2 , S.T. Paes 1 , M.S. Silva 1 , R.M.G. Garcia 3 , P.C.D.F. Mathias 2 1 Department of Physiology, Federal University of Juiz de Fora, Juiz de Fora, 2 Biology, State University of Maring a, Maring a, 3 Biology, Federal University of Juiz de Fora, Juiz de Fora, Brazil

Obesity is a worldwide epidemic and the most important factor in metabolic syndrome onset. The involvement of sympathoadrenal axis activity in obesity onset was investigated using the experimental model of treating neonatal rats with monosodium L-glutamate (MSG). To access general sympathetic nervous system activity, we recorded the firing rates of sympathetic superior cervical ganglion nerves in animals. Catecholamine content and secretion from isolated adrenal medulla were measured using the trihydroxyindole fluorescence method. High-performance liquid chromatography (HPLC) was used to measure plasmatic adrenaline. Intravenous glucose tolerance test was performed, and isolated pancreatic islets were stimulated with glucose and adrenergic agonists. MSG treatment increased the epididymal and retroperitoneal fat pad mass by 60.5% and 57.2%, respectively, compared with control animals (P < 0.001). The nerve firing rate of obese rats was decreased 58.8% compared to the rate for lean rats (P < 0.05). Pre-diabetic rats showed a 60% reduction in basal catecholamine secretion from the adrenal medulla and 32% lower plasma adrenaline concentration compared with the control animals (P < 0.05); whereas catecholamine secretion induced by carbachol, elevated extracellular potassium and caffeine in the isolated adrenal medulla were all increased in obese rats compared to control. Both glucose intolerance and hyperinsulinaemia were observed in obese rats. Adrenaline strongly inhibited glucose-induced insulin secretion in obese animals (72%, P < 0.05). These findings suggest that low sympathoadrenal activity contributes to impaired glycaemic control in pre-diabetic obese rats.

Objective: The aim of the present study was to evaluate the influence of physical activity patterns on cardiovascular health.

The study was conducted in Delhi, among adult Punjabi males and females. Total sample of 286 subjects was taken for the study. Data was collected crosssectionally using multistage stratified sampling.

According to pattern of physical activity using self administered proforma, two groups were formed, one regular physical activity group (RPA; at least 5 days/week brisk walk for 30 min, doing yoga for 45 min), and the other irregular physical activity group (IPA; <5 days a week with no consistency). Various anthropometric and physiological measurements were taken using standard protocol.

Results: Higher percentage of subjects with irregular pattern of PA was at risk of developing high BP, obesity and triglycerides. Higher values of WHR, WHtR among them showed that group was more disposed to cardiovascular health problem. Males with IPApattern had 5.51times, 3.81 times and 13.21 times more risk of increasing regional adiposity using WHtR, WHR and WC respectively. Among females, WHtR, WHR and WC respectively showed 9.53 times, 3.96 times and 6.00 times higher risk of developing regional adiposity with irregular pattern of PA. The increased risk of being obese was 7.16 times more among males with irregular pattern of physical activity while among females fat percentage and obesity level using BMI category were found to be at a risk of 2.74 times and 2.78 times respectively.

Conclusion: Subjects with regular pattern of PA showed higher percentage of normal values of various cardiovascular and obesity markers. Irregular pattern of PA increased the risk of regional and general adiposity markers besides that of high BP. Materials and methods: Serum glycemia, insulin and C-peptide level were measured at OGL hours 0-1st-2nd in: seven healthy controls, 15 patients with MS and 13 with Cushing; mean age was 29.8-31.4-29.8, BMI 26-40-35, OGL glycemia: 4.2-7.6-4.9; 5.0-7.5-4.8; 5.1-9.1-5.7 respectively. All patients had BP >145/90 mmHg and triglyceride level >2.0 mmol/l. HOMA assessment: (fasting insulin, pmol/l 9 fasting glucose, mmol/l):22.5. C-peptide and insulin increase above fasting level (in pmol) per 1 g of ingested glucose was calculated.

Results: (*P < 0.05 vs. control). HOMA was 20.1-38.8*-43.1* and fasting C-peptide and insulin level were 417/108, 1007/173*, 1160/196* pmol/l in control, MS and Cushing respectively. To the 1st hour of OGL the corresponding data were: 1720/486, 2342/614* and 2590/ 547* and increase of C-peptide and insulin concentration per 1 g of ingested glucose was almost equal: 26/7.5-27/8.8-29/7.0 pmol/l. The degree of C-peptide increase to the 1st hour was twice less than in control and increased fasting hepatic insulin clearance lowered almost to control level (judging by C-peptide/insulin ratio). To the 2nd hour of OGL C-peptide and insulin level became similar to fasting data.

Conclusion: IR characteristics were similar in MS and Cushing disease. Insulin requirement increase on the top of OGL was equal to control. Judging by C-peptide/insulin changes IR stops manifesting on the top of glycemia during OGL (probably due to normalizing hepatic insulin clearance). Introduction: IR is ATFR of high potential, but also one of the first signs of a Ateroscl. Process. Condition when the body has too much insulin at in the same time too much glucose is the resistance of peripheral tissues to the action of insulin.

Objectives: To investigate the relationship of concentrations of insulin and glucose in the peripheral blood, but also the conc. of GH, becose normalisation of GH secretion could corrects hiperinsulinemia and insulin resistance. On the other hand reduced GH secretion often points to the high expression of somatostatin and the presence of stress, which leads to secretion of somatostatin. Further increase in visceral adipose tissue and FFA relise under stress can worsen the condition of and insulin resistance.

Aims of study: Conducted 2 therapeutic program (combination of dietary and physical activity), in which only the group EDU implemented and behavioral therapy.

Monitoring parameters of glycemic control: fasting glucose, fasting insulin and GH and insulin sensitivity of peripheral tissues to insulin, always from in one blood sample, parallely in two different phases of therapy. We used ANOVA-Manova Statistics to determine the significance of an differencies.

Material and methods: Determining of glucose, insulin, and growth hormone. As and Qucki index for determining od insulin sensitivy Conclusion: Ours finding indicate that the synergistic effects of dieting and increased physical activity improves glucoregulation, reduce excessive insulin secretion and restoration of GH secretion. But only behavioral therapy may lead to permanent changes in nutritional habits and lifestyle.

The metabolic and endocrine dysfunctions that may occur with polycystic ovary syndrome (PCOS) can be associated with future comorbidities such as diabetes, cardiovascular disease, and endometrial cancer. Although a definitive link between PCOS and these chronic illnesses has not been demonstrated, there is significant overlap in the clinical characteristics of these disorders. Consequently, the issue of identifying and measuring potential conditions that may be associated with PCOS is a priority and should be the standard of practice in its management. Hiperhomocysteinemia has been shown as independent predictor of cardiovascular events in patients with atherosclerosis. The aim of our study was to determinate levels of homocysteine in woman with polycystic ovary syndrome compared with healthy woman. Thirty patients (age, 23, 5 AE 5.5) with PCOS and 24 (age, 25.5 AE 4.3) healthy woman were involved in the study. Blood samples were collected in early follicular phase. Total homocysteine was measured using fluorescent immunoassay. Statistically significant differences in serum concentration of homocysteine were observed between groups. Mean homocysteine level we found as (10.2 AE 2.9 vs. 7.0 AE 1.5) in PCOS and normal group respectively (P < 0.05). For Macedonian population we found statistically significant increased homocysteine levels in woman with PCOS. Although the mean homocysteine levels are within normal limits, there are significant higher mean homocysteine concentrations between these two groups. Because an increased concentration of tHcy has been shown as and independent risk factor for cardiovascular alterations, it is essential in this group of woman to be taken measures for early prevention.

A. Alkandari, N.J. Gooderham, H. Ashrafian Surgery and Cancer, Imperial College London, London, UK Globally 500 million people are obese and prevalence is increasing. Obesity and its many co-morbidities are leading causes of mortality and morbidity and pose substantial socioeconomic burdens on health services. Bariatric surgery is a form of gastrointestinal surgery that leads to sustained weight loss, a decrease in cancer risk and resolution of type 2 diabetes. MicroRNAs are a family of small, endogenous, non-coding RNAs that regulate gene expression at the posttranscriptional level. MicroRNAs control expression of over half the human transcriptome and are involved in processes fundamental to both normal physiology and disease, including obesity, diabetes and cancer. We hypothesise that urinary microRNAs are biomarkers for bariatric surgery reduction of type 2 diabetes. Here, we looked at expression of microRNAs involved in diabetes in urine samples prior to bariatric surgery and at 2 months and 1 year postoperatively. Urinary RNA was obtained using the Mirvana Paris kit and microRNA expression was determined through quantitative PCR. We found significant increases of two to three fold postoperatively in the expression of three microRNAs involved in diabetic nephropathy. These findings are consistent among patients undergoing laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy. Our results indicate that bariatric operations can modulate post-translational effects in end-organs postoperatively and may contribute to the beneficial effects noted after these procedures. Hepatic insulin resistance and the ensuing impairment of hepatic glucose metabolism is a major contributor to hyperglycemia in metabolic syndrome. Various factors appear to act in parallel to elicit hepatic insulin resistance. While impaired fatty acid handling with a resulting activation of PKC isoforms is one established route, a subacute inflammation also appears to contribute and the impact of cytokines on the insulin signaling cascade is well established. By contrast, the role of small lipid mediators e.g. prostaglandins and sphingolipids, which are also affluent in inflamed tissue, is not well characterized. The current study addressed this question. In a wide array of genetic and diet-induced mouse models of the metabolic syndrome, hepatic expression of key enzymes of prostaglandin formation was induced. Prostalgandin E 2 , which is released predominantly from Kupffer cells, directly attenuated insulindependent hepatic glucose utilization by an ERK1/2-dependent serinephosphorylation of IRS and hence attenuation of insulin-dependent Akt-phosphorylation. In addition, PGE 2 enhanced lipid accumulation in hepatocytes by inhibiting mitochondrial fatty acid oxidation and VLDL formation. Furthermore, PGE 2 in an autokrine feed forward loop increased the formation of oncostatin M in Kupffer cells, which in turn inhibited insulin signaling in hepatocytes by inducing SOCS3. Similar to PGE 2 , sphingosine-1-phosphate, whose production was strongly enhanced by exposing hepatocytes to palmitate, attenuated insulin-stimulated glucose use and the induction of glycolytic enzymes in hepatocytes. In summary, the study provides first evidence that in addition to the established mechanism, small lipid mediators like prostaglandins and sphingolipids may impact on hepatic insulin resistance.

Background: The progression of childhood cardio-metabolic risk factor to adulthood suggests early origin of pathogenic pathways leading to chronic non-communicable disease as diabetes.

Objective: We sought to examine the distribution of insulin resistance (HOMA-IR) among children inhabiting Delhi and clustering of cardio-metabolic risk variables among them.

Research design and methods: A cross sectional study was conducted among children aged 10-18 years. Estimates of insulin resistance were derived on the basis of homeostatic model assessment. The 75th percentile of HOMA-IR for normal weight subjects with normal fasting glucose was considered as cutoff for insulin resistance. Total body fat was assayed using body composition analyser (TBF-310H14A) employing bioelectric impedance technique. BMI was converted to age-and sex-standardized percentiles and subjects were classified as underweight if BMI <5th and overweight if BMI was >85th percentile. Children with blood pressure >95th percentile, adjusted for age and sex were categorised as hypertensive. Information on socio-demographic features and family history of diabetes was obtained through standardized questionnaire.

Result: Independent Student t-tests showed significantly higher percentage of body fat among girls (21.12%) as compared to boys (14.55%). Mann-Whitney U-test analysis depicts significantly higher level of fasting sugar among girls (3.96 mmol/ml) than boys (3.83 mmol/ml). Out of 98 children 27 (27.6%) were insulin resistant. Among them five were underweight while seven were overweight, 6/4 (SBP/DBP) were hypertensive and 14 had family history of diabetes.

Conclusion: High prevalence of insulin resistance, a precursor of diabetes among these children foreshadows a worrisome trend for the burden of type 2 diabetes in near future. 

Both aims, losing weight as well as improving metabolic conditions, should be reached within the first weeks of an intervention program already. Therefore, results of a short-time intervention concept should be presented.

In answer to a regional TV-report dealing with "successful weight loss", 55 overweight adults contacted the Freiburg Institute of Preventive Medicine (IPM) to participate in a 6-week intervention program. After looking for exclusion criteria, 48 patients (49.9 AE 13.9 years, 34.2 AE 4.7 m/kg 2 BMI) could be included. The IPM concept consists of an initial consultation in energy balance and life style changes, the use of a soy-yoghurt-honey product (Almased â , 29 per day as meal replacement), and the facility for guidance by phone. Forty patients completed the program attending the exit examination.

Starting from a comparable BMI, the females were younger (n = 23; 46.2 AE 14.1 years) than the males (n = 17; 55.0 AE 12.1 years) and showed less associated risk factors. Of significantly older age was the subgroup of patients with metabolic syndrome (MS) or type 2 diabetes mellitus (T2DM) (n = 12; 60.8 AE 5.9 years). All completers were successful in losing weight (pre-post diff. 5.5 AE 3.0 kg) and showed a comparable weight reduction after intervention: females À5.3%, males À5.6%, MS/T2DM patients À6.0%. The weight reduction was impressively accompanied by improvements of the metabolic milieu (TG, LDL-C, FBG, HbA1c) particularly in the MS/ T2DM patients.

The results confirm that the IPM concept is a successful way to lose weight initially and to improve the metabolic milieu within a shorttime period using a product with a high impact of bioactive compounds. Objective: Menopause-related changes in female body are associated with the greater risk of metabolic syndrome (MS), which includes obesity, dyslipidemia, impaired glucose tolerance, hypertension.

The purpose of our study: was to reveal peculiarities of fat and lean mass distribution between postmenopausal women with abdominal obesity and with MS.

Design and method: The sample consisted of 43 postmenopausal 60-69 years old women (age: mean = 64.8; SD = 0.4); duration of menopause: mean = 14.5; SD = 0.9). The diagnosis of MS was considered according to IDF (2005 year) criteria. Lean and fat mass distrubution were measured by dual-energy X-ray absortiometry, and were compared for the cohorts with and without MS. Data were analyzed using Statistical Package 6.0 (Statsoft). Background and aims: Attempts to curb the ongoing epidemic of obesity and diabetes in the US and other developed countries will benefit from better understanding of the broad and upstream determinants of the population prevalence of these conditions. This study explores how individual psychosocial characteristics in addition to the social and physical community environment correlate with prevalent obesity and markers of pre-diabetes in a statewide representative sample of the population of Wisconsin, USA.

Methods: We used cross-sectional data from the 2008 to 11 cycles of the ongoing Survey of the Health of Wisconsin (SHOW) a geographically diverse population-based research study of adults, age 21-74 years (n = 2479). Obesity (BMI ! 30 kg/m 2 ) and hemoglobin A1C levels were the main outcomes. Independent variables included individual socioeconomic status (SES), food insecurity, psychosocial status (depression, anxiety and stress), perceived discrimination and neighborhood resources, and access to health are. Contextual predictors included county and census-block group socioeconomic nutrition, and built environment indicators.

Results: The prevalence of obesity and prediabetes was positively associated with lower SES, food insecurity, markers of depression and anxiety, perceptions about lower access to healthy food and physical activity resources in the neighborhood, and poor health care access. Lower community-level SES and a poor nutritional and built environment were also associated with higher frequency of obesity and prediabetes.

Conclusion: Our findings on the psychosocial and contextual correlates of obesity and prediabetes offer insights regarding the profile of individuals and subgroups and where tailored individual and community level interventions are most needed. Objective: Gastric bypass (GBP) is currently the most effective way of treating obesity. Interestingly, the majority of Type 2 diabetes (T2D) patients display remission of the disease after GBP. The underlying mechanisms behind this remission are not known. We used a porcine model to study how hormonal and metobolite profiles are affected by GBP. In addition we studied the impact of GBP on endocrine cell populations in the gut and pancreatic islets.

Methods: GBP-pigs were subjected to oral (OGTT) and intravenous (IvGTT) glucose tolerance tests before and after surgery. Shamoperated, pair-fed pigs served as controls.

Results: During IvGTT GBP-pigs displayed lower glucose and higher insulin levels compared to controls. During OGTT, GBP-pigs displayed higher glucose and a more rapid and robust insulin response than controls. In line with this, GBP-pigs had higher beta cell mass and more extra-islet beta cells. Further, during OGTT GBP-pigs displayed robustly elevated GIP levels, whereas GLP-1 levels were unchanged. Furthermore, GBP-pigs displayed elevated density of GIPproducing K-cells, but reduced density of GLP-1-producing L-cells in the gut. Metabolomic analyses revealed a difference in the metabolite pattern between the two groups, mainly explained by the fact that GBP provoked lower levels of free fatty acids (FFA) and higher levels of branch-chain amino acids (BCAA).

Conclusions: GBP in pigs provokes, 1. enhanced insulin secretion and increased beta cell mass. Background: Several authors have recently reported that both HIV replication and antiretroviral therapy (ART) may influence adiponectin expresion which is correlated with insulin sensitivity via glucose transporter type 4 recruitment to plasma membrane.

We assessed serum adiponectin patterns in a cohort of HIV-1 positive Caucasian patients undergoing cART in relation to insulin resistance (IR) and HIV replication.

A cross-sectional study was performed in a cohort of HIV-1infected patients attending the National Institute of Infectious Diseases, Bucharest. Blood samples were tested for HIV viral load and adiponectin. Insulin resistance was estimated by homoeostasis model assessment. In order to evaluate differences between groups we used Mann-Whitney-Wilcoxon and T-tests.

Results: Eighty patients (56.3% males) with a median age of 28 years (IQR 21 years) were included in the study. The median time from HIV diagnosis was 74.0 months and the median time on cART was 68.0 months. Most patients (71.3%) had undetectable serum HIV loads. Median adiponectin serum value was 10.34 lg/ml (IQR 14). Most patients (68.8%) had insulin resistance. Insulin resistant patients had significantly lower median levels of adiponectin (9.3 vs. 19.7 lg/ ml, P = 0.04). There were no significant differences between median adiponectin serum levels in groups with persistent and undetectable HIV replication (P = 0.57). No significant correlation was noted between insulin resistance and HIV replication.

Conclusions: In our cohort of young HIV-1 patients with a high prevalence of IR decreased adiponectin serum levels were associated with decreased insulin sensitivity. HIV replication may not influence in vivo adiponectin expression. Objective: To examine obesity and metabolic disorders associated with vitD deficiency/insufficiency in Children older people.

Methods: Cross sectional study in 1106 community-dwelling subjects 60-98 year (766 women) residing in Santiago Chile. Plasma levels of 25(OH)D were determined by radioimmunoassay. Glucose, insulin and CRPus, were measured in a fasting blood sample. Blood pressure and complete anthropometry were measured.

Results: Mean serum 25(OH)D was 64.3 AE 33.6 nmol/l (men 67.8 AE 33.0; women 62.6 AE 33.7, P < 0.01). 25(OH)D levels were under 75 nmol/l in 65.0% of men and 71.9% of women (P = 0.020). Insulin resistance was present in 17.4% of all subjects and obesity in 38.5% of women and 26.1% of men (P < 0.001). Significant negative crude association between 25(OH)D across BMI categories was found in the total sample (P < 0.001). Crude association of vitD <50 nmol/l with obesity (P = 0.002), waist circumference (P = 0.011), Insulin resistance (P < 0.001), Metabolic syndrome (P = 0.004), HTA (P < 0.001) and Age ! 70 year (P < 0.001) was observed. After age, sex, waist circumference and season adjustment, vitD <50 nmol/l was associated with increased risk of insulin resistance, OR 1.65 (IC 95% 1.18-2.32) P = 0.003.

Conclusion: High prevalence of vitD deficiency/insufficiency was observed in the Chilean older people. VitD deficiency is associated with insulin resistance. In the future, randomized controlled trials are needed to establish a cause-effect relationship between vitD deficiency, obesity and its metabolic consequences. Surrogate markers are used to estimate degree of steatosis and liver fibrosis in NAFLD. Oxidative stress is important in the pathophysiology of NAFLD.

The aim of this study is to find correlations between blood antioxidants and laboratory variables that are routinely determined in patients with NAFLD in clinical practice and used in fibrosis test.

Thirty-five obese children (8-16 years old) with increased liver echogenicity on ultrasounds and 30 healthy lean children were enrolled. Other causes of chronic hepatitis, such as chronic viral hepatitis, were excluded. Erythrocyte superoxid dismutase (SOD), glutathione peroxidase (GPx) activities and plasma levels for albumin, uric acid and bilirubin were measured as antioxidants. The NAFLD fibrosis score was calculated by an altgoritm including: age, BMI, glycaemia, platelet number, albumin, AST/ALT. Pearson correlations were calculated.

None of the obese children had fibrosis according to the test score. Obese children with NAFLD had lower levels for albumin (P < 0.01), but higher levels for uric acid (P < 0.01), SOD and GPx activities (P < 0.05) vs. lean children. All the measured antioxidants were related with variables included in the fibrosis test. For P < 0.05, the calculated correlations were: SOD activity with ALT activity (r = À0.52) and albumin (r = 0.55), GPx activity with AST/ALT ratio (r = 0.56), uric acid with ALT activity, age and BMI (r = 0.42).

This study demonstrates strong relations between blood antioxidant defence systems with fibrosis test variables in NAFLD in obese children.

women; diabetes prevention programs (DPP) are only available for adults at high risk of developing T2D.

1. To develop a DPP for post-GD women.

2. To assess the feasibility/acceptability of this DPP through a pilot rollout.

Methods: A working group was formed to develop a DPP that incorporated the needs of a mother with a young family around established lifestyle modification goals. This program was piloted with a group of nine post-GD women.

The pilot had high attendance levels (70-90% for group sessions), but only 20% of participants attended all sessions (illness and travel commitments causing non-attendance). The original MAGDA DPP was restructured to: an individual session, five group sessions and two follow-up telephone conversations. Childcare arrangements were investigated, but participants elected to have their children attend sessions. Participants reported the program to be acceptable and suited to their needs.

The pilot determined that the program was feasible and met the needs of the target population. Currently, recruitment is underway for 574 post-GD women from three hospital sites for the MAGDA study, which uses a DPP designed for post-GD women and has a whole-of-family focus and tackles common barriers to success. Objectives: Assess the risk factors associated to physical inactivity (PI).

A cross-sectional study was performed in 2006 in subjects aged ! 18 years, in the urban area of Montes Claros, Brazil. The physical inactivity level was determined by the International Physical Activity Questionnaire short version. The subjects were classified in active ( ! 150 min per week) and sedentary (<150 min per week). The univariate analysis was first performed and were included in the model when associated with P < 0.2. The Poisson regression with robust variance was realized and the prevalence ratio (PR)-crude and adjusted-and 95% confidence intervals (CI) were estimated to determine the relationship between PI and risk factors like sex, age group, skin color, marital status, income, education, hypertension, dyslipidemia and overweight. The variables that remained significant when adjusted. The statistic was performed in STATA.

Results: A sample of 528 individuals were studied (74.8% women). The prevalence of PI was of 27.6%. The variables were associated with PI were sex, the age group, marital status, education, hypertension, dyslipidemia and overweight with P < 0.05. The following variables were significantly associated with PI after adjustment for confounding variables were: sex, female (RP = 0.71; IC: 0.53-0.96) and marital status, separated/divorced/widowed (RP = 1.71; IC: 1.12-0.60).

The gender and marital status were associated with PI with PR higher for these variables in this population, which shows the need for development of effective public policies, integrated to investigate the biological causes, but also the social risk factors. Objective: To determine whether an interactive mHealth exercise intervention is more effective than standard of care exercise in patients with metabolic syndrome.

Methods: Participants [n = 127, mean age 57.4 (SD 9.1) year, 74% female] reported to the laboratory at baseline (V0) and follow-up [12 (V1) and 52 (V2) weeks]. Anthropometrics, heart rate (HR) and blood pressure (BP) were measured and blood drawn to examine fasting glucose (FG) and glycated hemoglobin (HbA 1c ). Fitness (VO 2max ) was assessed and individualized exercise programs were prescribed. The intervention group received a Smartphone data portal and Bluetooth TM enabled biometric tracking. Differences between groups in outcomes (V1-V0) were examined using analyses of covariance, which adjusted for baseline levels of the outcome of interest. Group differences from V0 to V2 were examined with two-way repeated measures ANOVAs.

Results: At V1, systolic BP was reduced in both groups but significantly more in the control group (difference in mean change: À5.68; 95% CI: À10.86, À0.50, P = 0.03). There were no differences between groups at V1 for other outcomes. Across the follow-up period, systolic BP, diastolic BP, resting HR, weight, body mass index, waist circumference and HbA 1c were decreased, and VO 2max and target HR were increased for the entire study population (P < 0.001) with no difference in rate of change between groups. FG was significantly higher in the intervention group across the entire follow-up period (P = 0.02) and both groups had increasing levels over time (P = 0.03).

Conclusion: Over 52 weeks, cardio-metabolic risk factors improved with both standard and mHealth supported exercise interventions. Background and aims: Breastfeeding improves glucose tolerance in the early postpartum period of women with prior gestational diabetes (GDM), but it is unclear whether future risk of metabolic alterations, like type 2 diabetes, is reduced. The aim of this study was to investigate the effect of lactation, 3 years after pregnancy, on glucose metabolism and beta cell function in women with prior GDM.

Material and methods: Women with prior GDM (Carpenter and Coustan Criteria) were evaluated with comparison of results for "lactating" [BF] vs. "non lactating women" [non BF]. Breastfeeding was defined exclusive if lasting more than 4 weeks. Each woman performed a 75-g OGTT to analyze glucose tolerance, insulin sensitivity/resistance and b-cell function. Lipid and inflammatory profile was also studied. STATISTICS: Paired and Un-paired t-test, Mann-Whitney and v 2 tests. Methods: Subjects completed three randomly ordered conditions: MIE (50% VO 2 peak), HIE (82% VO 2 peak), and seated rest (Control). Exercise energy expenditure was equated to 200-kCal. One-hour postexercise (or control), subjects received a 75-g oral glucose tolerance test (OGTT). Plasma glucose and insulin concentrations were measured before and at frequent intervals after glucose ingestion. SI was derived using the following models (i) oral minimal model (OMM), (ii) Matsuda composite index, (iii) Cederholm Index, and (iv) Stumvoll index. Exercise induced changes in insulin action were expressed relative to the control condition (exercise-control). Spearman correlation coefficients and RM-ANOVA were used to compare relative changes in insulin sensitivity.

Results: SI calculated during the control condition was moderately correlated among the various indices (r-value range: 0.38-0.77, Pvalues: 0.13-0.001). Relative to control, SI after MIE ranged from 2% higher (Cederholm) to 22% higher (OMM), and after HIE ranged from 5% lower (Matsuda index) to 30% higher (OMM Excess caloric intake leads to metabolic overload and is associated with development of type 2 diabetes (T2DM). Current disease management concentrates on risk factors of the disease such as blood glucose, however with limited success. We hypothesize that normalizing blood glucose levels by itself is insufficient to treat the disease and the development of complications, and that dietary interventions which diminish metabolic overload may be more efficacious in retarding the disease. We explored the efficacy and systems effects of pharmaceutical interventions vs. dietary lifestyle interventions (DLI) in developing T2DM and complications. High fat diet (HFD)-fed LDLR À/À mice with already established disease phenotype, to mimic the human situation, were treated with 10 different drugs mixed into HFD or subjected to DLI (switch to lowfat chow), for 7 weeks. Interventions were compared to untreated reference mice kept on HFD or chow only. Although most of the drugs improved HFD-induced hyperglycemia, drugs only partially affected other risk factors and also had limited effect on disease progression towards microalbuminuria, hepatosteatosis and atherosclerosis. By contrast, DLI normalized T2DM risk factors, fully reversed hepatosteatosis and microalbuminuria, and attenuated atherosclerosis. The comprehensive beneficial effect of DLI was reflected by normalized metabolite profiles in plasma and liver. Analysis of disease pathways in liver confirmed reversion of the metabolic distortions with DLI. This study demonstrates that the pathogenesis of T2DM towards complications is reversible with DLI and highlights the differential effects of current pharmacotherapies and their limitation to resolve the disease. 

Introduction: Obesity may induce an oxidative stress in adipose tissue, leading to deregulated expression of inflammatory cytokines which could be an early instigator of obesity-associated diabetes and cardiovascular diseases. Thus, the biological effect of natural micronutrients such as plant polyphenols that may increase the antioxidant capacity of the body is of high interest.

Aim: Our objective was to explore the antioxidant polyphenol content of three medicinal plants (Gouania mauritiana, Antirhea borbonica, Doratoxylon apetalum) and their impact on the viability, production of reactive oxygen species (ROS) and inflammatory response of preadipocytes exposed to oxidative stress.

Methods: Polyphenol-rich extracts from plants were analyzed for their radical-scavenging capacity by DPPH method. Then, their ability to modulate 3T3-L1 preadipocyte viability and protection against H 2 O 2induced oxidative stress was assessed by both MTT viability and LDH death assays, as well as by DCFH-DA test evaluating intracellular ROS production. Finally, IL-6 secretion was measured by ELISA.

Results: All plant extracts exhibited high levels of antioxidant polyphenols which protected preadipocytes against oxidative stress by decreasing ROS generation and modulating the inflammatory response. Such an antioxidant activity of plant extracts could be partly mediated through their radical-scavenging capacity.

We identified three medicinal plants naturally rich in antioxidant polyphenols which exerted antioxidant and antiinflammatory properties on preadipocytes exposed to oxidative stress. Further studies are in progress to clarify the molecular mechanism as well as in vivo potential effects of such medicinal plants to protect against metabolic and inflammatory disorders known to play a key role in obesity-related insulin resistance.

Background: Increased fasting plasma glucose is known to lead to diabetes, and diabetes associated complications often manifesting prior to the identification of type 2 diabetes. We aimed to determine the association of fasting plasma glucose levels with cholesterol levels and oxidative stress markers.

Methods: One hundred and sixty two participants attended the Diabetes Screening Clinic, at Charles Sturt University, Australia between February 2006 and June 2008. Participants were investigated based on the American Diabetes Association′s diagnostic criteria of diabetes mellitus and prediabetes, i.e. fasting BGL.

Results: Atherogenic index of plasma (AIP) was elevated in the prediabetes group (0.076 AE 0.06) and continued to increase in the diabetes group (0.18 AE 0.057) compared to controls (À0.06 AE 0.04; P < 0.05). Serum 8-hydroxy-2-deoxy-guanosine (8-OHdG) level was greater in the prediabetes (525.8 AE 149.7 pg/ml) compared to controls (155.7 AE 100.3 pg/ml; P < 0.05). The diabetes group (2000.7 AE 132.7 pg/ml) had the highest level of 8-OHdG. These changes paralleled by a reduction in erythrocyte reduced glutathione (GSH) from controls (70.7 AE 2 mg/100 ml, P < 0.05) to prediabetes (66.9 AE 3 mg/100 ml; P < 0.05) and the diabetes group (61.3 AE 2.6 mg/100 ml, P < 0.001).

Conclusion: This increase in 8-OHdG may be related to the decrease in erythrocyte GSH antioxidant capacity. A statistical significant positive correlation (Pearson's R = 0.255; P < 0.001) between AIP and 8-OHdG suggests that 8-OHdG may be a useful additional biomarker to determine the degree atherogenic risk in the presence of elevated lipids. Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen, UK, 2 ILSI Europe, Brussels, Belgium, 3 Lund University, Lund, Sweden, Mechanistic evidence suggests that elevated blood glucose levels contribute to the development of T2DM. Adoption of a nutritional approach to manage postprandial glycaemia could deliver a cost-effective T2DM prevention and management strategy, applicable across the population. To implement a successful strategy it is essential to understand the impact of dietary modulation on the postprandial rise in blood glucose concentrations.

For this reason, a systematic and comprehensive literature review was undertaken, using the highest quality data. Included were the major macronutrients (carbohydrate, protein, fat), micronutrient vitamins and minerals, non-nutrient phytochemicals and additional foods including low-calorie sweeteners, vinegar and alcohol. The strongest corroboration of efficacy for improving glucose homeostasis was for insoluble and moderately fermentable cereal-based fibre and monounsaturated fatty acids as replacement of saturated fat. Postprandial glucose levels were decreased by intake of viscous soluble fibre and this was considered to be predominantly by delaying absorption of coingested carbohydrates. Weaker but substantial evidence demonstrated that certain phytochemical-rich foods were likely to be effective and this may be associated with the suggestion that the gut microbiota plays an important role in metabolic regulation, including provision of phytochemical and other metabolites.

It is clear that dietary components have significant and clinically relevant effects on blood glucose modulation. This suggests that employing a dietary regimen to attenuate the postprandial rise in blood glucose levels along with previously identified targets (reducing excess body weight and an increase in physical activity) will benefit the health of the population and limit the increasing worldwide incidence of T2DM. Knowing their metabolic control, and lipid profile, through an early intervention, we can reduce their risk factors for cardiovascular disease, and diabetes complications. The aim of our study was to determine the lipid profile of patients newly diagnosed with type 2 Diabetes.

Patients and methods: Hundred patients, selected at the outpatient policlinic Nr. 3 in Tirana, the capital of Albania. All the patients had completed anthropometric measures, HbA1c and lipid profile after a 12-h fast. The persons younger than 30 years, diabetes diagnosed prior to 6 months, or uncompleted data were excluded from the study.

Results: We obtained all the data for 75 patients. Males 48 (64%), mean age 55.6 AE 9.32 years, mean BMI 28.7 AE 4.2 kg/m², mean HbA1c 7.44 AE 2.54%. 47.6% of the patients had a total cholesterol >220 mg/dl, 16% of the patients had triglycerides >250 mg/dl, and 41.3% of them had TG <150 mg/dl, and 64% had the LDL >130 mg/ dl 83.3% of males had HDL <45 mg/dl and 100% of women had HDL <55 mg/dl respectively.

Conclusions: In our study the lipid profile of Albanian patients was somehow different from the common profile of patients newly diagnosed with T2 Diabetes. Even in the previous studies we have found a lipid profile with high total cholesterol levels, and especially very low HDL levels, probably due to the sedentary lifestyle, which needs further evaluation, because the metabolic control of our patients was not very bad. Background and aims: Physical activity (PA) in people with type 2 diabetes helps to improve metabolic control, lipid profile, and to reduce weight. The aim of our study was to demonstrate the effect of a single session of PA to the glycaemic profile, and the effect of increasing daily physical activity on the weight and lipid profile.

Patients and method: Fifty patients were recruited for a 8 weeks training session. Every PA session lasted 30 min of fast walking. The number of daily steps was measured through a pedometer, and all the participants were encouraged to complete at least 10,000 steps/day. All the patients had completed anthropometric measures, fat body composition and lipid profile at the beginning and the end of study period. Background: Homocysteine is a cardiovascular risk factor for the development of vascular pathology. Large population studies have been conducted demonstrating a positive association between homocysteine levels and risk of developing cardiovascular disease. Paradoxically in type 2 diabetes, if renal function is within a normal range, homocysteine levels are either similar or reduced when compared to levels in the normal non-diabetic population. Whether the same is true for pre-diabetes has not been previously explored. Our study examines the plasma levels of homocysteine in controls, and participants with prediabetes and diabetes from a screening program in regional New South Wales.

Methods: Seven hundred and forty-four participants attended the Diabetes Screening Clinic, at Charles Sturt University, Australia. Participants were investigated based on the American Diabetes Association′s diagnostic criteria of diabetes mellitus and prediabetes, i.e. fasting blood sugar levels. Venous plasma homocysteine samples were measured using the fluorescence polarization immunoassay on the IMx â analyzer (Abbott Laboratories, Abbott Park, IL).

Results: Median age across the three groups ranged from 61 to 64 years. The median levels for plasma homocysteine between groups were not significantly different. There was a trend for plasma homocysteine (μmol/l) levels to be higher in the prediabetic group 9.15 AE 2.7 (SD) compared to the control group with 8.4 AE 2.84 (SD) and in the diabetic group of 8.7 AE 2.7 (SD).

Conclusion: There is a non-significant median increase in homocysteine in the pre-diabetes group. Further larger cross-sectional population studies would be able to address whether this is a chance effect and also establish statistical significance if present. Clinical Endocrinology, Institute for Endocrine Pathology Problems, Kharkiv, Ukraine Introduction: Active acromegaly is associated with increased morbidity attributed by systemic complications such as carbohydrate dysfunction.

Aims: To evaluate the effects of chronic excess of GH and IGF-I on prevalence and structure of carbohydrate dysfunction in patients with active acromegaly.

Subjects and methods: Ninety-seven patients (37 men and 60 women; aged 18-76 years) with macroadenoma of hypophysis (67somatotropinoma, 30-somatomammo-tropinoma) were under investigation. Blood samples for GH, IGF-1, immuno-reactive insulin (IRI), glucose were taken in fasting state and on 120 min OTTG. Insulin sensitivity and B-cell function were estimated by HOMA Calculator v.2.2 Data are given as M AE SE and coefficient of determination (R 2 ) of multiple regression analysis.

Results: In 40.2% of patients with acromegalia (GH -22.8 AE 3.5 ng/ ml; IGF-1 -620.81 AE 301.30 ng/ml) different types of carbohydrate dysfunctions (CD) were found out: fasting hyperglycemia (10.2%); impaired glucose tolerance (17.9%), and diabetes mellitus (71.8%). 23.3% of patients have had hyperinsulinemic state. It was no sex differences in the CD structure. IRI level was 22.3 AE 3.5 mU/ml, insulin sensitivity -73.2 AE 7.45%, β-cell activity -161.4 AE 10.3%. HOMA2_IR was positively associated with GH (R 2 = 28.5%, P = 0.001) and IGF-1 (R 2 = 36.6%, P = 0.001). HOMA2_B% was positively associated with GH (R 2 = 17.4%, P = 0.001) and IGF-1 (R 2 = 15.2%, P = 0.01), and negatively with disease duration (R 2 = 12.8%, P = 0.04).

The GH hypersecretion and length of its pathologic action predetermine the stage of carbohydrate dysfunction from fasting hyperglycemia, impaired glucose tolerance to overt diabetes mellitus.

A. Vlassopoulos, M. Lean, E. Combet Human Nutrition, School of Medicine, University of Glasgow, Glasgow, UK Background: Protein glycation is a key mechanism behind chronic diseases in both diabetic and non-diabetic individuals. About 12-18% of circulating proteins are glycated in vivo in normoglycaemic blood, but in-vitro studies have hitherto failed to demonstrate glucose-driven glycation below concentration of 30 mmol/l.

Methods: Albumin, mercaptalbumin (40 g/l) and plasma was incubated with glucose at different concentrations (0-20 mmol/l) for 4 weeks at 37°C. To investigate the effect of oxidation on protein glycation, all protein models were used as native proteins or oxidized proteins (exposed to 10 nmol/l H 2 0 2 for 8 h prior to incubation with glucose and throughout the incubation period). Fructosamine was measured at 2 and 4 weeks (nitroblue tetrazolium method).

Oxidised mercaptalbumin and plasma had higher fructosamine concentrations at 2 weeks at 5 mmol/l glucose compared to native controls (P < 0.05). At 10 mmol/l glucose, the same effect was observed for albumin and mercaptalbumin but not plasma. Only oxidized albumin was significantly glycated at 2 weeks with 5 mmol/l glucose (compared to glucose-free control) when native was not. At 4 weeks no effect of oxidation was observed.

The current study has for the first time demonstrated the importance of oxidative stress in physiological protein glycation, interacting with glucose and promoting glycation in the early stages of the process.

K. Elksne 1 , Z. Paunina 1 , A. Jurka 2 , D. Rezeberga 1 , P. Tretjakovs 2 1 Obstetrics and Gynecology, 2 Physiology, Rigas Stradins University, Riga, Latvia Introduction: A growing number of obese women in their reproductive years increases their risk for obstetric complications, but still the exact mechanisms is not known.

We created a prospective study in which clinical data were collected from antenatal visits in pregnant women. Obstetric outcomes were assessed at delivery. Obstetrical outcomes depending on fetal macrosomia and maternal BMI were analysed using the Fisher exact test. Relationships between pre-pregnacy BMI, gestational weight gain and fetal weight were analysed using Spearman rank correlations.

Results: Overweight women had lower total weight gain during pregnancy, but higher risk for obstetric complications such as fetal macrosomia, uterine dysfunction, ceasarean section and ruptures of the birth canal.

Fetal macrosomia positively correlated with pre-pregnancy weight, but not with gestational weight gain during pregnancy. Also male gender is a risk factor for birth weight above 4000 g.

It is important to increase the number of planned pregnancies, pre-pregnancy visits to doctor in order to inform women about the impact of excess weight on perinatal outcome as fetal macrosomia is associated with impaired maternal BMI.

Women with BMI normal before pregnancy increased their weight above recommendations during gestation. As excessive weight gain may be a risk factor for long term complications, more information about diet should be provided in antenatal visits. Obesity and fetal macrosomia correlate with complications during labour, so additional attention in birth conducting should be paid. Background: The obesity epidemic is widely blamed for the rise in type 2 diabetes, but new research suggests it is also linked to the increase in type 1 diabetes (T1D). The combination of obesity and T1D has a negative impact on metabolic control in patients with T1D in particular during pregnancy.

Aim: To evaluate the rate of overweight or obese women with T1D at pregnancy onset according to their body mass index (BMI) and its relation to metabolic control.

We performed an analysis of 50 singleton pregnancies of 38 women with T1D, who consulted our diabetes outpatient clinic since 2007.

Results: All women were caucasians with mean age of 32 AE 6 years and average diabetes duration of 18 AE 9 years. Only 45% of all women with T1D had a BMI of <25 kg/m 2 , 49% were overweight with BMI between 25.0% and 29.9% and 6% were obese. The metabolic control was similar between the group with normal BMI and BMI >25 kg/m 2 (7.5 AE 1.3% vs. 7.2 AE 1.5%). In the patients with normal BMI only 30% started the pregnancy with a HbA1c <7%, which was mainly due to unplanned pregnancies.

Conclusion: Our data revealed a high proportion of overweight women with T1D at onset of their pregnancy, confirming the worldwide trend of rising obesity rates and which calls for preventive measures in the preconception counseling. Hypertension is more prevalent in HIVinfected subjects than in general population, contributing to increased cardiovascular risk in HIV+ patients. Moreover, HIV patients more frequently showed metabolic alteration than general population. Aim of this study was to evaluate the effect of 144 weeks of administration with telmisartan 80 mg daily in HIV+ patients.

We enrolled 13 HIV+ Caucasian male patients treated with combined antiretroviral therapy (cART) and discovered to be na€ ıve hypertensive. Systolic (SBP) and diastolic (DBP) blood pressure, viro immunological parameters and triglycerides, cholesterol, insulin resistance (HOMA-IR), inflammatory markers, C-reactive protein (CRP), indexes of renal function and cardiovascular risk, microalbuminuria, cystatin C, were measured at baseline (T0), and after 24 (T24), 48 (T48), 72 (T72), 96 (T96), 120 (T120) and 144 (T144) weeks.

Treatment with telmisartan decreased SBP and DBP levels during the 144 weeks of observation. We also observed improved in totalcholesterol, triglycerides, and in total cholesterol/HDL cholesterol ratio. We also observed an microalbuminuria and cystatin C improvement at the end of study. Throughout in the course of the trial our patients showed a significant improvement of the percentage of CD4+ and CD8.

Telmisartan doesn't interfere with the recovery of immunological parameters in this patients. Telmisartan has confirmed durability and effectiveness, excellent tolerability and an high persistance with a good blood pressure control. Therefore telmisartan should be the first choice in the treatment of hypertension in HIV+. Methods: The subjects studied were patients diagnosed with GDM at Ska˚ne University Hospital, Lund, Sweden, 2004 -2011 . Sera were analyzed for antibody positivity (GADA, IA-2A and ZnT8A) with commercially available ELISA and SNPs were studied with restriction fragment length polymorphism.

Results: Combinations of two or more autoantibodies (1.5%) were less frequent than single positivity for GADA (2.9%) or ZnT8A (2.6%), but not IA-2A (0.3%). Patients that developed T1D postpartum often had combinations of autoantibodies. Heterozygosity for R325W was increased (62%) in patients that developed ZnT8A compared to ZnT8A negative patients (35%). However this was not statistically significant (P = 0.06).

Conclusions: The previously reported prevalence of ZnT8A in GDM was confirmed. Positivity for ZnT8A did not seem to be a good independent predictor for development of T1D. The tendency of increased R325W heterozygosity in ZnT8A positive GDM patients is a novel finding and of interest since the SNP has been suggested to be of importance in both T1D and T2D. Among several consequences, obesity seems to have detrimental effects on reproductive function, causing low levels of sex hormones and reduced sperm concentration. The excess of lipids on diet influences metabolism and affects testis reproductive function. The relationship between obesity, reproductive changes and metabolic syndrome is not yet fully clarified. Thus, the aim of the study was evaluate the effect of high fat diet, containing soybean oil, on body composition and male reproductive system of young rats.

Wistar rats, at 21 days, received diet containing 7% (control diet) or 19% (high fat diet, HF) of soybean oil, until 30 and 60 days of age. Food intake and body mass were monitored. At the end, body composition was evaluated by DEXA and blood, liver, adipose tissue, testis and epidydimis were collected. Glucose, triglycerides, cholesterol, HDL, VLDL, insulin and leptin were measured.

Food intake, body mass gain, lean mass, total fat mass and bone mineral content did not differ between the groups at 30 and 60 days. At 30 days, glycemia and epidydimal adipose tissue mass were increased in rats fed with HF. At 60 days, glycemia, leptinemia and the mass of mesenteric adipose tissue, liver and epidydimis were high after HF ingestion, while TG was low.

The excess of lipids reflected negatively on intra-abdominal adipose tissue since 30 days, accompanied by hyperglycemia. The HF ingestion maintained high glucose and leptin concentrations without insulin alteration. At the same time, it could predict some testis function change, once epidydimis mass increased in these young animals. Adipose tissue is linked to cardio-vascular and metabolic complications of obesity by increased local production of adipokines.To investigate serum levels of adipokines (adiponectin and leptin) and relationship with obesity anthropometric markers and insulin resistance in overweight/obese patients with type 2 diabetes. Two groups of subjects were selected: group with type 2 diabetes mellitus (n = 80) and control group (n = 50). The first group was subdivided in two subgroups, according with BMI (overweight and obese). In all individuals were assessed BMI, waist and hip circumference, visceral fat index, serum levels of adiponectin, leptin, insulin and proinsulin and HOMA-IR was calculated. The determined parameters were modified significantly in the diabetic patients vs. control. Comparing the obese diabetic patients with the overweight, serum levels of leptin were higher on obese/overweight (P < 0.001) and levels of adiponectin were lower (P < 0.05). Also, serum levels of insulin and proinsulin were higher in diabetic vs. control group maintained their statistical significance difference in the subgroups of overweight/obese (P < 0.01 and, respectively, P < 0.001). BMI was positively correlated with leptin (P < 0.001) and adiponectin negatively (P < 0.005). Moreover, leptin was positively correlated with visceral fat index (P < 0.001), waist circumference (P < 0.001) and HOMA-IR (P < 0.01); adiponectin was negatively correlated with waist circumference (P < 0.01), visceral fat index (P < 0.05) and HOMA-IR (P < 0.05). In conclusion positive correlation (leptin) and negative (adiponectin) with anthropometric markers of obesity and HOMA-IR, demonstrating the role of adipokines in the pathogenesis of peripheral insulin resistance in patients with "diabesity." Materials and methods: Based on Research Institute of Nutrition we randomly chose 12 patients with varying class obesity, who were outpatient for this disease. All patients were tested on the personal scale manifestations of anxiety (D. Teylor in adapting T. Nemchina).

Patients were asked to read a set of sentences (41 questions) about their traits. If they agreed with the statement they should answer "Yes" if they did not agree -"No". The test had a ball-evaluation, in which anxiety is defined as very high, high, medium and low. Objectives: The process of converting prediabetes to diabetes remains a matter of debate. The aim of the study was to assess insulin sensitivity/resistance indices and markers of oxidative stress in prediabetic persons.

Methods: Obese non-smoking Caucasians, using neither special diet nor medication, without acute and chronic disorders, were qualified for OGTT and assigned to groups: normal glucose tolerance-NGT, impaired fasting glycemia-IFG, impaired glucose tolerance-IGT and newly diagnosed type 2 diabetes-T2DM, each group n = 22 subjects: 11f/11 m; age 52:46-58 (median: quartiles 1-3). Plasma glucose (Siemens) and insulin (BioSource) were determined during OGTT (0',120'). Plasma Total Antioxidant Status-TAS (Randox), thiobarbituric acid-reacting substances-TBARS (Sigma), lipids and hsCRP (Siemens), as well as HbA 1 c (HPLC) were assayed fasting. Different indices of insulin sensitivity/resistance, fasting steady-state and derived from OGTT, were calculated.

Results: The groups did not differ according to age, BMI, waist, blood pressure, lipids and hsCRP.

Insulin sensitivity/resistance indices presented variety of sensitivities and specificities for prediction of dysglycaemia categories, as well as different correlations with metabolic parameters, including oxidative stress, i.e. ISI 0,120 &TAS (R = 0.37), ISI 0,120 &TBARS (R = À0.41) in the population n = 88.

The comparison of NGT-IFG-IGT-T2DM, showed the highest TAS in IFG and the lowest in T2DM (P = 0.000), together with increasing TBARS from NGT to T2DM (P = 0.001).

The results of ROC curves analysis pointed ISI 0,120 (91% sensitivity; 100% specificity) for prediction of IGT, and TAS (86% sensitivity; 90% specificity) in differentiation between IGT and T2DM.

Conclusions: Insulin-sensitivity indices predict prediabetes in obese subjects near perfectly, while the development of diabetes is preceded by antioxidant insufficiency rather.

M. Smiraglia 1 , G. Bott a 2 , E. Orsi 1 1 Endocrinology and Diabetolgy, Fondazione Ca' Granda IRCCS -Ospedale Maggiore Policlinico di Milano, 2 Biomolecular Sciences and Biotechnology, University of Milan, Milan, Italy T2DM is a metabolic disorder and evidences show that Medical Nutrition Therapy improving glucose metabolism reducing the risk of complications, leads to an improvement in life quality and increase life expectancy. The aims of diabetes management are normalize blood glucose levels and weight control. Obesity influences the development of T2DM and complicates its management. The study aim was to value the effect of two different Nutritional Treatments (NT) on the anthropometric parameters and glucose metabolism in patients with T2DM and obesity.

The two NT are: the "Low GI Diet" that promotes the carbohydrates quality and the food choice is made on the Glycemic Index; the "Low-Carbohydrate Diet" is based on the concept that glucose metabolism is influenced also by the carbohydrates amount. Subjects, selected on including and excluding criteria, were randomly divided in two groups, to each of which one of the two NT was assigned. During the study participants were measured three times. All statistic differences in the values were analyzed with the use of ANOVA test. The "Low-GI group" showed a significant decrease in HbA1c (À12.26%; P = 0.09). Data suggest that this NT positively influences the glycemic control. The "Low-Carb group" showed a significant decrease in insulin level (À26.5%; P = 0.03), a greater reduction in BMI and WHR and a HOMA-Insulin Resistance Index reduction (À30.97%; P = 0.06). The daily reduction of carbohydrate intake influenced positively the blood glucose response and significantly reduced plasmatic insulin levels. Data suggest that either NT improves glycemic control and peripheral insulin sensitivity. Aims of study: The use of metformin to control Glucose in pregnant Women with gestational diabetes mellitus (GDM) to evaluate its safty use during the first trimester of pregnancy.

Design: Cases report of four patients with GDM from the first trimester of pregnancy non smoking with no family history of congenital malformation disease, aged between (20 and 45) and have no liver diseases put on metformin were participated in this study and who had indicating good comliance at more than one visit over several month until delivery.

Result: All four patient in oure study delivered healthy babies. Internal Medicine, Ist Medical Clinic, UMF Iuliu Hatieganu Cluj-Napoca, 2 Immunology Laboratory, Emergency County Clinical Hospital, Cluj-Napoca, Romania Introduction: The potential role of oxidative stress (OS) in metabolic syndrome (MetS) is rapidly evolving. Reported results support the concept that increased OS may play a key role in the development of atherosclerosis, hypertension and diabetes.

Study aim: The purpose of the present study was to analyze the impact of MetS and its individual components on OS and on the antioxidant status.

Material and methods: Seventy-two hospitalized patients with a mean age 59.18 AE 5.37 years were taken under study between October 2010 and June 2011. MetS was diagnosed based on AHA/NHLBI/IDF 2009 definition. OS was assessed by urinary 8iso-prostaglandinF2a (8iso-PGF2a) (immunometric assays) and plasmatic uric acid. Antioxidant status was evaluated by plasmatic gluthatione peroxidase (GPx). These data were compared to those of 100 biologically and clinically healthy subjects (mean age 59.93 AE 4.7 years).

Results: All biomarkers were significantly higher in MetS patients as compared with healthy individuals (P < 0.05), except GPx which was significantly lower (P < 0.001). GPx and uric acid were statistically significant correlated. In multivariate analysis 8iso-PGF2a concentrations were influenced by hypertension, fasting glucose and triglycerides, uric acid levels were directly influenced by hypertension, waist circumference, fasting glucose and triglycerides. GPX levels were inversely correlated with blood pressure (all P < 0.05). Only GPx was influenced by the number of MetS components. Objective: The purpose of this study was to compare changes in the plasma metabolome during an intravenous glucose tolerance test (IVGTT) among persons with low or high insulin sensitivity (Si <2.5 or >4.5).

Methods: IVGTTs were performed in 12 men and 12 women, 52 AE 1 years, with low Si (1.45 AE 0.10) and 12 men and 13 women, 53 AE 2 years, with high Si (7.82 AE 0.44). Targeted electrospray ionization, tandem mass spectrometry was used to measure plasma concentrations of 15 amino acids and 45 acylcarnitines during the first phase of the IVGTT. Other metabolites (glucose, insulin, etc.) were measured by conventional methods.

Results: Fasting glucose, insulin, triglycerides, glycerol, free fatty acids, leucine/isoleucine, tyrosine, glutamate/glutamine, 3-hydroxypalmitoleylcarnitine (C16:1-OH)/dicarboxytetradecanoylcarnitine (C14:1-DC), and docosanoylcarnitine (C22) were significantly higher in the low Si group, whereas ornithine was significantly lower. In response to glucose infusion, rates of disappearance of alanine, proline, valine, leucine/ isoleucine, methionine, and phenylalanine were 105%, 92%, 78%, 27%, 129%, and 79% lower, respectively, in the low Si group. There were no group differences in changes in circulating concentrations of free fatty acids, glycerol, triglycerides, or acylcarnitines.

Conclusions: Insulin resistance is associated with lower rates of disappearance of neutral, non-polar amino acids during the first phase of the IVGTT, suggesting insulin-mediated clearance of amino acids and/or suppression of protein catabolism may be impaired. Cigarette smoking is worrisome in adults and also in adolescents. Actually, smoking rates have grown, especially among girls, and little is known about the damages caused in these organisms still young or the consequences in adulthood. This study aim evaluates the influence of smoking in puberty and the consequences of withdrawal, body composition of female and male mice.

At 35 days, mice were exposed to 3R4F cigarette (Tobacco and Health Research Institute) smoke, 8 h/day for 15 days (S, n = 24). Then, half of animals were evaluated and the other half was maintained and evaluated 30 days after stop exposure (30d AS). An unexposed group accompanied the events (NS, n = 24). Body mass, body composition (DEXA), food intake, blood, ipGTT and adipose tissue were evaluated. During exposure food intake was similar all groups, however, S groups showed low body mass gain. 30dAS, S groups increased body mass and food intake in females. No alterations body composition were in males, while in females, increased total body and trunk fat during exposure and lean mass 30dAS. Fat was high epidydimal and retroperitoneal in females. In regard blood, males did not alter insulin or ipGTT during exposure whilst females had high insulin levels and glycemia at 30 min. Withdrawal induced in males, high insulin and low glycemia the ipGTT and in females normal insulin and low glycemia.

The set of results indicates different response cigarette smoke in young that seem to start in females and lead malefic metabolic alterations in adulthood. Methods: This retrospective study included 763 children and youths (344 boys) from The Children's Obesity Clinic. Data were measured at the time for inclusion and included values of body mass index (BMI) standard deviation score (SDS), blood pressure, gender, and biochemical measures, including the fasting concentrations of blood glucose, serum insulin, HbA1c, and serum lipids. The BMI SDS was median 2.64 (range 1.33-5.10) and the age was median 11.6 (range 2.4 -24.7) years. Prediabetes was classified as a fasting blood glucose ! 5.6 and <6.9 mmol/l. The Mann-Whitney-Wilcoxon test was used for the analyses.

Results: Prediabetes was present in 97(47 boys) patients. These patients were older, age median 12.29 vs. 11.50 years (P = 0.015), had a higher BMI SDS median 2.74 vs. 2.61 (P = 0.005), an increased fasting HbA1c median 36 vs. 34 mmol/mol (P < 0.0001), an increased fasting serum insulin median 110.5 vs. 64 pmol/l (P < 0.0001), and an increased median HOMA-IR 5.01 vs. 2.34 (P < 0.0001), respectively, compared to the patients with a fasting plasma glucose <5.6 mmol/l. No differences were found in any of their fasting serum lipid levels or blood pressure (P > 0.05).

In this large group of overweight and obese children prediabetes is prevalent. Thus it seems important to identify obese subjects with prediabetes in order to prevent development of diabetes during childhood. Introduction: Epidemiological spreading of diabetes and developing in early age urge for finding causes and prevention before manifestation. Aim of the study was testing accelerator hypothesis T. Wilkin and colleges.

Method: The study is combined retrospective prospective. We examined history and follow up till age of 16 years 200 children who were referred to pediatrician endocrinologist because of obesity or diabetes.

Results: Children from obese mothers and children with lower birth weight have more metabolic disturbances (insulin resistance, neonatal hypoglycemia, obesity, diabetes, precocious puberty, menstrual irregularity). Subjects and methods: Twenty-two obese women (BMI 35 AE 5 kg/m 2 ) were followed during DI that consisted of a 28 days′ very-low-caloriediet (VLCD) and subsequent 2 months low-calorie-diet followed by a 3 months′ weight maintenance diet (WM). mRNA expressions of adipokines (leptin, adiponektin, interleukines (IL) -6,-8,-18, TNFa, macrophage-chemoattractant-protein (MCP-1), haptoglobin) were measured, using RT-PCR, in samples obtained from abdominal SCAT at baseline and at the end of VLCD and WM, respectively.

Results: Body weight (BW) and plasma CRP decreased during VLCD and at the end of WM (BW: 98.1 AE 16.5 vs. 90.7 AE 15.7 vs. 87.8 AE 15.3 kg (P < 0.001), CRP: 6.3 AE 0.8 vs. 2.6 AE 0.3 vs. 2.9 AE 0.3 mg/l (P < 0.001), respectively). The decrease of plasma CRP during the entire 6 months′ DI correlated positively with the decreases of mRNA expression of MCP-1. (r = 0.54, P < 0.001) and IL-18 (r = 0.38, P < 0.05) during the entire DI and with the decrease of leptin mRNA during initial VLCD (r = 0.532, P < 0.01). No correlations were found for other adipokines. Objective: To determine associations between change in lean body mass (LBM), fat mass and muscle strength with IS following 4 month of resistance training in obese postmenopausal women.

Methods: Thirty-four (12 with and 22 without metabolic syndrome) non-diabetic obese postmenopausal were recruited. Participants completed a 4 month resistance training program (3 times/week). Body composition (DXA), handgrip strength and quadriceps strength were measured. Fasting glucose and insulin levels as well as OGTT derived IS indices (Stumvoll, Matsuda) and HOMA were also measured. Non parametric correlations were performed with SPSS (17.0).

Results: Significant increases in muscle strength, IS and LBM as well as decreases in fat mass were observed after the intervention. However, no correlations were observed between changes in IS with changes in muscle strength, LBM or fat mass in all participants as well as in subjects with or without the metabolic syndrome.

Conclusion: Our results suggest that the changes in muscle strength, LBM and fat mass may not be associated with changes of IS in obese postmenopausal women. Therefore, other potential variables seem to be implicated in the changes of IS in our cohort. Objective: To examine the relation between total work (TW) performed and total heart rate work performed (TRIMPS) with changes in cardiometabolic risk factors after resistance training in obese postmenopausal women.

Methods: Thirty seven postmenopausal women (Age: 60 AE 4.87, BMI: 34.24 AE 3.53) completed a 4 month resistance training program (3 times/week). Body composition (DXA), blood pressure, metabolic risk factors (insulin sensitivity, 2 h glucose, lipid profile and CRP) and muscle strength were measured before and after the intervention. Moreover, TW was calculated in each session by multiplying the number of repetitions, sets, weight and range of motion. Thereafter, we added all training sessions. A heart rate monitor was used to assess TRIMPS during each session. Subjects were also categorized into two groups based on the top or lower 50th percentile of TW and TRIMPS (High (n = 17) vs. Low (n = 17)).

Results: We showed that TW negatively correlated with systolic blood pressure and 2 h glucose levels (P < 0.05). In addition, CRP was negatively associated with TRIMPS (P < 0.05). Furthermore, high workers had lower levels of fat mass percentage and 2 h glucose as well as higher lean body mass content than low workers. As for the high TRIMPS group, we observed lower levels of CRP compared to the low TRIPMS group (P < 0.05).

Conclusion: Results indicate that the quantity of work performed during resistance training is associated with better changes in metabolic risk factors in obese postmenopausal women. Research design and methods: This cross sectional study included gestational diabetes patients who were diagnosed with GDM by a 100 g OGTT and who underwent a standardized mixed meal tolerance test (MMTT). Patients were divided into three groups according to the number of abnormal hyperglycemic values (Group I for 2 values, Group II for 3 values, and Group III for 4 values). Glycemic parameters were compared to assess glycemic control (glucose, A1c, GA) and gluco-metabolic homeostasis (HOMA-β, HOMA-IR).

Results: A total of 92 GDM patients were recruited for this study. Subjects whit a greater number of hyperglycemic values were also more hypertensive and obese, and had decreased insulin secretory functions than those with a lower number of hyperglycemic values (lnHOMA-β, 5.37 AE 0.84 vs. 5.14 AE 0.46, 4.65 AE 0.64, P < 0.001). Those with higher hyperglycemic values tended to have increased insulin resistance, but this result was not significant (lnHOMA-IR, 0.25 AE 0.61 vs. 0.47 AE 0.59, 0.65 AE 0.76, P = 0.062). LnHOMA-β correlated negatively with fasting glucose, A1c, GA and GA/A1c. Multivariable regression analysis revealed that age and GA were significant independent predictors for lnHOMA-β (standardized β = À0.202, À0.423, respectively, P < 0.05) but not A1c.

Conclusions: Korean women with dysfunctional pancreatic β-cells and increased insulin resistance are prone to gestational diabetes. GA, but not A1c, is significantly correlated with pancreatic β-cell function. Conclusion: Altered adipokine profile is associated with increased CVD risk in PCOS patients. These markers can serve as potential therapeutic target for decreasing their CV risk.

Objective: To determine the prevalence and determinants of nonalcoholic fatty liver disease (NAFLD) in a sample of adult Iranian general population.

Method: This was a cross-sectional study being performed in Shiraz, southern Iran during a 10-month period from November 2010 to September 2011 through cluster random sampling of Iranian general population in Shiraz region. All individuals underwent anthropometric and blood pressure measurements and thorough medical history and physical examinations. Laboratory measurements included fasting blood glucose (FBS), lipid profile, complete blood count (CBC) and liver function tests. NAFLD was diagnosed by transabdominal ultrasonography.

Result: Overall we included 819 subjects in this study among which there were 340 males (41.5%) and 479 females (58.5%) with the mean age of 43.1 AE 14.1 years. NAFLD was diagnosed in 176 (21.5%) subjects. Patients with NAFLD were significantly older (P < 0.001), had higher proportion of male gender (P = 0.004) and had higher BMI (P < 0.001). They also had higher prevalence of hypertension (P < 0.001), high FBS (P < 0.001), high cholesterol (P = 0.026), high triglyceride (P < 0.001) and high waist circumference (P < 0.001). Taking all these together, patients with NAFLD had significantly higher prevalence of metabolic syndrome when compared to healthy subjects (P < 0.001).

Conclusion: The prevalence of NAFLD in this group of Iranian adult general population is 21.5%. NAFLD in Iranian population is associated with male gender, old age, obesity, and features of metabolic syndrome.

A. Othman 1 , T. Hornemann 2 1 University Hospital Zü rich, 2 Clinical Chemistry, University Hospital Zü rich, Zü rich, Switzerland 1-Deoxysphingolipds (dSL) are atypical and neurotoxic sphingolipids which are formed by the enzyme serine-palmitoyltransferase (SPT) due to a promiscuous use of L-alanine over its canonical substrate L-Serine. Pathologically elevated dSL levels were identified as a cause for the rare and inherited sensory neuropathy HSANIwhich is associated with several missense mutations in SPT. Significantly elevated dSL levels were also found in patients with MetS or T2DM as demonstrated in various clinical studies. Principal component analysis identified the dSLs as important descriptors for the MetS statecomparable to triglycerides and superior to conventional MetS biomarkers like fasting glucose or wcf. Partial correlation analysis showed an independent correlation to plasma glucose and triglycerides. Strikingly, recent data from prospective clinical studies identified plasma dSLs as highly significant and independent predictors for the risk to develop T2DM. Elevated dSL levels were also confirmed in plasma and liver of STZ rats. The dSLs are therefore clinically relevant blood biomarkers for an impaired glucose homeostasis but might also be directly involved in the pathology of diabetes related sequelae. Like observed in HSAN1 the 1-dSL formation is significantly suppressed in response to an oral L-serine supplementation. Feeding an L-Serine enriched diet to STZ rats resulted in a significant reduction of plasma dSLs, a significant improvement of neuropathic symptoms and reduced cataract formation.

Our findings strongly support the value of dSLs as novel and clinically relevant biomarkers in MetS and T2DM but also as therapeutic targets for the treatment of the diabetic neuropathy and other sequelae. Objectives: Prevention of cardiovascular disease focused on the early stages of atherosclerosis, including endothelial dysfunction, should arouse attention of clinicians in dysglycaemia patients especially.

The aim of the study was to assess plasma E-selectin concentrations in newly diagnosed type 2 diabetes (T2DM) and in T2DM patients treated with metformin, comparing with normoglycaemic individuals.

Material and methods: Excess body mass non-smoking males and females, 41-73 years old, presented with neither acute nor chronic disease, were enrolled into the study. Oral glucose tolerance test (OGTT) was performed to find normal glucose tolerance, Group-1 (n = 20, age: median 58; interquartile range 52-63) and newly diagnosed T2DM, Group-2 (n = 21, age: 57; 54-67). Group-3 consisted of T2DM patients who take medication (metformin) for at least 1 year (n = 22, age: 58; 54-65) and present no retinopathy, nephropathy and neuropathy, as well as no history of coronary incident or stroke. All participants were measured plasma glucose (G-0, G-120), fasting lipids and insulin, and HbA1c level. E-selectin concentration in plasma was assessed using ELISA method (R&DSystems). Data are shown as median and interquartile range.

Results: Groups 1-2-3 did not differ in respect to their age and BMI. The comparison among groups, followed by post hoc analysis, revealed different (P = 0.001) E-selectin concentrations, ng/ml: Group-1: 23.3 (18.5-34.5), Group-2: 43.5 (36.3-51.7), Group-3: 26.6 (18.7-32.7). In combined group1 + 2 (n = 41) the correlation E-selectin&G-120' was observed independently from BMI and triglycerides (multiple regression β = 0.506; R 2 = 0.35; P = 0.0025).

Conclusion: Metformin therapy may limit early stages of atherosclerosis in T2DM patients not only works to decrease plasma glucose. 

Aim: To evaluation clinical efficacy of candesartan and its effect on parameters of vascular elasticity, lipid profile, lipid peroxidation and antioxidative protection against a background of single-candesartan therapy in females with arterial hypertension (AH) and abdominal obesity (AO) during menopause.

Methods: Forty-six patients were divided into two groups. Group1 (25 subjects) were given candesartan and group 2 (21 subjects)enalapril. Twenty-four hour blood pressure monitoring (BPM), pulse wave velocity; plasma lipids, diene conjugates (DC), malonic dialdehyde, superoxide dismutase (SOD) and homocysteine, uric acid were estimated. The dynamics of all parameters was evaluated initially and in 6 weeks.

Results: Candesartan is a more effective hypertensive drug that has a valid effect on the readings of systolic blood pressure (SBP) and diastolic blood pressure (DBP) measured in the doctor's office and on the parametrs of BPM (daily SBP and DBP, daytime and nighttime SBP and DBP, SBP and DBP variability, the rate of morning rise in SBP and DBP). We revealed a favorable effect of the medication on vascular wall elasticity, valid reduction of cholesterol, low-density lipoprotein cholesterol, triglycerides, DC, homocysteine and uric acid increase in SOD in group 1.

The proved antihypertensive effect of the candesartan therapy against a background of normalization of vascular wall elasticity, plasma lipids and processes of lipid peroxidation, in the presence of differently directed correlations between clinical and biochemical characteristics, shows that candesartan has pathogenetic mechanisms of correcting AH in females with AH and AO during menopause. Background: High intensity interval training (HIIT) may improve insulin action in skeletal muscle, but this has never been shown.

Objective: To study the effect of HIIT on insulin mediated glucose uptake rate in skeletal muscle.

Methods: Four healthy sedentary males [age 53 AE 4 years (mean AE SE), BMI 28.4 AE 1.2 kg/m 2 ] were included. A total of eight one-legged training sessions were performed on an ergometer bicycle as 10 9 1 min high intensity exercise (workload >60% of one-legged VO 2 -peak, and heart rate >80% of maximal heart rate) with 1 min recovery between each interval. Lean leg mass before and after the training period was assessed using dual-energy X-ray absorptiometry. Forty hours after the last training session, a two-step isoglycemic, hyperinsulinemic clamp was performed in combination with arteriofemoral venous catheterization. Blood flow was measured with Doppler ultrasonography. Data were expressed per kg lean leg mass, and differences were tested by t-test.

Results: Insulin stimulated glucose clearance rates were significantly higher in trained compared with untrained legs in both steps of the clamp (figure). The lean mass of the trained legs did not significantly differ from the untrained legs (P = 0.51).

Conclusion: HIIT increases insulin stimulated glucose uptake in skeletal muscle in the leg after a very short training period. It is a time-effective training modality which may be attractive in the treatment of insulin resistance and type 2 diabetes. (HTGpos) and that this HTGpos is related with the degree of insulin resistance. Our aim was to characterize the adipose tissue of morbidly obese patients with mild or severe HTGpos after a fat overload though the expression of a battery of genes involved in lipid metabolism.

Methods: We studied 57 morbidly obese patients who had mild or severe HTGpos after fat overload (patent P201030776). Measurements of anthropometric and biochemical variables and oxidative stress biomarkers were done. Samples of visceral adipose tissue were obtained during bariatric surgery in the morbidly obese patients. The RNA isolation from adipose tissues was done using RNeasy Lipid Tissue Mini Kit and the gene mRNA expression levels were assessed by real-time PCR using an ABI Prism 7000 Sequence Detection System.

Results: No significant differences were observed in biochemical variables except in triglyceride levels between the two groups of morbidly obese patients with postprandial mild or severe HTGpos. The morbidity obese patients with severe HTGpos had a higher oxidative stress levels. Genes involved in the management of triglycerides or lipid metabolism were up-regulated in morbidly obese patients with severe HTGpos.

Conclusion: Morbidly obese patients with severe HTGpos had a more active adipose tissue regarding the expression of genes involved in lipid metabolisms, these data could indicate a greater flow of lipids and a greater insulin resistance in these patients. Patients and methods: Three hundred and nine workers (78M/231F; aged 50 AE 13; BMI 33.7 AE 5.3 kg/m 2 ), without previous cardiovascular events, were enrolled. All subjects were evaluated for 13 biochemical analytes (fibrinogen, C-reactive protein, uric acid, creatinine, triglycerides, t-cholesterol, HDL, LDL, homocysteine, glucose, insulin, HbA1c, 25 (OH) D). All parameters were routinely assayed in corelab. These parameters together with HOMA-IR, systolic and diastolic blood pressure, BMI, age, percent of fat and waist circumference were processed by neural networks (AutoCM). The AutoCM matrix of connections preserves non linear associations among variables, while at the same time capturing elusive connection schemes among clusters that are often overlooked by traditional cluster analyses.

Results: With an appropriate pre-processing able to handle each variable according to its high and low values, Auto-CM showed a clear association between 25 (OH) D and metabolic status with graph links suggesting a protective role of high 25 (OH) D against increase in BMI, waist circumference and abdominal fat. These associations were not clearly visible with traditional data mining tool.

The neural networks map identifies the key role of vitamin D respect to all metabolic parameters considered in our study in the development of prediabetes drawing a physiopathologic road map for obesity and type 2 diabetes. Patients and methods: The study included 62 type 1 diabetic patients and 30 healthy volunteer of the same age and sex. Blood sample was taken for assessment of omentin and OxLDL by ELISA technique. Also blood sample were taken for analysis of glycosylated hemoglobin, lipid profile and urine sample was taken for assessment of albumin/creatinine ratio. Twenty-four hour holter was also done.

The study included 62 patients with type 1 diabetes, their mean age were 16.3 AE 1.5 years (14.0-19.0 years), and mean duration of diabetes were 9.4 AE 2.9 years (5.0-16.5 years). Omentin was significantly lower, while OxLDL was significantly higher than controls. Omentin had a significant negative correlation with OxLDL and albumin/creatinine ratio and 24 h holter (minimal HR, RMS) and positive correlation with VLDL.

Conclusion: A significant reduction of omentin and elevation of OxLDL imply that they influence glucose metabolism in type 1 diabetes. Omentin had a significant relation to 24 h holter may reflect its role in cardiac affection. While, albumin/creatinine ratio had a significant negative correlation with omentin and positive correlation with OxLDL reflect their role in renal affection. Patients and methods: The study included 62 type 1 diabetic patients and 30 healthy volunteer of the same age and sex. Blood sample was taken for assessment of chemerin, vaspin, ADMA and OxLDL by ELISA technique. Also blood sample were taken for analysis of glycosylated hemoglobin, lipid profile and urine sample was taken for assessment of albumin/creatinine ratio. Twenty-four hour holter was also done.

The study included 62 patients with type 1 diabetes, their mean age were 16.3 AE 1.5 years (14.0-19.0 years), and mean duration of diabetes were 9.4 AE 2.9 years (5.0-16.5 years). Chemerin, vaspin and OxLDL were significantly higher, while ADMA was significantly lower than controls. Chemerin had a significant positive correlation with vaspin, ADMA and OxLDL. Vaspin had a significant positive correlation with waist/height ratio, SDANN, SDRR and SDDRR. Albumin/creatinine ratio had a significant positive correlation with chemerin, ADMA and OxLDL.

Conclusion: A significant reduction of ADMA and elevation of chemerin, vaspin and OxLDL imply that they influence glucose metabolism in type 1 diabetes. Vaspin had a significant relation to 24 h holter may reflect its role in cardiac affection. While, albumin/ creatinine ratio had a significant positive correlation with chemerin, ADMA and OxLDL reflect their role in renal affection. Patients and methods: The study included 62 type 1 diabetic patients and 30 healthy volunteer of the same age and sex. Blood sample was taken for assessment of apelin, nitrous oxide and preptin by ELISA technique. Also blood sample were taken for analysis of glycosylated hemoglobin, lipid profile and albumin/creatinine ratio in urine. M mode echocardiography was also done.

Results: The study included 62 patients with type 1 diabetes, their mean age were 16.3 AE 1.5 years (14.0-19.0 years), and mean duration of diabetes were 9.4 AE 2.9 years (5.0-16.5 years). Nitrous oxide was significantly lower, while apelin, preptin and albumin/creatinine ratio were significantly higher than controls. Nitrous oxide had a significant positive correlation with LVEDD, LVESD, PWT and LV mass and negative correlation with preptin and albumin/creatinine ratio.

Conclusion: A significant reduction of nitrous oxide and elevation of apelin and preptin and their relation to echocardiographic data imply that early assessment of these markers may unmask the initial endothelial dysfunction in type diabetic patients before overt microalbumin and renal impairment supervenes. Obesity co-morbidities may appear already early in life in high-risk individuals. Today we have no means to identify which obese children who are at highest risk. Consequently, we have implemented a study with the objective to identify factors in obese children that could indicate early development of related co-morbidities. In this abstract we have concidered fasting glucose, 2 h OGTT, and degree of obesity as predictors.

Severely obese children and adolescents treated for obesity between 1996 and 2007 (n = 600), but not undergone bariatric surgery, are included. Currently, follow-up measurements have been conducted in 15 subjects.

Study participants undergo extensive examinations during 2 days including e.g. cardio respiratory fitness, body composition, both oral and intravenous (IVFSGTT) glucose tolerance tests.

Average age of the first subjects is 20.4 years (17.4-22.1). Follow-up time varies from 4.7 to 13.3 with an average of 6.8 years. BMISsds at baseline 5.6 (4.2-7.0) correlates with BMI at follow-up (y = 6.0x + 10.9, R 2 = 0.24). No other correlations with degree of obesity at baseline could be found. Fasting glucose at baseline correlates with CRP 6.8 years later. However, fasting glucose was not correlated with 2 h OGTT, insulin sensitivity, diabetes, or prediabetes at follow-up. No correlations between 2 h OGTT value at baseline and later co-morbidity was found.

In the first studied subjects all, but one, of the severely obese children remained obese in early adulthood. Higher level of fasting glucose at baseline predicted higher CRP at follow-up. Analyses from more collected data will be presented. Background: Obesity acts as an independent cardiovascular risk factor by mechanisms that are not fully understood. Elevated levels of the pro-inflammatory cytokines interleukin(IL)-6, IL-8 and plasminogen activator inhibitor (PAI)-1 are found in obese patients. Recent studies suggest that inflammation could be an adaptive response to hypoxia within the expanding adipose tissue mass. In this study we investigated the impact of hypoxia on PAI-1, IL-6 and IL-8 regulation in human adipose tissue ex vivo and in vitro.

Methods: Primary human preadipocytes and adipocytes were prepared from subcutaneous and visceral adipose tissue. Explants, preadipocytes and adipocytes were cultured under hypoxic conditions. PAI-1, IL-6 and IL-8 antigen were quantified by ELISAs, mRNA levels were determined by RealTimePCR.

Results: PAI-1, IL-6 and IL-8 secretion was significantly increased under hypoxic conditions in subcutaneous and visceral adipose tissue explants. Hypoxia significantly upregulated IL-6 production in preadipocytes and adipocytes up to 5-fold and 10-fold. IL-8 and PAI-1 were significantly increased by hypoxia in preadipocytes and adipocytes up to 3-fold and 2-fold (IL-8) and 7.5-fold and 6.5-fold (PAI-1), respectively. These results were confirmed on the level of mRNA expression.

Conclusion: Our data show that hypoxia increases IL-6, IL-8 and PAI-1 production in adipose tissue explants and in cultured human preadipocytes and adipocytes. We therefore hypothesize that hypoxia promotes the pro-inflammatory state seen in obese patients and thus could contribute to the elevated risk for cardiovascular diseases. This study sought to characterize the antioxidant properties and interaction of phenolic (free and bound) extracts from Clerodendrum volubile (a leafy vegetable commonly grown and consumed in South eastern part of Nigeria), with key enzymes relevant to Non-insulin dependent diabetes mellitus (a-amylase and a-glucosidase) in vitro. The free phenolics of Clerodendrum volubile were extracted with 80% acetone, while the bound phenolics were extracted from the alkaline and acid hydrolyzed residue with ethyl acetate; and their interaction with the enzymes were assessed. The phenolic extracts inhibited a-amylase, aglucosidase and Fe 2+ -induced lipid peroxidation in pancreas (in vitro) in a dose-dependent manner. However, bound phenolics had significantly higher (P < 0.05) a-glucosidase inhibitory activities, than free phenolics while there was no significant difference (P > 0.05) in their a-amylase inhibitory activities. The stronger inhibition of a-glucosidase when compared to a-amylase in both extracts is of pharmacological relevance. The stronger action of the bound phenolic extract on a-glucosidase may explain the possible bioactivity of the phenolics at the brush border end. The phenolic profile in both extracts revealed the presence of phenolic acids and flavonoids. Moreover, the inhibitory properties of phenolic rich extracts from Clerodendrum volubile on a-amylase, a-glucosidase and Fe 2+ -induced lipid peroxidation in pancreas could be attributed to the antioxidant properties of the extracts. From the study, Clerodendrum volubile could serve as functional foods and nutraceuticals for early intervention and management of Non-insulin dependent diabetes mellitus. Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA Background: Alternate day fasting (ADF), consisting of a feed day (24-h ad libitum food intake) alternated with a fast day (75% energy restriction), is effective in reducing body weight and modulating adipose tissue physiology. However, the ability of ADF in combination with endurance exercise to improve the above variables has never been tested.

Objective: Accordingly, this study examined whether the combination of ADF plus exercise produces superior changes in body weight and plasma adipokine levels, when compared to each treatment alone.

Methods: Obese subjects (n = 64) were randomized to one of four groups for 12 weeks:

1. combination (ADF + endurance exercise), 2. ADF, 3. exercise, or 4. control.

Results: Body weight was reduced (P < 0.05) by 7 AE 1, 5 AE 1, and 1 AE 1 kg, and fat mass decreased (P < 0.001) by 6 AE 1, 4 AE 1 and 1 AE 1 kg in the combination, ADF and exercise group, respectively. Fat free mass was retained in all groups. Adiponectin and resistin values did not change in any group post-treatment. Leptin levels significantly decreased (P < 0.05) by 38 AE 10, 15 AE 6 and 15 AE 6 ng/ ml in the combination, ADF, and exercise group, respectively.

Conclusion: These findings suggest that the combination of ADF plus exercise produces superior changes in body weight, body composition and leptin levels, when compared to each intervention alone. the plasma total cholesterol and triglycerides concentration were higher than other groups.

Adipokines results were that resistin, adiponectin, leptin, and TNF-a were significantly lower than [HF], [BR] and [HC] . So it had a effect on anti-obesity. These results showed that functional rice especially giant embryonic components will probably be useful in the management of high fat diet-induced chronic disease.

M.G. Watve 1 , M.S. Diwekar 1 , P. Patil 2 1 Biology, Indian Institute of Science Eduction and Research, 2 Physiology, Bharati Vidyapeeth Medical College, Pune, India A crucial link in the classical thinking of type 2 diabetes (T2D) is that insulin resistance (IR) is primary and hyperinsulinemia develops to compensate. High levels of insulin are associated with an insulin resistant state. There have been alternative suggestions that insulin overproduction is primary and IR develops to compensate it. It is also likely that both are secondary effects of an unknown primary cause. We critically examine the alternative possibilities in the light of theory and evidence. Temporally hypoglycemia and/or hyperinsulinemia precede insulin resistance in human and animal IUGR models. Various gene knockouts show that primary muscle and adipose insulin resistance does not lead to HI. In insulinomas, where hyperinsulinemia is primary, insulin resistance develops almost invariably and removal of such tumors increases insulin sensitivity. If IR sets in first, pancreas must sense the IR and increase the insulin production accordingly. If raised blood glucose mediates the response, we expect a positive correlation between fasting glucose and fasting insulin in prediabetic individuals. However, such a correlation is not seen in a large set of data on normoglycemics. No other mechanisms have been postulated that can measure the level of IR and in turn regulate the insulin secretion by beta cells. On the other hand many pathways exist that can induce IR when beta cells overproduce insulin. Overall there is substantially more evidence for the hyperinsulinemia-first hypothesis. This can potentially undermine our current understanding of T2D and the entire chain of processes leading to T2D needs to be re-examined. 

Non-alcoholic fatty liver disease (NAFLD) is emerging as the most common liver disease in industrialized countries. The discovery of food components that would ameliorate NAFLD is therefore of interest. Betulinic acid (BA) is a pentacyclic triterpenoid showing many pharmacological activities, but effect of BA on fatty liver is largely unknown. To explore the anti-fatty liver activity and mechanism of BA, insulin resistant HepG2 cells, primary rat hepatocytes and liver tissue of ICR mice fed on HFD were utilized. Oil Red O staining revealed that BA significantly suppressed the excessive triglyceride accumulation in HepG2 cells and liver of mice fed on HFD. Ca +2 -calmodulin dependent protein kinase kinase (CaMKK) and AMP-activated protein kinase (AMPK) were both activated by BA treatment. In contrast, protein expression of sterol regulatory element-binding protein 1 (SREBP1), mammalian target of rapamycin (mTOR) and S6 kinase (S6K) were all suppressed when hepatocytes were treated with BA for up to 24 h period. BA activated AMPK by phosphorylation, suppressed SREBP1 mRNA expression and nuclear translocation and repressed SREBP1 target gene expression in HepG2 cells and primary hepatocytes, leading to reduced lipogenesis and lipid accumulation. These effects were completely abolished in the presence of STO-609 (a CaMKK inhibitor) or compound C (an AMPK inhibitor), indicating that BAinduced anti-hepatic steatosis was mediated through modulation of CaMKK-AMPK-SREBP1 signaling pathway. Taken together, our results suggest that BA can effectively ameliorate intracellular lipid accumulation in liver cells, and thus it may be a potential therapeutic agent for treating fatty liver disease. Blood glucose concentration, insulin level, Glucokinase, G6pase and PEPCK were significantly decrease relative to the [HF] . In addition, Antioxidantresults were that CAT, SOD and GPx were higher than [HF] . Effect of rice supplementation 2 type of giant embryonic on Erythrocyte TBARS and Plasma TBARS showed significantly decrease than other groups. These experiments suggest that components of giant embryonic help to lower the level of and blood glucose which reduces the risk of heart disease and diabetes. Method: A 75 g o-GTT was performed in 289 normal-weight (N) healthy females, 562 females with overweight and 696 females with obesity (grades 1-3), with measurements of glucose and insulin. HOMA-insulin resistance (IR) and Belfiore-insulin sensitivity (IS) were caldulcated. The 90th percentile in the N group was used as cut-off.

Results: IR was present in 22.5% of women with normal weight and in 45.0% of women with overweight/obesity. 65.4%, 74.2% and 89.6% of women have IR in the obesity grade 1, 2 and 3, respectively. Further risk factors for IR are age, hip-waist ratio, triglycerides, HDL, uric acid, PAI-1 and fibrinogen (P < 0.00001). HbA1c is irrelevant for the detection of IR. Hormonal imbalances (hyperandrogenemia, IGF1 deficiency, hypothyroidism, elevated estradiol) play a major role in obese women. Postmenopausal women receiving hormone replacement therapy (HRT) develop hyperglycemia, as expected by age, but not IR. HRT improves IS.

Discussion: IR is the common pathogenetic factor for risk components summarized as "metabolic syndrome": dyslipidemia, hypertension, hyperandrogenism and obesity. The vicious circle is intensified with the degree of IR. During the 15 to 20-year interval between the onset of IR and the manifestation of DM, significant micro-and macroangiopathies can develop. Early detection of IR is therefore crucial for the prevention of DM and CVD. The costs involved for diagnosis are minimal (60-80 €) compared to the cost of treatment for DM and CVD. 

The effect of dietary feeding of "Superjami" on the glucose metabolism and antioxidative status in mice under high fat diet conditions was investigated. The mice were randomly divided and given experimental diets for 8 weeks: normal control (NC group), high fat (HF group), and high fat supplemented with Heukjinju (HF + HJ group), Suwon 425 (HF + SW group) and Superjami (HF + SJ group). At the end of the experimental period, the HF group exhibited markedly higher blood glucose level. However, diet supplementation of Superjami was found to counteract the high fatinduced hyperglycemia and oxidative stress via regulation of antioxidant and hepatic glucose-regulating enzyme activities. These findings illustrate that Superjami was similarly effective in improving the glucose metabolism and antioxidant defense system in high fat-fed mice and they may be beneficial as functional biomaterials in the development of therapeutic agents against high fat diet-induced hyperglycemia and oxidative stress. Objective: To evaluate the effectiveness of two types of intervention: personal and group therapy in preventing or delaying diabetes.

Methods: Two hundred and twenty-two pre diabetes adults were assigned to both interventions, which included physicians, dietitians, social workers and physical activity consultants, to modify patients' lifestyle and reduce weight. Glucose, total cholesterol, LDL, HDL; tryglesirides and BMI were measured before (T1), immediately after (T2) and post 18 months (T3) of the intervention. Mix linear; logistic regression and cox models were employed.

Results: Mean age was 51.9 and 55.4 (P = 0.001) for the personal and group therapy, respectively. No significant differences in time trends for all the clinical measurements between the groups were observed. However, (i) reduction (À5.68 P < 0.0001) in glucose for the personal therapy group between T2 and T1; (ii) reduction in total cholesterol (À12.5 P = 0.001; À14.8 P < 0.0001) in personal and group therapy, respectively, between T1 and T3; (iii) significant HDL increase in both groups between T1, T2 and T3; and (iv) significant decline in LDL, triglycerides and BMI between T3 T2 and T1. 39.3% and 38.7% of the group and personal therapy, respectively (P = 0.933), developed type 2 diabetes during the study period. No differences to time to onset of the disease between the two groups.

Conclusion: For patients with pre diabetes, both types of intervention were effective in delaying and preventing the disease. Group therapy is recommended since it requires fewer resources and can be implemented for the benefit larger population. Methods: The present population-based case-control study was performed in Shiraz, southern Iran, over a 12-month period from December 2010 to 2011, on a randomly selected study population group consisting of inhabitants of the metropolis of Shiraz in southern Iran. All the patients underwent anthropometric and blood pressure measurements as well as thorough medical history and physical examinations. Laboratory parameters including fasting blood glucose, lipid profiles, liver enzymes and ferritin, in addition to liver ultrasonography and CIMT, were performed for all subjects. The cutoff value for the CIMT was set at 0.8 mm and the measured values were correlated with other risk factors.

We evaluated 290 patients with NAFLD and the same number of controls. Subjects with NAFLD had a significantly higher prevalence of increased CIMT (OR: 1.66, P < 0.001). In patients with NAFLD the age of 50 years represented an appropriate cut-off value for predicting increased CIMT. A systolic blood pressure (SBP) of 117 mmHg and a diastolic blood pressure (DBP) of 72 mmHg were shown to be appropriate cut-off values for predicting increased CIMT.

Conclusion: Cardiovascular risk factors such as increased intimamedia thickness (IMT) occur more frequently among NAFLD patients when compared to healthy individuals. We recommend a careful evaluation of not only the liver, but also of the cardiovascular system in these patients, in order to prevent later morbidity related to atherosclerosis. mitochondrial capacity of oxidizing fatty acids and increased mitochondrial ROS production. The peroxisomal β-oxidation, which starts the oxidation of the long-chain fatty acid and contributes with approximately 35% of all oxygen peroxide produced in the cell, was increased in OVX mice. These effects could lead to oxidative damage, a condition that was, in fact, evidenced by the reduced levels of reduced glutathione and elevated levels of TBARS found in livers of OVX mice.

The decreased mitochondrial capacity of oxidizing fatty acids could contribute, at least in part to development of HS in OVX mice. Besides, the higher mitochondrial and peroxisomal ROS generation resulted in oxidative damage in livers from OVX mice. Background: Elevations in high-sensitivity C-reactive protein (hs-CRP) are associated with an increased risk of insulin resistance (IR). Investigation of relationship between hs-CRP, parameters of glucose metabolism and leptin in patients with T2DM and IGT could be help to assess the role of hs-CRP in development of IR.

Aim: Of the study was investigation of relationship between hs-CRP and hepatic glucose production (HGP), leptin and HbA1c in women with T2DM and IGT.

Materials and methods: Forty-eight women with IGM (31newly diagnosed T2D and 17 IGT were observed). Hs-CRP and leptin were assessed in fasting states. Intravenous glucose tolerance test was performed (0.75 г glucose on kg of body mass). Mathematical analysis of results with definition of HGP (the H-index, mmol/l) was done with the special program (accessible in Internet: www.diabet.ru/ivgtt).

Results: BMI was significantly correlated with hs-CRP, r = 0.48, P < 0.001 and the level of hs-CRP in women with BMI >30 kg/m 2 was almost four times greater compare to hs-CRP in women with BMI >30 kg/m 2 [3.4 (2.5-4.5) and 11.3 (4.1-17.8) accordingly, (P < 0.05)]. Between hs-CRP and HGP and between hs-CRP and leptin direct correlation (r = 0.40, P < 0.05) and (r = 0.45, P < 0.005, accordingly) was revealed. Correlation between hs-CRP and HbA1c wasn't found.

Conclusions: Association between hs-CRP and leptin level, hs-CRP and HGP could be demonstrate the role of hs-CRP in development of insulin resistance. Institute for Sport and Physical Activity Research (ISPAR), University of Bedfordshire, Bedford, UK Objective: Hypertriglyceridemic waist (HW) and waist-to-height ratio (WHTR) are simple clinical tools that identify adults at risk of cardiometabolic disorders and cardiovascular disease. Whether this applies in youth is under-researched and this study therefore investigated whether the HW phenotype and WHTR are associated with cardiometabolic disorders in children and adolescents.

Methodology: This was a cross-sectional design study. Anthropometry, biochemical variables, and cardiorespiratory fitness were assessed in 234 participants (122 girls) aged 10-19 years from Bedfordshire, United Kingdom. The HW phenotype was defined as a waist circumference ! 90th percentile for age and sex, and triglyceride concentrations ! 1.24 mmol/l, and a high WHTR defined as >0.5. ANCOVA and logistic regression were used in the analysis.

Results: In participants with the HW phenotype, clustered risk score was lower (P < 0.05), the odds of having high cardiorespiratory fitness (ml/kg/min) lower (0.045; 95% CI 0.01, 0.42), and the odds of having low HDL-cholesterol (4.41; 1.50, 12.91), impaired fasting glucose (3.37; 1.06, 10.72), and ! 1 (4.78; 1.32, 17.29) and ! 2 risk factors (7.16; 2.38, 21.54) higher than those without the phenotype. Those with a high WHTR had lower clustered risk (P < 0.05), higher odds of having low HDL-cholesterol (2.57; 1.11, 5.95), high diastolic blood pressure (3.21; 1.25, 8.25) , and ! 2 risk factors (5.57; 2.05, 15.17) than those with normal WHTR.

Conclusion: The HW phenotype may be a better simple marker than WHTR for identifying children and adolescents at risk for cardiometabolic disorders. Treatment with ACE inhibitors (ACEi) and AT1 receptor blockers (ARBs) has been shown to reduce the number of new-onset DM2, improve insulin sensitivity and reduce adipocyte size 1,2 .

We investigated additional metabolic effect of renin-angiotensin system (RAS) blockade with ARB in comparison with ACEi. Specifically we studied the effect of Candesartan cilexetil therapy on glucose metabolism and parameters of subcutaneous adipose tissue (SAT) in hypertensive subjects.

Antihypertensive treatment with ACEi was replaced by candesartan for 6 months in 18 subjects with essential hypertension. Experimental procedures involved measurements of anthropometric data, blood pressure, oral glucose tolerance test, RAS components and adipokines gene expression in SAT obtained by biopsy. Intersticial fluid from SAT was collected by using microdialysis.

Six months after replacement ACEi by candesartan, the systolic blood pressure decreased by 6.95 AE 4.07 mmHg (P < 0.05), diastolic blood pressure decreased by 5.68 AE 2.35 mmHg (P < 0.05) and fasting plasma glucose decreased by 0.84 AE 0.06 mmol/l (P < 0.01). Insulin sensitivity index (Matsuda) tended to increase (P = 0.08). Among the adipokine and RAS genes studied in SAT only PPARc expression tended to increase (P = 0.052) after candesartan treatment.

As expected, candesartan had blood pressure lowering effects comparable to those of ACEi. Seeing that candesartan reduced fasting glycemia and strongly tended to increase PPARc expression in SAT, we speculate that ARBs treatment might have additional positive effect on glucose metabolism compared to ACEi. The study is continuing and samples of serum and microdialysate are currently under analysis of RAS peptide content. Purpose: Diastolic dysfunction in the metabolic syndrome/type 2 diabetes (D) is an epidemic without evidence-based treatment strategies. Studies on dietary interventions are scarce. We tested the hypothesis, that a low-carbohydrate diet (LC) improves cardiac function in overweight-obese D more than the traditionally recommended low-fat diet (LF).

Methods: Two groups of 16 D without cardiac disease (BMI 34 AE 6 kg/m 2 ) were studied in a parallel and partial cross-over design during a 3-week rehabilitation program with either LC or LF. The group on LF (carbohydrate 55%, fat 25%, protein 20%) had subsequent 2 weeks on LC (25%, 45%, 30%, respectively). Cardiac function was assessed as myocardial velocity during systole and diastole (E′) and metabolic control before and 2 h after (pp) a standardized breakfast (400 kcal). Both groups had supervised aerobic training 2 h a day.

Results: In the parallel groups, both diets induced similar and significant reductions of weight, HbA1c and cholesterol. LC considerably improved insulin resistance, triglycerides, systolic and diastolic blood pressure and E′ (9.5 AE 1.0-10.4 AE 1.5 cm/s, P = 0.023), but LF did not whereas all these variables improved significantly after subsequent LC (E′ from 10.6 AE 1.5 to 11.5 AE 1.4 cm/s, P = 0.016). Intact proinsulin was unchanged with LF but decreased with subsequent LC fasting and pp (P = 0.032 and 0.004).

Conclusions: These data indicate, that a LC but not LF nutrition modulates diastolic dysfunction in overweight diabetics, improves insulin resistance and may prevent or delay the onset of diabetic cardiomyopathy and the metabolic syndrome. Methods: We studied 358 adolescents, males (n = 144) and females (n = 214), who were collected waist circumference, office BP, serum glucose and lipids. They underwent a 24-h ABP monitoring (ABPM) to record 24-hs, awake and sleep BP, and the BPV was calculated as the standard deviation BP. The MS was defined according to the National Cholesterol Education Program, Adult Treatment Panel III modified for adolescents. Statistical analysis: The variance ratio test (F-test) was applied to compare the BPV between adolescents with MS and those without MS.

Results: The MS prevalence was 11.5% (n = 41) in all, 22.9% (n = 33) in males and 3.7% (n = 8) in females (P < 0.0001). The ABP values (systolic/diastolic) were the following: 116/56, 116/68 and 108/ 58 mmHg in adolescents with MS; and 105/78, 107/65 and 100/ 57 mmHg in adolescents without MS, for 24-hs, awake and sleep periods, respectively. The highest statistically significant values in systolic and diastolic ABP during 24-hs and awake and systolic ABP in sleep were showed by MS group. Likewise, adolescents with MS showed significant higher 24-hs systolic BPV than those without MS (10.36 vs. 9.40 mmHg, P < 0.05).

The MS has important effects on the ABP values in adolescents. Also, systolic BP variability during 24-hs is associated with MS. These findings suggest that ambulatory blood pressure monitoring is important in adolescents with MS to detect subjects in cardiovascular risk.

Montfort Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada

Organochlorine compounds (OC), are chemicals that were mostly used historically as pesticides, solvents, flame retardants, and other applications. OC have been recognized to be of environmental and potential toxicologic concern. Due to their persistence and lipophilicity, these compounds will remain present in the environment for decades and accumulate in living organisms. The presence of OC is a major concern since they could act as endocrine disruptors and have recently been associated with the development of hepatic steatosis and lipotoxicity. The objective of this project is to define intra-hepatic molecular mechanisms implicated in the development of hepatic steatosis and lipotoxicity in OC exposed hepatocytes and rats.

Results: Lipid quantification was assessed in human hepatocytes using steatosis colorimetric assay (Cayman Chemical Company). Lipid accumulation was higher in hepatocytes exposed to PCB126 [2.5 lmol/l] for 72 h compared to chloroquine (15%), a potential lipid droplet infiltration inducer, as well as our control group treated with DMSO (38%).

Conclusion: Understanding the emerging role of OC in the physiology of hepatic steatosis and lipotoxicity is of great importance as it is becoming clear that chronic lipotoxicity is strongly related to the suppression of insulin receptor signaling in the liver and activation of the apoptotic pathway. These results only represent the necessary first step on OC and their impact on the liver metabolic activity. Experiments in OC-contaminated rats are presently undertaken, as well as protein quantification involved in intra-hepatic mechanisms in cells.

Nutrition, Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC, USA Insulin a precursor of T2DM, various cardiocerebrovascular disorders, non-alcoholic fatty liver, Alzheimer's disease, and many other major health problems associated with excess calories. To study the mechanism of insulin resistance, we investigated the role of insulin and each category of macronutrients (glucose, fat, and amino acids) in the development of insulin resistance. Our results show that glucose (hyperglycemia) does not cause insulin resistance in the absence of insulin in cultured cells or animals. Dietary carbohydrate is not necessary for high fat diet (HFD) induction of insulin resistance but a small amount of it can promote insulin resistance in the maximal level in animals on HFD. Our results also show that fat is necessary for the development of insulin resistance although fat can't induce insulin resistance in the absence of insulin. Supplementation of amino acids such as leucine does not necessary cause insulin resistance in animals on HFD. Finally, our results show that insulin can cause insulin resistance through (i) accumulation of long-chain acyl CoAs and cholesterol in mitochondria, (ii) inhibition of production of new mitochondria; and (iii) turnover of aged/damaged mitochondria. In summary, our results show that insulin and each category of macronutrients are necessary for the development of persistent insulin resistance. Wellness Institute, Cleveland Clinic, Cleveland, OH, USA Background: Lifestyle factors are key in the development and progression of chronic disease. Here we report outcomes for prediabetic participants in the Lifestyle 180 â program, a 12-month intervention for patients with chronic diseases that integrates education in cooking, nutrition, exercise, and stress management.

Methods: Pre-post changes in biometric, laboratory, and psychosocial variables were evaluated by paired student's t-test or Wilcoxon test.

Results: Of participants who met ADA criteria for prediabetes (n = 270), most were female (68%) and obese (85%) and had hyperlipidemia (52%) or hypertension (54%). One fifth (21%) had depression. Average age was 56 AE 10 years. At month 12, biometric, laboratory, and psychosocial data were available for 143 (53%), 172 (64%) and 108 (40%) participants, respectively. Average BMI decreased by 7% (35.7 AE 6.4-33.2 AE 6.1) and there were decreases in waist circumference, blood pressure, resting heart rate, fasting glucose, and HbA1c (P < 0.001 for all). Insulin decreased from 17.5 AE 10.8-12.1 AE 7.6 μU/ml (À31.2%; P < 0.001). More diabetic medications were stopped or reduced in dose than were started or increased in dose (ratio 4.6:1). Average depression (CES-D10) and perceived stress (PSS-4) scores decreased by 32% and 25% respectively (P < 0.001 for both). Physical, mental, and perceived health (measured by Veterans RAND 12 Item Health Survey) improved from 16% to 63% (P < 0.001).

Conclusion: Participation in a comprehensive lifestyle modification program of adults with prediabetes results in significant and clinically meaningful improvements in biometric, laboratory, and psychosocial outcomes. Diabetes is frequently associated with both extracellular and intracellular magnesium (Mg) depletion. Epidemiologic studies found high prevalence of hypomagnesaemia in subjects with type 2 diabetes, especially with poorly controlled glycemic control. Erythrocyte and serum magnesium levels were measured in 35 healthy control subjects, 35 Non-diabetic normal glucose tolerant offspring of type 2 diabetic subjects and 35 Non-diabetic impaired glucose tolerant offspring of type 2 diabetic subjects in addition to routine laboratory investigations, HbA1c, Lipid profile, fasting insulin by ELISA and HOMA-IR.

Our study showed that fasting, 2 h postprandial plasma glucose, serum insulin level, HbA1c, HOMA-IR index, serum LDL-C, serum triglycerides, serum cholesterol and serum Malondialdehyde levels were higher and serum HDL-C and both serum and erythrocyte Magnesium levels were lower in impaired glucose tolerant offspring of type 2 diabetes as compared to each of normal glucose tolerant group and control group, while there was no significant difference in those parameters between normal glucose tolerant and control groups.

We can conclude that the Magnesium depletion and the increase in Malondialdehyde level in non diabetic impaired glucose tolerant offspring of type 2 DM were associated with increasing severity of insulin resistance and dyslipidemia and, this may increase the risk of development of type 2 diabetes complications in there offspring. Possily use of Mg suplemenaion in those subject may delay and prevent the development of type 2 diabetes. Obstetrics and Gynaecologist, Catholic University of Sacred Heart, Rome, Italy Background and aims: GDM, overweight and gestational weight gain (GWG) are important determinants for an adverse pregnancy outcome and particularly for having Large for Gestational Age (LGA) newborn. The aim of this study was to evaluate the pregnancy outcome among women affected by a GDM, belonging four different classes of pre-pregnant BMI and to investigate the specific role of the anthropometric parameters and therapeutic regimen on the foetal growth.

Material and methods: This was a prospective study including 183 pregnancies affected by GDM. Only women with a mean pre-prandial glucose level <92 mg/dl and 2 h post-prandial values <120 mg/dl were enrolled. We considered other variables such as GWG, excessive GWG (eGWG), therapeutic regimen used and maternal age to investigate their role in foetal growth.

Results: At the linear univariate analysis, a dependence of neonatal birth weight from pre-pregnant BMI class, eGWG, GWG and gestational week at delivery was found (P < 0.001). The dependence from the pre-pregnant BMI (P = 0.001) and the eGWG (P = 0.002) was confirmed even when the percentile was considered. At the multivariate analysis the birth percentile resulted associated both with the prepregnant BMI (P < 0.001) and the GWG (P = 0.003).

Conclusions: Pre-gestational BMI, GWG and eGWG are important parameters involved in fetal growth. Their control during pregnancy could be an important way to improve pregnancy outcome even in women with GDM. Obstetrics and Gynaecologist, 2 Internal Medicine, Catholic University of Sacred Heart, Rome, Italy Background and aim: Continuous Subcutaneous Insulin Infusion (CSII) may be an alternative treatment to Multiple Daily Injections (MDI) in pregnant subjects with Type 1 Diabetes(¹). The aim of this study was to compare metabolic control and obstetric outcome of these pregnancies treated with CSII vs. pregnancies treated with different type of insulin analogs administrated by MDI.

Material and methods: We studied 172 pregnancies in 150 women, three twin pregnancies, affected by type 1 Diabetes. Thirty-four pregnancies treated with CSII and 138 treated with MDI treatment were evaluated. In the group of women treated with MDI 78 women used human analogs, 32 used insulin aspart and 28 used insulin lispro. Metabolic control and obstetric outcome were compared between the groups. statistically significant differences were found in metabolic control in term of HbA1c mean level for each trimester of pregnancy.

Conclusion: No clear advantage of CSII vs. MDI treatment is shown in our study for pregnancies complicated by type 1 Diabetes in term of metabolic control or obstetric outcome(²). However, it might be that some selected patients with unstable metabolic control or high HbA1c levels, who become pregnant with a better metabolic profile after CSII treatment, may have a better pregnancy outcome. Poblations and methods: A cross-sectional study was performed on 424 children and adolescents (244 female and 180 male) between 6 and 18 years old, without cardiovascular, metabolics, oncology and immunology diseases. Were excluded all subjects who took drugs with effects on glucose, insulin, lipids or weight. Each subject was determined: weight, height, BMI, neck, waist, hip circumferences, adiposity, blood pressure and glucose, insulin, cholesterol, tryglicerides, C-LDL, C-HDL. Was performed oral glucose tolerance test to glucose and insulin postprandial. Was estimated insulin secretion and insulin sensitivity. Conclusi on: Neck circumference is a potential marker for to identify children and adolescents with metabolic and cardiovascular risk factors.

Aim: To assess the efficacy of a lifestyle modification in preventing diabetes mellitus type 2 (DM 2) among subjects with risk factors of DM 2 including impaired glucose tolerance and impaired fasting glucose (IGT/IFG), obese adults and first-degree relatives of patients with diabetes.

Materials and methods: The study included 100 patients (32 m, 68 f) 25 -65 years old at risk factors of DM 2. All patients received recommendation on a balanced diet and physical activity. We measured fasting plasma glucose (FPG), 2-h plasma glucose concentrations. Fasting serum insulin (FI) levels were detected by sensitive ELISA. Index HOMA-R were used as the index of insulin resistance.

Results: In 48 weeks our study 56 patients carried out this recommendations (research group) and 44 patients did not it (control group). Patients of the research group demonstrated mean reduction of weight (À5.3 kg), BMI (À2.6 kg/m 2 ) and WHR (À0.2) (P < 0.01) and persons of the control group had significant increase these parameters (P < 0.05). Among subjects with IGT, glucose levels normalized in 56% of patients from the research group and 4.5% in control group (P < 0.001). FI and HOMA-R in research group decreased from 11.9 AE 4.3 to 9.6 AE 4.5 lU/ml and from 3.6 AE 1.1 to 2.7 AE 1.4 accordingly (P < 0.05). In control group the specified parameters had increased significantly (P < 0.01). The risk reduction of development DM 2 among patients of the research group was 53.7% comparer the control group.

Conclusion: Thereby, lifestyle modifications are effective in preventing DM 2 development in individuals at risk living in Belarus. 

Objectives: It is suggested that the kind and frequency of snacks as well as dairy consumption can influence body weight and composition. As the number of students are increasing rapidly in Iran and regarding their unhealthy food habits, we decided to carry out this study.

Methods: One hundred and twelve female students who were selected from university dormitories inhabitants randomly, participated in this cross-sectional study. Weight, height and waist circumference (WC) of the participants were measured. Demographic and food frequency questionnaires were filled face to face. Data were analyzed using SPSS # 16.

The results showed that 14.6% of participants were under weight, 75% normal and 10.4% overweight. Besides, 94.80% and 5.2% had normal and above normal WC respectively. Sixty-one percent of female students had just one snack. Fruits (63%) and confectionaries (61%) were the most popular snacks. Mean AE SD of the dairy consumption was 1.78 AE 1.20 serving per day. There were no correlations between BMI and WC and snacking pattern or dairy intake.

Conclusion: It is assumed that as most of our subjects had normal weight and WC, we did not find any correlation between BMI and WC and snacking pattern or dairy intake. Conducting similar studies, using both overweight and normal weight subjects is suggested. Obstetrics and Gynaecologist, Catholic University of Sacred Heart, Rome, Italy

Background and aims: The management of pregnancies complicated by T1DM has changed with the introduction of new short acting insulin analogs. The aim of this study was to have a comparison of obstetric outcome among the different insulin regimens.

Methods: One hundred and sixty singleton pregnancies were assessed. Seventy-four women were treated with human analogs, 46 with insulin aspart and 40 with insulin lispro.

Results: No significative differences were found in term of incidence of pre-eclampsia, IUGR, Large for Gestational Age newborn, Cesarian sections, preterm delivery, APGAR score <7, mean week at delivery, mean birth percentile. A significative difference was found in term of incidence of newborn infants with a birth weight ! 4000 g (23.33% in the human analogs group, 2.22% in the aspart group t and 29.03% in the lispro group; P = 0.14); a trend (P = 0.06) was observed comparing the mean birth weight among the groups (3277.30 AE 689.77 g in human analogs group, 3000.00 AE 685.20 g in aspart group and 3313.59 AE 720.07 g in lispro group). No significative differences were found in term of HbA1c mean levels for each trimester of pregnancy.

Conclusions: The use of insulin aspart is correlate with a lower incidence of fetal macrosomia and with a lower mean birth weight. In vitro observations highlighted that lispro and aspart have a similar affinity for insulin receptor; regarding the affinity for IGF-1 receptor lispro is 1.5 fold more potent than human insulin in binding IGF-1 receptor. Further investigations are necessary to explain the correlation between insulin affinity for IGF-1 receptor and fetal growth. Methods: This study was performed on 180 women diagnosed with GDM (Gestational DM) 3-4 months after delivery. The Jewish and Bedouin women were divided into, intervention and control groups. The intervention group was instructed in healthy lifestyle habits every several months by a dietician and sports instructor. The control group was informed of the potential risks for diabetes following GDM and advised to improve lifestyle. All women had fasting insulin, glucose and lipid level tests 3-4 months post partum. Height, weight, BMI, blood pressure, waist circumference were measured. Food frequency and exercise questionnaires were filled. The same tests were repeated at 1 and 2 years follow up.

Results: The prevalence of GDM was 5.7% in Jewish and 3.5% in Bedouin women. Lack of pregnancy care was greater among the Bedouin. All the metabolic tests post GDM period improved in the intervention group in both ethnicities compared to control. There was a decrease in insulin, glucose, LDL, triglycerides and HOMA-IR (Homeostasis Model Assessment) values and an increase in HDL. A significant decrease in carbohydrate consumption, calorie consumption, fat consumption and increase in protein consumption was observed and an increase in physical activity.

The intervention program significantly improved the metabolic indices measured in both Jewish and Bedouin populations. The results underscore the need to provide lifestyle optimization guidance to women with GDM in order to reduce the risk of type 2 diabetes. Introduction: Fatty liver is strongly associated with type 2 diabetes. However, it is unclear whether hepatic triglyceride accumulation causes diabetes, or merely is a consequence of excess adipose tissue, that is related to insulin resistance. We aimed to investigate the association between hepatic triglyceride content (HTGC) and insulin resistance, and whether this association could be explained by measures of adiposity.

Methods: In this cross-sectional analysis of the Netherlands Epidemiology of Obesity (NEO) study, fasting glucose and insulin concentrations were measured. Abdominal fat depots were measured using MRI, HTGC using MRS. We performed linear regression analysis of HTGC with the updated homeostasis model assessment (HOMA2-IR), adjusting for age, sex, ethnicity, education, smoking, alcohol consumption, visceral adipose tissue (VAT) and total body fat (TBF).

Results: After exclusion of participants with missing data (n = 65) or known diabetes (n = 69), alchohol consumption >4 glasses/day (n = 72), 1160 participants were included with a median (IQR) age of 56 (50.61) years, mean fasting glucose: 5.6 AE 0.8 mmol/l, 52% men. Per SD HTGC (9.6%), the HOMA2-IR increased with 37% (95% CI: 22%, 54%), this attenuated to 23% (95% CI: 11%, 36%) after adjustment for VAT and to 21% (95% CI: 10%, 33%) after additional adjustment for TBF. Per SD VAT (0.06 dm 3 ) the HOMA2-IR increased with 55% (95% CI: 47%, 63%), this attenuated to 43% (95% CI: 33%, 53%) after adjustment for HTGC and to 27% (95% CI: 18%, 36%) after additional adjustment for TBF.

The association between hepatic fat and insulin resistance was for a large part explained by VAT. VAT may be most important in the etiology of insulin resistance. The aim was to carry out complex estimation of mutual relations between the proinflammatory condition and basic components of the metabolic syndrome (MS) in patients with ischemic heart disease hospitalized for coronary artery bypass grafting.

Forty-three patients were examined by standard methods and were divided into three groups depending on presence of separate MS components: 1st group with abdominal obesity (AO), arterial hypertension (AH), type II diabetes, dyslipidemia; 2nd group with AO, AH, hyperglycemia; 3rd group with AO, AH, dyslipidemia.

Indicators of chronic subclinical inflammation have been revealed before operation in all groups of patients. The strongest ones have appeared in the 2nd group of patients. Hyperuricemy was more frequently registered in patients of the 3rd group (18.8%). The correlation analysis revealed authentic interrelations of uric acid level with lipid profile and inflammation markers. A strong inverse relation with triglycerides, a strong direct relation with low density lipoprotein cholesterol and inverse one with total amount of leukocytes were revealed in the 1st group. The strong direct relations with segmented neutrophils and the inverse ones with lymphocytes were registered in the 2nd and 3rd groups. The average direct correlation with CRP was revealed in the 3rd group. Activation of inflammatory process was noted in patients of all groups after operation, and it was already of acute nature in the 3rd group that allows attributing it to a risk group. The study of expressiveness of inflammatory reaction depending on presence of the MS components allows revealing risk groups among patients. Introduction: The soft drink intake has increased worldwide and its high consumption is associated with the development of metabolic syndrome.

Objective: To estimate the association between the consumption of sugar-sweetened beverages (SSB) and the burden metabolic syndrome diseases (BMSD).

A cross-sectional telephone survey was conducted with 3419 adults (46.03% men and 53.97% women, mean age 41.7 years) in the urban area of Belo Horizonte, Brazil. Data from the telephone-base Brazilian surveillance system for chronic diseases was used (VIGITEL -2008/2010). Burden Metabolic syndrome diseases were defined as the self-reported of at least two of the following factors: diabetes, dyslipidemia, hypertension and obesity. The intake of ! 5 days/week soft drinks and artificial juices was assessed. Sociodemographic, selfreported health status and lifestyle habits were also used. Odds ratios (OR) and 95% confidence intervals were estimated by multivariate logistic regression.

Results: In this sample, 24.07% of participants consumed ! 5 days/ week sugar-sweetened beverages (SSB). The prevalence of BMSD in the sample was 15.61%. The prevalence of BMSD in people who consumed SSB ( ! 5 days/week) was lower than people didn't consume the beverages (OR: 0.53; 95% CI: 0.39-0.71) five or more days per week. The final model was also adjusted for physical activity, education, marital status, poor self-reported health and poor consumption of fruits and vegetables. Obesity is an heterogeneous condition due to fat distribution and storage. The aim of our study was to compare the predicting role of HOMA index and of BMI on early vascular impairment in 65 morbidly obese subjects (BMI 44.6 AE 7 kg/m 2 ) before and after sleeve gastrectomy (SG). Glycemia, insulinemia, lipids, flow mediated dilatation (FMD), carotid intima media thickness (IMT) and visceral fat area (VFA) by ultrasound were performed in all subjects. Patients were divided on the basis of HOMA-IR median values: ! 3.5 group 1, <3.5 group 2. Group 1 had significantly higher values of BMI (P < 0.05), waist circumference (P < 0.0001), VFA (P < 0.0001), triglycerides (P < 0.005), glycemia (P < 0.0001), and lower HDL-C (P < 0.005) than group 2; FMD was significantly lower (P < 0.05) and IMT significantly higher (P < 0.05) than in the group 2. The same population divided on BMI median values did not show any difference in lipids, IMT and FMD. At stepwise regression analysis VFA was the independent predictor of reduced FMD (β À0.541, P 0.002). HOMA-IR (beta 0.399 P < 0.001) was the independent predictor of IMT (beta 0.413, P = 0.001).

In 30 patients, re-evaluated 9 months after SG, BMI, VFA and HOMA were significantly reduced (P < 0.0001); FMD significantly increased only in the subgroup with HOMA-IR pre intervention ! 3.5 (P 0.003). BMI, index of overall adiposity, seems less useful in the prediction of early atherosclerosis in morbidly obese; HOMA-IR, strictly related to visceral fat, is expression of metabolic impairment thus able to predict early vascular damaging.

Methods: Swiss albino mice were given a high fat diet containing lard (H) (23.9% wt/wt), supplemented with AS or F and in combination alongwith H (F + AS + H) for 8 weeks. The control mice (C) were fed with normal diet. After the treatment period the physical, physiological and cellular parameters were evaluated by body weight, liver weight, biochemical estimation, western blot, PCR or IHC.

Results: The H mice exhibited increased body and liver weight; Treatment with F or AS and (F + AS + H) in the diet significantly counteracted the HFD induced body and liver weight gain, hyperlipidemia; hepatic lipid profile; level of ROS; hyperglycemia; hyperinsulinemia; TNF-a, IL-6 level; nuclear translocation of NF-jB; lipid peroxidation. Activities of antioxidant enzymes (SOD, CAT, GSH, FRAP) were up regulated significantly in F or AS and (F + AS + H) mice. Therefore simultaneous treatment with AS or F and their combination protected against HFD induced weight gain and oxidative stress.

Conclusion: This novel approach of combinatorial preventive medicine is validated not only with the parameters of metabolic syndromes yet it is evidenced with oxidative stress and crucial molecular targets. This study illustrates for the first time that AS and F has relatively similar hypolipidemic, antioxidative, anti inflammatory actions and the AS + F combination along with HFD has shown prominent preventive effects as compared to other treated groups.

S. Sivapraksh 1 , I. Shabir 1 , N. Gupta 1 , J. John 1 , A. Ammini 2 1 AIIMS, 2 Department of Endocrinology, AIIMS, New Delhi, India

Background: Insulin resistance/hyperinsulinemia is associated with a variety of reproductive endocrine dysfunction in girls. However, there is a scarcity data regarding hypothalamic pituitary testicular axis functioning among boys with hyper insulinemia.

Aim: Aim of this study was to assess effect of hyper insulinemia on pubertal development in boys.

Subjects and methods: Children of subjects with Type 2 Diabetes Mellitus (T2DM) were invited to participate in this study. Children and adolescent with any chronic medical condition were excluded. Detailed medical history, physical examination including anthropometry, Haemogram, liver, renal functions, oral glucose tolerance test (OGTT), insulin, LH, FSH, Prolactin and testosterone were done for all subjects.

Results: Seventy-four boys, 6-18 years of age participated in this study. Results are given in Table 1 . Thirty boys (all except 1 were overweight) had gynaecomastia. Objectives: To find out the prevalence and factors associated with dyslipidemia among adults aged 18 years and above in a resettlement colony located in central Delhi.

A cross sectional study, that included a random sample of 200 adults, was designed. A study tool based on the World Health Organisation (WHO) STEPwise approach to surveillance of noncommunicable diseases and their risk factors (STEPS) questionnaire was used. Fasting venous blood sample was collected. Criteria based on the third report of the National cholesterol education program expert panel on detection, evaluation and treatment of high blood cholesterol in adults (NCEP ATP III), were used to define the cut offs for dyslipidemia. Data was analysed using the statistical package for social sciences (SPSS) version 17.

Results: Out of a total of 200 study subjects, 34% had raised cholesterol levels ( ! 200 mg%). Thirty-eight percent had raised low density lipoprotein (LDL) levels ( ! 130 mg%), 40% had raised triglyceride levels (triglycerides ! 150 mg%) and 39% had low high density lipoprotein (HDL) levels (<40 mg%). Age, hypertension, alcohol consumption and abdominal obesity were found to be associated with increased odds of dyslipidaemia, using the logistic regression model. Aim: In the present study we explored whether oral consumption of the probiotic Lactobacillus casei Shirota bacteria in form of the Yakult probiotic drink has any effects on energy metabolism in patients with impaired metabolic functions.

A cross-over-study with daily intake of one portion Yakult light during 12 weeks was carried out in 66 patients with impaired glucose regulation or metabolic syndrome. Fasting blood samples were collected, anthropometric parameters were measured and a frequently sampled oral glucose tolerance test was performed at 3 time points (week 0, 12 and 24). Effects on the human gut bacterial communities were studied via T-RFLP fingerprinting of 16S rRNA genes amplified from microbial DNA preparations from fecal samples.

Our results reveal a significant increase of total cholesterol (mean increase: 7.9 mg/dl; P = 0.044), triglycerides (mean increase: 19.9 mg/dl; P = 0.004) and a significant decrease of HDL-cholesterol (mean decrease: 2.0 mg/dl; P = 0.030) after 12 weeks of daily intake of Yakult. No significant influence of Yakult light consumption on indices of insulin sensitivity, HbA1C and LDL-cholesterol could be demonstrated. A small decrease of fasting glucose levels after Yakult consumption was revealed (mean decrease: 2.9 mg/dl; P = 0.005). No consistent changes in the community profiles of the gut microbiota were observed following 12 weeks of Yakult light consumption. In Mexico, breakfast is one of the most important meals during the day, but changes in food consumption habits, also known as nutritional transition have been associated with a poor food quality intake. Scholars, during the recess use to buy some food in internal shops of schools and this food are not generally the healthiest. The aim of this study was to evaluate the quality of the food consumed during the recces by scholars in Tepic Nayarit, Mexico. Scholars (563, about 9-12 years) from 10 different public schools were evaluated by means of food register questionnaires during 2 days, there has determined the ingestion of nutrients and nourishment healthy index (IAS) using the nutrition program DIAL. Anthropometric data were measured for weight and height, and body mass index (BMI) was calculated. The BMI showed that 7.6% of children have low weight for height, 44.6% have normal weight and 48.7% overweight/obesity. Twenty percent of scholars declared that they did not take breakfast until the hour of recess. Energy intake during recess was on average 25% of the daily requirement. The foods most frequently consumed were sweetened beverages (400 ml) containing 44 g of simple sugars, fried-wheat snacks (68 g/24 g fat), candies (19 g/simple sugars) and some fruit such as mango, apple or watermelon (100 g/portion) with chilli. These combinations of foods are risk factors to the development of diabetes in scholars were the prevalence of overweight/obesity is in high levels. Introduction: Incidence of type 1, 2 and gestational diabetes mellitus (GDM) are increasing worldwide. Given that women with previous GDM have a higher risk of diabetes development later in life compared to women with a physiological pregnancy, the aims of our study were (i) to ascertain a frequency of early postpartum conversion of GDM into permanent diabetes or persistent impaired glucose tolerance and (ii) to find an eventual significant predictive factors from those routinely measured during the GDM follow up.

Methods: We carried out a retrospective epidemiological analysis of anamnestic, anthropometric, biochemical and clinical data of female patients (n = 1090) from Faculty Hospital Brno with GDM diagnosis during the 2005-2011 period that underwent repeated oGTT up to 1 year after the delivery.

Results: Any degree of impairment of glucose tolerance postpartum was detected in 11.7% subjects, of those 4.1% had manifest DM (2.8% T2DM and 1.3% T1DM). Glycaemia in all three time-points of baseline oGTT, area under the curve (AUC oGTT ) and baseline HbA1c were significantly associated (P < 0.05, Mann-Whitney) with the postpartum disorder. Using regression analysis predictive risk model was developed using these baseline parameters.

Conclusions: Parameters of glucose metabolism measured during 24-28th week of pregnancy fulfilling criteria of GDM diagnosis exhibited highly statistically significant differences between women with and without persistent postpartum glucose metabolism abnormality and conferred significant predictive potential. Considering generally lowcompliance of GDM women any more specific assessment of future risk stratifying GDM population could enable more effective screening of postpartum glucose metabolism disorder. Institute of Molecular Biomedicine, Comenius University Medical Faculty, 2 Department of Health, Bratislava Self-Governing Region, 3 Regional Public Health Office, Bratislava, Slovak Republic

Background and aims: In the adults, microalbuminuria is considered as biomarker of present/future cardiovascular and/or renal disease. The roots of these diseases extend back into childhood/adolescence. Data on prevalence of microalbuminuria, renal excretion of albumin (albumin/creatinine ratio, ACR) and its relationship to obesity and blood pressure in apparently healthy adolescents are scares.

Methods and results: Fourteen to 21-years-old apparently healthy students of secondary schools in Bratislava district were enrolled (n = 2139, boys: 53%). ACR was determined in a spot urine sample. In underaged subjects overweight/obesity was classified according to age-and sex-based Slovak population tables from 1991. Blood pressure values were recorded. ACR (IQR: 0.29-0.67 mg albumin/ mmol creatinine vs. 0.25-0.51 mg albumin/mmol creatinine, P < 0.001), and the prevalence of microalbuminuria (3.6% vs. 1.2%, chi-square: P = 0.024) were higher in girls than in boys. Prevalence of overweight (15.3% vs. 10.4%) and obesity (15.6% vs. 8.7%), as well as blood pressure values in pre-hypertensive (51.6% vs. 13.4%) and hypertensive (10.6% vs. 0.9%) ranges were higher in boys if compared with girls. In underweight subjects, particularly boys, ACR was significantly higher if compared with the overweight/obese subjects. ACR correlated inversely with the markers of peripheral and central obesity.

Conclusions: Our data suggest the need of specific interpretation of data on ACR in the adolescents, and the need of further analysis of this (in the adults risk) marker in population of adolescents with regard to other important determinants of ACR, such as insulin sensitivity and other metabolic syndrome risk factors. Inclusions criteria were BMI between 35 and 45 kg/m 2 , morbidities as diabetes type 2 more than 10 years in oral treatment and without control, hypertension in oral treatment too, moderate or severe liver steatoses diseases and lipid diseases.

Results: All patients in a both of groups (laparoscopic and robot approach) had a effective loss of weight, with mean about 25-48 kg (25-55%) after 1 year period. One case of robot approach presented a staple line bleeding at first postoperative day, without transfusion. Morbidity rate after RASG was 9%, but no gastrointestinal leaks occurs.

Conclusions: RASG can be a safely and feasible tool to the surgical treatment of obese patients and co-morbidities, with good results and satisfactory outcomes. Results: Patients were nine males and six females with mean age of 50 years (range 32-58). Seven patients were under insulin treatment and 8 with oral medications only. Glycemia at 6 months post-surgery (132.0 AE 40.8 mg/dl; n = 8) was significantly reduced (P = 0.012) compared to time 0 (188.2 AE 68.3 mg/dl). The same occurred with HbA1c at 6 months (6.2 AE 0.6%; n = 8) compared to time 0 (8.8 AE 1.8%) (P = 0.006). BMI was also reduced at 1 month (26.3 AE 2.0; n = 12) compared to time 0 (28.5 AE 1.4) and 6 months (25.1 AE 2.8; n = 10) compared to time 0 (28.6 AE 1.7) (P = 0.001).

Only one patient remained under insulin after surgery.

The procedure was considered safe and significantly improved metabolic control of non-obese T2DM patients, although moderate weight loss was also observed. Recent studies have shown that the practice of a proper diet provides health benefits. Also, it has been observed that the body weight gain is associated with consumption of unbalanced diets. The objective of this study was to evaluate the quality of the diet in adult residents of Tehcnological Institute of Tepic and establish differences for normal weight (NW) and overweight/obesity (OW/OB). Forty two adults >18 years were evaluated, they were taken anthropometric data for weight, height and body mass index (BMI, kg/m 2 ) was calculated. For the diagnosis of NW and OW/OB, were taken established by World Health Organization (WHO). It was used a 3-day dietary record, for diet analysis was used DIAL software, which contains tables of food composition Mexicans. Dietary data were adjusted for the degree of discrepancy between energetic intake and energy expenditure obtained estimate. For statistical analysis was used the program Rsigma Babel and statistical differences were established <0.05. The caloric profile was unbalanced in 85% of the study population: a high consumption of fat in detriment of carbohydrates. The difference between groups were not significant (P > 0.05) in the caloric profile, but nor in lipidic profile. The analysis of the discrepancy intake/energy expenditure describes a probable undervaluing of the diet in both groups, but higher in adults with OW/OB compared to NW ( Patients with long standing diabetes had a higher leptin, HSP70, HbA1c and triglyceride than controls. Serum leptin levels were significantly lower in patients with newly diagnosed diabetes. Women with type 2 diabetes had a higher leptin levels compared to men, both before and after treatment. We showed a positive correlation between leptin-HSP70 in women with type 2 diabetes. The correlation was highest in women with newly diagnosed diabetes (r = 0.59) and was attenuated in women who were on treatment (r = 0.3). The significance of this correlation was only observed in women with type 2 diabetes. There was no correlation between leptin and HSP70 in men. The positive correlation between leptin and HSP is observed in chronic inflammation such as type 2 diabetes. It could be hypothesized that the observed correlation between serum HSP70 and leptin imply a higher state of chronic inflammation. Materials and methods: Carotid atherosclerosis (measurement of intiamedia thickness -IMT) and the presence of steatosis were assesed using ultrasonography in 254 subjects (40.16% men and 59.84% women, mean age 54.75 AE 16.25 years), selected from a rural population (were excluded those with known liver disease and those with alcohol consumption >20 g/day).

Results: 89.19% of subjects had different degrees of steatosis: 28.38% mild, 28.83% moderate, 31.98% severe. The metabolic syndrome and all its individual traits, were significantly more frequent in NAFLD patients, especially in those with severe steatosis (P < 0.001). The mean value for IMT was 0.8545 AE 0.10492 mm, increasing in parallel with the severity of steatosis. Also, subjects with MS had significantly higher IMT values than those without MS (P < 0.005). In the group without MS, IMT mean was significantly higher in patients with steatosis than in those without steatosis (P = 0.032), and in patients with moderate/severe steatosis than in those with mild steatosis (P = 0.022). By multiple regression analysis, larger waist circumferince (r = 0.423), increasing alcohol consumption (r = 0.219) and the presence of steatosis (r = 0.213), were significant predicting factors for increased IMT.

Conclusions: These data confirm the hypothesis that the presence of steatosis, independently of the MS, is associated with a significant risk for development of atherosclerosis and its detection should be an alert for the existence of an increased cardiovascular risk. The prevalence of the metabolic syndrome (MS), a cluster of central obesity, hyper/dyslipidemia, hyperglycemia, and hypertension is constantly increasing worldwide. Although, the exact mechanisms underlying the development of the MS are not completely understood, modern lifestyle of physical inactivity and unhealthy nutrition, obesity, and their interaction with genetic factors are considered largely responsible. This study was carried out to identify the association between physical inactivity and burden metabolic syndrome diseases (BMSD) in an urban Brazilian population.

A cross-sectional telephone survey was conducted with 3419 adults (46.0% men and 54.0% women, mean age 41.7 years) in the urban area of Belo Horizonte, Brazil. Data from the telephone-base Brazilian surveillance system for chronic diseases (VIGITEL -2008/ 2010) was used. Burden metabolic syndrome diseases (BMSD) was defined as the self-reported of at least two of the following factors: diabetes, dyslipidemia, hypertension and obesity. Physical activity (PA) indicators were evaluated in free time (leisure), work, home and transportation domains. Sociodemographic, health status and lifestyle habits were also used. Odds ratios (OR) and 95% confidence intervals were estimated by multivariate logistic regression.

In this sample, 13.5% of participants were physically inactive in all domains and the prevalence of BMSD in the sample was 15.6%. Physical inactivity was independently associated with BMSD (OR = 0.02; 95%CI: 1.03-1.80), adjusted to age, schooling, poor selfreported health and gender.

In this sample, BMSD is a significant public health problem. The evidence from this study shows that physical inactivity was independently associated with proxy of metabolic syndrome. Aim: To assess the prevalence of insulin resistance (IR) and glucose homeostasis alterations (GHA) in overweight and obese children and the risk factors for IR and GHA.

Method: We collected data from 145 subjects: 66 girls and 79 boys aged 2.8-17.5 years (median: 9.3). GHA was measured by fasting glucose. Glucose ! 90 mg/dl was treated as high normal fasting plasma glucose (HNFPG). IR was estimated by homeostasis model assessment (HOMA-IR), quantitative insulin sensitivity check index (QUICKI) and fasting glucose/insulin ratio (FGIR). We adopted the following cut-off points for diagnosing IR: HOMA-IR ! 2.5, QUICKI 0.34 and FGIR 7.0.

Results: Table 1 . Fasting glucose, insulin and IR-indexes.

In obese children we observed a significant (P < 0.05) positive correlation between HOMA-IR and age (r = 0.46), BMI (r = 0.49), fasting insulin (r = 0.99), triglycerides (r = 0.29), CRP (r = 0.2) and a negative correlation with birth weight (r = À0.24) and HDL 

The results provide evidence for an association between PD and SM in the adolescent population, which would mean that Depression may influence MS in this group that is more vulnerable to PD due to hard changes typical of their life stage. The aim of this study was to evaluate the electrical activity of the pelvic floor muscles (PFM) in women with Polycystic Ovary Syndrome (PCOS) diagnostic and insulin resistance (IR). Through a crosssectional study, it was recruited 42 women with PCOS. The total PCOS patients was divided into two groups according to the presence of RI (Group A) and without IR (Group B). The diagnosis of RI was made through fasting insulin. The muscle tone (MT) and maximal voluntary contraction (MVC) was evaluated by electrical activity, that it was measured by surface electromyography. Among the PCOS patents, 18.4% had insulin resistence. There was significant difference between the tone (P = 0.01) and CVM (P = 0.005) between groups A and B. The correlation test showed a strong negative correlation between muscle tone and fasting insulin levels in Group B (r = À0.8, P = 0.01).

Considering the results, it seems that the presence of insulin resistance may adversely affect the electrical capacity of the pelvic floor muscles. Central Hospital of the Army, 2 CPMC, Algiers, Algeria

The polycystic ovary syndrom is a disorder affecting approximatively 5-10% of reproductive age women. Hyperinsulinemia and insulinore´sistance are common features of a larger number of patients affected by PCOS.

Objective: The objective of this study was to characterized the prevalence of the insulinore´sistance in a cohort of Algerian women with PCOS.

Methods: A total of 181 patients with evidence of PCOS defined by the Rotterdam consensus were recruted for a prospective study. All women had a standard oral glucose tolerance test with the mesure of glycemia, insulinemia and SHBG. The prevalence of insulinore´sistance grows significantly with BMI (P = 0.0002) but didn't change with age (P = 0.25).

The non hyperandrogenic phenotype is less insulinoresistant (33.3% vs. 68.7%).

Conclusion: In our population of PCOS near half of them are insulinresistant and need to be treated in order to avoid metabolic features. 

The aim of this study was to analyze the parameters of glycemic index (IG) in foods intended for feeding patients with impaired glucose metabolism.

For this purpose, a new design selected food products, characterized by a higher nutritional value, that pass attempts technological and toxicological studies and have been classified as human food. The food consisted of inulin, buckwheat, pumpkin seeds, buckwheat hulls, the addition of mulberries, kale and beans.

The products were characterized by nutritional value and composition. Designed food products were the nature of small snacks, designed to supplement the basic diet and enriching it with ingredients desirable from the standpoint of prevention of civilization diseases. Characterized by elevated natural origin and health-related properties.

The study took part of 20 healthy, non smokers volunteers between 20 and 30 years of age, with proper blood biochemical parameters.

The results allow to characterize these foods as relative low glycemic index and possible to use to enrich the diet in the components with pro-health effect. For all the products the dose and single-serving size consumption was described and proposed. The possible potential changes in glucose levels after consumption were characterized.

The results are the test pilot study of the project aimed to the creation of the increased food with bioactive healthy properties and are the result of the first stage of the researchclinically-nutritional studies of those products.

Financial supported by the UE Project nr PO IG 01.01.02.00-061/09. One of the fastest growing trend in food production is designing of health promoting foods, including so-called bioactive food. Only food products enriched with bioactive components of natural origin might be perceived as bioactive. It is highly possible that well established technological process of bioactive foods production leads to obtain products useful in prevention and non-pharmacological treatment of metabolic diseases. The Project aims to designing these kind of prohealth food, which would simultaneously be organoleptically attractive to the consumer and be an equivalent of conventional, habitually eaten products. The important aspect of bioactive foods is their antioxidant potential, which positive impact on various diseases (obesity, diabetes mellitus and hypertension) is already well known from prior literature.

In the studies the antioxidant capacity of the selected bioactive foods designed in the Project was assessed. The method used for assessment of antioxidant potential was ORAC, as the most widely applied and the most reliable one. The analysis included products from three following groups of enriched foods: fruit and vegetable juices, bakery products and confectionery, and meat products, as well as the corresponding placebo products.

Most of the products enriched in bioactive components was characterized by significantly higher ORAC values in comparison to placebo correspondents. The results support the correctness of applied production technology and proper selection of bioactive components. Based on the antioxidant potential of new products, one can decided which of them should be use for further controlled clinical trial. Background: Obesity in adolescent tends to persist into adulthood which associated to metabolic disease thereby increasing mortality and morbidity.

Objective: To investigate the association between central obesity and inflammation marker, insulin resistance and dyslipidemia in adolescent with central obesity.

Methods: This study was case-control study, compared central obesity adolescent and normal to hsCRP, HOMA-IR, triglyseride, LDLcholesterol, HDL-cholesterol, and sdLDL-cholesterol.

Results: Sixty two adolescent were included, 41 were central obesity and 21 were normal. We found that they were with BMI >25 kg/m 2 had hsCRP level higher compared with non obesity, P-value < 0.001 (OR: 10.293; 95% CI: 0.002-0.004) and HOMA IR, P-value < 0.021 (OR: 8.711; 95% CI: 0.019-0.025). Adolescent with WC ! 91 cm for boys and ! 85 cm for girls, had hsCRP levels, HOMA-IR and HDLcholesterol higher than they were with WC < 84 cm, P-value < 0.001 (OR: 11.899; 95%CI: 0.001-0.002), P < 0.022 (OR: 8.208; 95%CI: 0.020-0.026) and P-value < 0.036 (OR 4.397; 95%CI: 0.064-0.074), respectively. The visceral fat was associated with hsCRP levels, P < 0.02 (OR: 5.247; 95%CI: 0.031-0.38), and HDL cholesterol P < 0.007 (OR 7.242; 95%CI: 0.008-0.012). Triglyceride and sdLDLcholesterol had not significanty for BMI, WC and visceral fat, however LDL-cholesterol significantly association with visceral fat, P < 0.008 (OR: 6.947; 95%CI: 0.011-0.016).

Conclusion: Central obesity adolescents showed increased inflammatory markers and insulin resistance with consequent increased the risk of metabolic diseases so that early intervention in obese adolescents should be done. 

Aims: Consumption of high fat diet (HFD) leads to accumulation of intramuscular ceramide (Cer). Cer is implicated in induction of muscle insulin resistance. The initial step in the de novo Cer synthesis is catalyzed by serine palmitoyltransferase (SPT). The aim of the present study was to elucidate the role of HFD, myriocin (an SPT inhibitor) and metformin on the content of skeletal muscle Cer and key proteins implicated in lipid and glucose metabolism in HFD insulin resistant rats.

The experiments were performed on male Wistar rats, divided into groups: Cfed standard rodent chow (control); HFDfed high fat diet; HFD/Myrfed HFD and treated with myriocin; HFD/Myr/Metfed HFD and treated with both the myriocin and metformin. Muscle Cer and plasma free fatty acids (FFA) were analyzed by LC/MS/MS. Content of SPT, carnitine palmitoyltransferase (CPT1A), fatty acid transporters (CD36, FABPpm) and glucotransporter 4 (GLUT4) was measured by WB.

Results: Compared to control values, plasma FFA and muscle Cer content and expression of all lipid-related proteins were elevated in HFD group. Myriocin decreased muscular Cer but increased plasma FFA and the expression of both the SPT and CPT1A. Introducing metformin to HFD/Myr group decreased the plasma FFA and muscular Cer, lowered the expression of SPT, CPT1A, CD36 and FABPpm, but increased muscular GLUT4 expression as compared to HFD and HFD/Myr group.

Conclusions: Simultaneous treatment with myriocin and metformin decreases the plasma FFA and muscular CER and improves glucose tolerance by augmentation of muscle GLUT4 expression.

Internal Medicine, New London Hospital, New London, NH, USA hyperglycemia, and hyperlipidemia. Understanding whether side effect profiles differ between the most commonly prescribed agents could greatly inform prescribing decisions.

Objectives: To quantify differences in weight gain and metabolic side effects between aripiprazole, quetiapine, and risperidone in adults and children requiring chronic antipsychotic therapy.

Selection criteria: Randomized controlled trials that compared at least two of the three atypical antipsychotics of interest and reported change in weight. All dosing ranges were included and there were no age or diagnosis restrictions.

Data collection and analysis: Two blinded clinicians independently completed data extraction with a piloted, standardized data collection form. Study quality was assessed through the Cochrane risk of bias tool. We calculated weighted mean differences (WMD) and 95% confidence intervals (CI) using random effects models on Review Manager 5.

Main results: Of 95 studies identified through our search, 15 published trials involving 8923 study participants met full inclusion criteria. Quetiapine resulted in more weight gain than risperidone and risperidone resulted in more weight gain than aripiprazole). No trials directly compared aripiprazole to quetiapine, but an indirect method of comparison demonstrated that quetiapine causes more weight gain than aripiprazole. Similarly, quetiapine led to a greater increase in glucose levels, a greater increase in blood pressure, and a greater increase in total cholesterol than risperidone.

Non insulin dependent diabetes mellitus (NIDDM) as a most common form of diabetes is a major public health problem; there is a subgroup of NIDDM patients which develops the disease at an early age and shows a dominant mode of inheritance. This type is nominates Maturity onset diabetes of the young (MODY). The prevalence of MODY is difficult to access as patients with MODY genes mutations are often identified during routine screening for other purposes.

MODY2 was linked to mutations in glucokinase gene (GCK), and account for 8-56% of MODY, with the highest prevalence being found in the southern Europe. The aim of this study was to examine the prevalence and nature of mutations in GCK gene in Iranian paients. We have screened GCK mutations by single stranded conformation polymorphism (SSCP) technique of polymerase chain reaction (PCR) in 12 Iranian families with clinical diagnosis of MODY, included 30 patients (eight males and 22 females) and their 21 family members. PCR products with abnormal mobility in denaturing gradient gel electrophoresis (DGGE) were directly sequenced.

We identified six novel mutations in GCK gene in Iranian families (corresponding to 36.6% prevalence). Our findings and the last study on MODY1 highlight that in addition to GCK, other MODY genes such as MODY3 and MODYX may play a significant role for diabetes characterized by monogenic autosomal dominant transmission. This is clear that the knowledge of the specific defect can be used to pre-symptomatically identify family members at risk for developing MODY. Background: Several epidemiological studies proposed an association between Helicobacter pylori (H. pylori) infection with Insulin Resistance (IR) and Metabolic Syndrome (MetS). However, up to date there is no conclusive evidence regarding this association.

Objectives: To investigate the prevalence and correlates of H. pylori infection among Lebanese adults and to evaluate its association with IR and MetS.

Materials and methods: Stored blood samples of adults participating in the national Nutrition and Non-Communicable Diseases Risk factors survey conducted in Lebanon were used for this study (n = 308). H. pylori-specific immunoglobulin G antibody titers were measured by ELISA. Data available included, in addition to anthropometric measurements, sociodemographic and lifestyle characteristics, blood pressure, biochemical indices (serum insulin, HDL, LDL, TAG, glucose). A HOMA -IR level was used to assess insulin resistance. The International Diabetes Federation criteria were used to classify study participants with MetS.

Results: The prevalence of H. pylori infection in the study sample was 52% (95% CI: 46.43-57.57%). A higher crowding index was associated with a 50% increase in the odds of infection (OR: 1.52, CI: 1.04-2.37). Blood pressure, waist circumference, serum HDL, LDL, TAG, and glucose levels were comparable between H. pylori positive and negative subjects. The odds of IR and MetS were not significantly different between the two groups.

comparable to other developing countries. Furthermore, our findings suggested no association of H. pylori infection with IR or MetS. Eradication of H. pylori infection to prevent IR or MetS is not warranted.

The economic burden resulting from diabetic neuropathy (DN) consumes a major portion of resources allocated for health-care services. The present study was undertaken to assess the costeffectiveness of medical intervention in patients with DN. Two hundred patients with DN were purposively selected from Out-Patient Department of BIRDEM hospital, Bangladesh. Of them 100 were late in detection of DN (LDN) and 100 were detected early (EDN). In LDN group, 22% had Diabetic Peripheral Neuropathy (DPN), 17% had Diabetic Autonomic Neuropathy (DAN), 11% had Diabetic Proximal Neuropathy (DPXN) and 9% had Diabetic Focal Neuropathy (DFN). In EDN group, 16% had DPN and 7% had DAN. The average annual cost of care was US$ 26846 (direct US$ 17893 and indirect US$ 8953), with an average US$ 134 per patient. Among the average annual cost LDN consumed US$ 18918 (US$ 189 per patient) and EDN US$ 7928 (US$ 79 per patient). The annual medical costs increased with the increased number of complications from US$ 1320 to 2296 to 3989 and to 6520 in LDN with one, two, three and more than three complications which is increasing at a rapid rate and US$ 917 to 1556 to 1872 and to 2073 in EDN respectively, increasing at a diminishing marginal rate. The regression equation showed that medical cost is significantly related to complications tested in both univariate (P < 0.0001) and multiple linear regression analyses (R 2 = 0.69; F-81.5, P < 0.0001). Proper management with regular screening substantially reduces the expenditure related to care and complications.

A. Alizadeasl 1 , Z. Ojaghi-Haghighi 2 , R. Azarfarin 1 1 Tabriz University of Medical Sciences, Tabriz, 2 Rajaei Hospital, Tehran, Iran Background: Metabolic syndrome (MS), the combination of hypertension obesity, dyslipidemia, and insulin resistance, is a precursor of diabetes mellitus (DM) and highly prevalent among patients with acute myocardial infarction (AMI). Diabetes mellitus is associated with larger infarct size and worse outcomes after AMI. This study examind the clinical presentation and hospital outcomes among nondiabetic patients with MS following AMI.

This investigation is prospective Analytic study (cohorts type) in 500 consecutive infarct survivors who admitted to our heart centers through 2 years (2009) (2010) (2011) . Patients with diabetes (n = 129) were excluded. Those with MS (n = 227) included patients with three or more of the following criteria: hypertension, elevated fasting blood glucose, hypertriglyceridemia, low high-density lipoprotein, and obesity [body mass index (BMI) >or = 30]. The control group (n = 144) included patients without MS or DM.

Results: Baseline characteristics were similar except for hypertension, BMI, and dyslipidemia, which by study desing were higher in the MS group. The nondiabetic MS group had larger left ventricular dimension (P = 0.03), left atrium dimension (P = 0.01) and higher rate of ejection fraction 40% (48% vs. 29%, P < 0.05). Also nondiabetic MS patients had higher rates of in-hospital death (14.3% vs. 6.9%, P < 0.05); post infarction angina (14.5 vs. 5.1, P < 0.05) and more frequent left main coronary artery or three-vessel disease than the control group (54.2% vs. 23.8%, P < 0.05).

Conclusion: Nondiabetic metabolic syndrome is common in patients with AMI and strongly associated with poor outcome of them. Background: This Study assessed the prevalence of the metabolic syndrome (MS) and its impact on hospital outcomes in patients with acute myocardial infarction (AMI) using both NCEP ATP III and IDF definitions.

This investigation is propective Analytic study (cohort type) in 500 consecutive AMI survivors (mean age: 60.3 AE 10.09 years; 308 men and 192 women), who admitted to our heart centers through 2 years (2009) (2010) (2011) .

Results: Q-wave myocardial infarction (MI) was present in 72.8% of patients and non-Q-wave MI, in 27.2%. The MS was found in 56.6% of the patients and was significantly more common in women than in men (64.8% vs. 49.6%, P = 0.003). One component of the MS was found in 15.3% of patients; two, in 21.9%; and none, in 6.2%. 31.3% of the patients had four or five components. Hypertension was the most common component of the MS (70.2%). 49.6% of MS patients had triple-vessel disease on coronary angiography in comparing with 27.7% in non-MS, AMI patients (P < 0.001). The MS group had larger infarct size as determind by peak creatine kinase-MB (85.4 AE 97.5 vs. 48.1 AE 53.9, P < 001). Overal inhospital complications (mechanical and electrical) were higher in patients with MS (46.8% vs. 21.6%, P = 0.01). MS is associated with a 8.9-fold increased risk of acute renal failure after MI (P = 0.0001).

Conclusion: MS in patients with AMI is prevalent and associated with larger infarct size, more in-hospital complications, and marked increase of acute renal failure.

Background and aims: According to current views metabolic syndrome (MS) and obesity, especially with increased amount of visceral fat is characterized by prothrombogenic changes of hemostasis and fibrinolysis.

Methods: Cross-sectional observational study included 165 postmenopausal women (age 48-65) with MS. Coagulant system was assessed by measurement of parameters of plasma haemostasis [Activated Partial Thromboplastin Time (APTT), fibrinogen concentration], and the activities of coagulant factors VII (FVII), VIII (FVIII) and IX (FIX) in plasma. In order to investigate the functioning of anticoagulant system the activities of antithrombin III. Also we assessed adiponectin (ADP) and homocysteine (HM) concentrations in plasma.

Results: Prothrombotic alterations were observed in 86.1% women. The APTT was decreased in 13.9%, hyperfibrinogenemia was revealed in 49.6%, the increased activity of: FVIIin 26.0%, FVIIIin 19.4%, FIXin 21.8%, and the decreased activity of antithrombin IIIin 11.5%. The HM levels was increased in 76.4%, the ADP levels was decreased in 39.3%. There were a significant positive associations between some of revealed prothrombotic alterations (FVII, FVIII and fibrinogenemia) and anthropometric markers of visceral obesity and MS (weight, body mass index, and waist circumference). The ADP levels were inversely correlated with the HM levels (r = À0.57, P < 0.05) and the activity of FVII (r = À0.34, P < 0.05).

Conclusion: Results of our study demonstrate high prevalence of various prothrombogenic abnormalities in coagulation and anticoagulation systems in patients with visceral obesity and MS.

Plasma B-type natriuretic peptide (BNP) and blood urea nitrogen (BUN) are elevated in heart failure. Renal function is known to be an important factor related to BNP and BUN determination. The aim of the present study was to examine whether BNP and BUN are associated with left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes (T2DM) without chronic kidney disease (CKD). The subjects in this study were 107 consecutive patients with T2DM [68 men (64%); age 65 AE 9 years old (mean AE SD); diabetic duration 10 AE 8 years; HbA1c 7.9 AE 1.7%]. Subjects with overt heart failure or NYHA class >1, history of coronary artery disease, severe valvulopathy, chronic atrial fibrillation, and estimated glomerular filtration rate <60 ml/min/1.73 m 2 were excluded from the study. All patients underwent clinical evaluation, laboratory tests including BNP determination, and echocardiographic examination. Doppler echocardiographic indices including peak early diastolic mitral annular velocity (E′) and early diastolic myocardial velocity (E) were obtained in each patient. None of the patients exhibited systolic impairment of left ventricular function (ejection fraction >50%), whereas LVDD (E/E′ >8) was detected in 91 cases (85.0%). E/E′ correlated with age (r = 0.344, P < 0.0001), sex (r = 0.204, P = 0.020), diabetic retinopathy stage (r = 0.207, P = 0.033), systolic blood pressure (r = 0.222, P = 0.026), BNP (r = 0.306, P = 0.002), and BUN (r = 0.257, P = 0.007). In multiple regression analysis, age (b = 0.220, P = 0.024), sex (b = 0.191, P = 0.041), BNP (b = 0.260, P = 0.005), and BUN (b = 0.210, P = 0.026), correlated independently with E/E′. BNP and BUN could be useful tools to screen for preclinical ventricular diastolic dysfunction in patients with T2DM without CKD.

H. Kawano, Y. Nagayoshi, Y. Kinoshita

Objective: This study compared the effects of combination statin and fibrate therapy with either statin or fibrate monotherapy on lipid profiles in patients with impaired glucose tolerance (IGT) and a high risk for cardiovascular disease.

Methods and patients: Forty-five patients with IGT and dyslipidemia (men 25, women 20, mean age 61.7 AE 2.4 years) were assigned randomly to the three treatment groups for a 6-month period.

Results: After 6 months of treatment, low density lipoprotein levels decreased in every group, especially the statin and statin + fibrate groups. Triglyceride levels also decreased in all three groups, especially the fibrate and statin + fibrate groups. High density lipoprotein cholesterol and fasting blood glucose levels did not change in any group. The levels of remnant like cholesterol particles decreased in the fibrate and statin + fibrate groups. There was no change during the study in the levels of creatine phosphokinase, lactate dehydrogenase, or creatinine.

Conclusion: Combination statin and fibrate therapy results in greater improvement in lipid profiles than monotherapy with either drug. No marked adverse effects were observed with combination therapy during the study.

Background: Gout is considered a metabolic disease and ranked among the diseases connected with obesity, such as an arterial hypertension, coronary artery disease, stroke, and type 2 diabetes mellitus (WHO, 2000) . It has been proven that intake of a considerable quantity of meat products is predictor of acute gouty arthritis. For this reason there is great interest in studying the prevalence of gout among inhabitants of the Republic of Sakha (Yakutia) where a lipid-protein diet prevails. This is a preliminary report on the incidence of gout requiring hospitalization in 2006-2011.

Objectives: Patients hospitalized in the Yakut City Hospital with gouty arthritis were studied.

Methods: Patients are being studied by means of a questionnaire developed by the Institute of Rheumatology (Moscow).

Results: Forty-four patients were registered (42 men and two women). The majority of patients (n = 35) are inhabitants of Yakutsk City. Median age of the subjects is 56 years, with a range of 35-76 years; four patients are over 65. Secondary forms of gout and relapses of disease are common. Accompanying pathology includes: AH in 22 patients, CAD in seven patient, type 2 DM in four patients, glucose intolerance + obesity in one patient, metabolic syndrome + obesity in one patient, uncomplicated obesity in one patient, metabolic syndrome without obesity in one patient, chronic renal insufficiency in one patient, and cardiovascular accidents in three patients.

The research proceeds. Results will be used for characterization of the incidence and diagnostic features of gout in Yakutia especially among young patients with accompanying metabolic abnormalities. Background: The prevalence of obesity, a major public health problem, is rising in many countries including Iran. Non-drug dependent interventions for obesity management include physical activity, dietary restriction and acupuncture.

Primary study objective: We examined the effects of body electroacupuncture and low-calorie diet on plasma leptin in obese and overweight individuals with the excess or deficiency pattern (according to Chinese medicine).

Methods/design: The case group received authentic electroacupuncture and the placebo group received sham acupuncture. Both groups consumed a low-calorie diet for 6 weeks.

Settings: This study was conducted in Nutritional clinic of Ghaem hospital, Mashhad, Iran.

Participants: People (n = 86), aged between 18 and 65 years with Body Mass Indexes (BMI) between 25 and 45 kg/m 2 were randomized into two groups.

Interventions: Comparison of either real or shame electro acupuncture combined with a low caloric diet was investigated in this trial.

Primary outcome measures: Plasma leptin, body fat mass (BFM), body weight and body mass index were measured before and after treatment.

Results: In volunteers in the case group with both the excess and the deficiency patterns, we found a significant reduction in plasma leptin (24.96%, P = 0.001) and BFM (8.29%, P = 0.001). In the placebo group, we found a less significant reduction in leptin and BFM. The difference between the two groups was significant for leptin (P = 0.03) but not for BFM (P = 0.8).

Conclusions: Body electroacupuncture with a low-calorie diet may reduce plasma leptin concentration; through a mechanism that will require further clarification.

M. Darbandi 1,2 , S. Darbandi 1,2 , A.A. Owji 1 , P. Mokarram 1 , M. Ghayour Mobarhan 2 effects of auricular acupressure combined with low-calorie diet on the leptin hormone level.

Methods: Volunteers (n = 86) with body mass indexes (BMI) between 25 and 45 kg/m 2 were randomised into a case (n = 43) or a control (n = 43) group. The participants in each group received a low-calorie diet for 6 weeks. The case group was treated with auricular acupressure and the control group received a sham procedure. Plasma leptin levels, body fat mass, body weight (BW) and BMI were measured before and after treatment.

Results: Participants who received auricular acupressure showed significant reductions in their plasma leptin levels (18.57%, P < 0.01) as well as in their body fat mass (4%, P < 0.05). These changes were not observed in the control group. The reduction in leptin was significantly greater in the acupressure group than the controls.

Conclusion: Auricular acupressure combined with a low-calorie diet significantly reduced plasma levels of leptin. However, the mechanism of this reduction is not clear. Background: Premature arteriosclerosis may be one of the mechanisms linking pre-diabetes mellitus (pre-DM) and cardiovascular disease. We assessed premature arteriosclerosis in pre-DM using arterial stiffness indices and analyzed the associated contributors of this process.

Methods: We collected clinical data of 33 patients without DM, 53 pre-DM patients, and 34 DM patients. Both the compliance index (CI) and stiffness index (SI) were measured to indicate large and peripheral arterial stiffness.

Results: Patients with pre-DM and DM had lower CI (3.8 AE 2.1 vs. 5.2 AE 3.0 units; P < 0.05 and 3.6 AE 1.8 vs. 5.2 AE 3.0 units; P < 0.05, respectively) and higher SI (8.0 AE 2.0 vs. 6.7 AE 1.6 m/s; P < 0.01 and 9.4 AE 2.3 vs. 6.7 AE 1.6 m/s; P < 0.001, respectively) than patients without DM. Both pre-DM and DM patients had higher glucose and hemoglobin A 1C , higher HOMA index, higher hsCRP, and a lower adiponectin level than patients without DM. Using multivariate linear regression analysis, age, heart rate and HOMA index were independent determinants for SI (whole model: R 2 = 0.47, P < 0.001), whereas male gender, hsCRP, and HOMA index were independent determinants for CI (whole model: R 2 = 0.34, P < 0.01).

Conclusions: HOMA index was an independent determinant for arterial stiffness. Increased insulin resistance may associate with increased arterial stiffness both at large and peripheral arteries in pre-DM patients. King's College London, London, UK, 2 Uppsala University, 3 Regional Cancer Centre, Uppsala, Sweden, 4 Guy's & St Thomas' NHS Foundation Trust, London, UK, 5 Karolinska Institute, Stockholm, Sweden Background: Impaired glucose metabolism has been linked with increased cancer risk, but the association between serum glucose and cancer risk remains unclear. We used repeated measurements of glucose and fructosamine to get more insight into the association between the glucose metabolism and risk of cancer.

Methods: We selected 11,998 persons (>20 years old) with four prospectively collected serum glucose and fructosamine measurements from the Apolipoprotein Mortality Risk (AMORIS) study. Multivariate Cox proportional hazards regression was used to assess standardized log of overall mean glucose and fructosamine in relation to cancer risk. Similar analyses were performed for tertiles of glucose and fructosamine and for different types of cancer.

Results: A positive trend was observed between standardized log overall mean glucose and overall cancer risk (HR = 1.08; 95% CI: 1.02-1.14). Including standardized log fructosamine in the model resulted in a stronger association between glucose and cancer risk and a statistically significant protective effect of fructosamine (HR = 1.17; 95% CI: 1.08-1.26 and HR: 0.89; 95% CI: 0.82-0.96, respectively). The highest risk for cancer was among those in the highest tertile of glucose and lowest tertile of fructosamine. Similar findings were observed for prostate, lung, and colorectal cancer.

The contrasting effect between glucose, fructosamine, and cancer risk suggests the existence of distinct groups among those with impaired glucose metabolism, resulting in different cancer risks based on individual metabolic profiles. Further studies are needed to clarify whether glucose is a proxy of other lifestyle-related or metabolic factors. patients in two groups were compared according to age, parity, prepregnancy weight, family history of diabetes mellitus, history of macrosomia in their previous pregnancies, history of hypertension, previous malformed fetus, history of IUFD and abortion. Based on the obtained results there was a statistically significant difference between two groups in terms of age (P < 0.05), parity (P < 0.05), prepergnancy weight (P < 0.05), family history of diabetes mellitus (P < 0.05), previous macrosomia (P < 0.05), history of hypertension (P < 0.05), previous malformed fetus (P < 0.05) and previous IUFD (P < 0.05), but abortion was not significantly different. Older age, parity (three or more) obesity, family history of diabetes mellitus, history of macrosomia, hypertension, malformed fetus and also previous IUFD are risk factors for gestational diabetes. Therefore, these women should be screened and handled for gestational diabetes in their pregnancies, and controlled for possible diabetes mellitus in the future. Methods: This family based study was conducted on 529 nuclear families from among Tehran Lipid and Glucose Study with two biological parents and at least two offspring (1066 parents and 1394 offspring), aged 3-80 years. Selected families had at least one person with overweight or obesity. All obesity-related variables (height, weight, hip, waist circumference (WC), body mass index (BMI), body size (BS), resting energy expenditure (REE), waist to hip ratio (WHR)) were measured and calculated. The heritability estimate of continuous variables was calculated using a standard quantitative genetic variance-components model which was implemented in the SOLAR software.

Results: The heritability estimates for obesity-related variables such as height, weight, hip, WC, WHR, BMI, BS, and REE, after adjustment for sex, age were 16%, 31%, 21%, 32%, 27%, 43%, 51%, and 25%, respectively. The h 2 for the above mentioned variables, expect of BS, after adjustment for sex, age, and body size varied to 28%, 32%, 21%, 26%, 25%, 32%, and 47%, respectively (P < 0.05).

We clearly demonstrated a significant heritability of obesity-related variables among TLGS families. The results of the present study confirmed the important impress of genetic factors on the obesity-related variables phenotype. Method: PWV determined with BPULS apparatus using left external carotid and left dorsalis pedis arteries as "central" and "peripheral" points respectively. Pulses picked up by infrared sensors and recorded simultaneously with single lead ECG. Time difference between pulses measured. Shorter time delay or faster PWV indicates decreased arterial elasticity.

Materials: Nine hundred and fifty-seven asymptomatic Filipinos studied. Males-447, Females-500. Age 17-84 years. Three hundred and twenty-seven Hypertensives. Classified into groups according to BMI and WC. Average PWV Time (adjusted for height) for each group noted. Relationship of increased BMI and WC to variations in PWV Time determined.

Results: Elevated BMI does not significantly influence PWV Time in: All subjects-(P < 0.1397); Females-(P < 0.2372); Normotensives-(P < 0.0866); and, Hypertensives -(<0.1548). However, for every centimeter increase of WC there is a corresponding decrease of PWV Time by: 0.000743 s (P < 0.0001) in All Subjects; 0.00063 s (P < 0.0001) in Females; 0.000759 s (P < 0.0001) in Normotensives; and, 0.00035 s (P < 0.0001) in Hypertensives.

Discussion: Abnormal PWV is a high CVD risk factor. In four groups above, elevated BMI does not significantly influence PWV Time. However, in the very same groups, increased WC significantly affects PWV Time. This indicates that if we rely solely on BMI to predict CVD we will miss cases which are at high risk as shown by abnormal WC. correlation (r = 0.22). An increased risk of CVD and cancer was identified with elevated levels of GGT or CRP or both markers (GGT-CRP score ! 3); the greatest risk of CVD and cancer was found when GGT-CRP score = 6 (HR: 1.40 (95%CI: 1.31-1.48) and 1.60 (1.47-1.76) compared to GGT-CRP score = 0, respectively).

Conclusion: While GGT and CRP have been shown to be associated with metabolic abnormalities previously, their association to the components investigated in this study (hyperglycaemia and dyslipidaemia) was limited. Results did demonstrate that these markers were predictive of associated diseases, such as cancer and CVD.

Metabolic Syndrome is the aggregation of conditions that together increases the risk of cardiovascular disease and diabetes mellitus in both normal glucose tolerance (NGT) and impaired glucose tolerance (IGT) subjects. It is estimated that around 20-25% of the world′s adult population have the metabolic syndrome. Over the last 20 years the prevalence of metabolic syndrome has steadily increased in all populations, and making it one of the major global public health challenge. The objective of this study is to estimate the prevalence of metabolic syndrome and cardiovascular risk factors in impaired glucose tolerance (IGT) subjects.

Two hundred and four Impaired glucose tolerance and 30 normal glucose tolerance subjects of both genders were selected for the present study according to the American Diabetes Association ADA criteria, on the base of 2 h glucose tolerance test. Anthropometric characteristics like Waist circumference, BMI, systolic blood pressure, and diastolic blood pressure were measured with standard techniques. Biochemical parameters like fasting blood sugar, fasting insulin, cholesterol, triglycerides, HDL-C, and LDL-C were determined by standard techniques, the HOMA-IR values were calculated with the help of formula.

It is concluded from the present study that the prevalence of metabolic syndrome is significantly increased according to AACE, ATPIII definition criteria's in impaired glucose tolerance subject, the study emphasizes strongly that MS is major factor to enhance the incidence of type 2 diabetes and cardiovascular diseases in impaired glucose tolerance subjects. It is suggested that preventive measures and treatment can reduce incidence of CVD, type 2 diabetes in our population.

Anthropology, Vidyasagar University, Midnapore, India Waist circumference (WC) and waist-hip ratio (WHR) were reported as imperative abdominal obesity related measures having influence on many cardiovascular disease (CVD) risk factors. Present study attempts to evaluate the possible association of abdomen circumference (AC) with hypertension and dyslipidaemia among the Bhutias, a tribe residing the sub-Himalayan State of Sikkim, India.

Five hundred and eleven Bhutias of both sexes aged ! 20 years inhabiting Gangtok, the State capital and its neighbourhood were systematically selected to participate in the study. After providing informed consent data on blood pressures, blood lipids, anthropometrics and other lifestyle related variables such as perceived stress, diet, energy expenditure, socioeconomic status and so on were collected following standard methods.

The results evidently indicate that the AC is the best predictor of the selected CVD risk factors. After log transformation, the effect of age on CVD risk factor variables and anthropometrics was found and regressed out through linear regression. Data was pooled for sex as significant sex difference was absent for most of the variables. After adjusting for significant lifestyle related predictors, multiple logistic regression was carried out to evaluate the significant obesity related predictors of hypertension and dyslipidaemia. Receiver operating characteristic (ROC) curve finally showed AC as the best predictor of hypertension and dyslipidaemia.

Although WC and WHR were found to be important abdominal obesity related predictors of CVD risk factors in many studies, present population based cross sectional study has proved the importance of considering AC as a central obesity related predictor of different CVD risk factors. The achievement of therapeutic goals is of great importance in patients with chronic diseases such as diabetes mellitus (DM), because of its impact on morbidity and mortality.

Objective: To explore the relationship between therapeutic adherence and metabolic control in patients with DM-2, who were seen at a hospital in the city of Medellı´n (Colombia).

Methods: Cross-sectional study involving patients with the following selection criteria: age ! 18 years, diagnosis of DM-2 ! 6 months, who signed informed consent. The Summary of Diabetes Self-Care Activities (SDSCA) score was applied for the measurement of therapeutic adherence and Duke-Unc score for the assessment of perception of social support. Glycosylated hemoglobin (HbA1c) was processed by turbidimetric inhibition immunoassay (TINIA) Cobas C-501 equipment. Adequate metabolic control was defined as value of HbA1c 7%. Version 19.0 of the SPSS program was used for the statistical analysis.

Results: Seventy patients studied: 66% are female, 76% suffer from hypertension, 70% have dyslipidemias and 16% smoke. In addition, 59% are insulin dependent, 70% have inadequate glycemic control and 87% has no social support. Items with the highest proportion of adherence were: medication (79%), foot care (71%) and diet (62%). Whereas the lowest were: HbA1c (32%) and exercise (28%). HbA1c correlated significantly (P < 0.05) with adherence to diet, blood glucose monitoring, foot care, social support and sex.

Conclusion: Therapeutic adherence was associated with metabolic control in patients with DM-2. mellitus. However, it is unclear if severity of DR is associated with LVDD, which is recognized to result in subsequent heart failure. The subjects in this study were 120 consecutive patients with type 2 diabetes mellitus (T2DM). All patients underwent clinical evaluation, laboratory tests, and echocardiographic examination. Doppler echocardiographic indices including peak early diastolic mitral annular velocity (e′) and early diastolic myocardial velocity (E) were obtained in each patient. The patients were divided into three groups according to presence of DR and its severity: no diabetic retinopathy (n = 80), simple retinopathy (n = 20), and preproliferative or proliferative retinopathy (n = 20). No patients showed systolic impairment of left ventricular ejection fraction (LVEF >50%), whereas impaired LV diastolic function (E/e′ >8) was detected in 104 cases (87%), furthermore LVDD (E/e′ >15) was detected in 19 cases (16%). E/e′ was correlated with age (r = 0.303, P = 0.001), sex (r = 0.208, P = 0.021), diabetic duration (r = 0.279, P = 0.002), DR stage (r = 0.241, P = 0.007), systolic blood pressure (r = 0.199, P = 0.031), and serum creatinine level (r = 0.265, P = 0.003). In multiple regression analysis, age (b = 0.322, P < 0.001) and DR stage (b = 0.266, P = 0.002) were independently correlated with E/e′. In this study, we showed that almost all subjects had asymptomatic LVDD, and severity of DR was associated with LVDD in patients with type 2 diabetes mellitus. Objectives: This study explores the contribution of the Sasang constitutional types as a risk factor for hypertension by examining the prevalence and risk for hypertension across different constitutional types (SE, SY, TE, and TY types) and investigating whether certain constitutional types can increase the risk of hypertension in an individual.

Design: This retrospective chart review evaluated the charts of patients who had visited the clinic for routine physical check-up.

Subjects: Among 12,140 visitors, those aged between 21 and 80, with complete data concerning the past medical and social history, blood pressure and body size measurements, results of blood test, and confirmatory constitutional typing (excluding the TY type) were included in the final analysis group (n = 1701).

Results: Especially, even after adjusting for the different variables, the odds ratio for hypertension in the TE type was found to be 1.72 (CI 1.14-2.62) (taking the SE type as the reference group), indicating that the TE constitutional type can act as a risk factor for hypertension. Moreover, when comparing the TE type to non-TE types, the odds ratio was found to be 1.37 (CI 1.06-1.78), implying a weak but valid contribution of the TE constitutional type toward increasing the risk of hypertension.

The results of this study show that the prevalence of hypertension differs across different constitutional types, and that the constitutional type (the TE type) can act as a risk factor for hypertension independently of other possible variables.

A.B. Shetty 1 , P.K. Roy 2 1 Physical Therapy, University of St Mary, Leavenworth, KS, 2 Bon Secours Hospital, Baltimore, MD, USA Introduction: The purpose of this research was to determine whether habits of individuals contributed to changes in metabolic rate. As the daily physical activity levels increase, there is an increase in the metabolic rate and caloric expenditure. It can be inferred that people who are overweight may not participate in physical activities due to social, psychological, and physical reasons. They may spend more time in less physically demanding activities during their leisure time.

Hypothesis: It was hypothesized that the individuals who like to read for pleasure during leisure will have higher Body-Mass-Index.

Subjects: A group of 37 college aged, 18-25, females volunteered to be the subjects for the study.

Method: Each subject's weight and height were collected to determine BMI. The leisure time activities that were included were reading, sleeping, watching television, use of computers, and sports and physical activities. A Likert scale questionnaire was developed and had four levels of answers for each of the leisure time activities. A Person-Product moment correlation was used to determine the relationship between BMI and five leisure time activities.

The results indicate that a positive correlation of 0.57 between BMI and Leisure Time Reading habits. There is a negative correlation of À0.73 between BMI and Sports and Physical Activities.

Conclusion: This research demonstrates that the BMI is significantly higher for individuals who like to read during their leisure time activities. Therefore, it is also important to develop physical activities as habits during early years that may carry into adulthood. Objectives: The main goal of this retrospective cohort study was to compare the incidence of over-all and site-specific cancers among Israeli Arabs with diabetes mellitus (DM) with that of Israeli Arabs without DM.

Methods: A retrospective cohort study was conducted in northern Israel, involving all Arab subscribers of Clalit Healthcare Services (CHS), which is the major HMO service in the region, serving over 70% of the concerned population.

Results: During a period of 10 years (1999-2008) of follow-up, 752 and 2045 incident cases of cancer were found among 13,450 people with DM and 74,484 adults free of DM, respectively. The follow-up time involved 817,506 person years. DM was associated with a standard incidence ratio (SIR) of 3.27 (95%CI: 1.49-5.05) and 2.87 (95%CI: 1.25-4.50) for pancreas cancer in men and women, respectively. A significantly reduced SIR was observed for esophageal, stomach and intestine cancer 0.67(95%CI: 0.36-0.99) in men.

Our findings support an association between DM and increased risk cancer of the pancreas in Arab men and women. A significantly reduced risk of all other cancers was observed only in Arab men.

A.E. Berezin 1 , O.A. Lisovaya 2 1 Methods: Seventy-two mild-to-moderate arterial hypertension patients within 1-2 weeks after ischemic stroke were enrolled to the scrutiny at baseline. Both VEGF-1 and MMP-9 plasma levels were measured at the study entry and in 6 months after baseline by ELISA. We has been assessed all new cardiovascular events including myocardial infarction (MI), unstable angina (UA), recurrence stroke (RS), TIA, advance heart failure (HF) during study period.

Results: Analysis of obtained outcomes have been shown that all cases (n = 28) of new cardiovascular events identified during first 4 weeks after start of observation are correlated well with VEGF-1 plasma levels (r = À0.58; P < 0.001) measured at baseline. On the other hand, 4-weeks survival rate was 87.0% and 68.6% respectively for group subjects (P < 0.01) with top and low quartile of VEGF-1 plasma level at baseline. However, lack of tightly interrelationship between cardiovascular outcomes and VEGF-1 (r = 0.2; P = 0.16) in 6 months after study entry. The mean MMP-9 plasma levels were significantly higher in dead patients in comparison to survival subjects of the study end. Both new events associated with RS and TIA incidences independently study period are correlated well with VEGF-1 (r = À0.63; P < 0.05 and r = À0.58; P < 0.02 respectively) only.

We has been proposed that circulating VEGF-1 might have more predicting value in comparison with MMP-9 concentration among hypertensive patients during early ischemic stroke period.

Introduction: Clinician should change the health care system from on diseases treatment to prevention of diseases. Obesity increase mortality, morbidity and psychological problems through life but beneficial effects of risk reduction by changing life style have been documented.

Objective: Sedentary life style is the most important factor for promoting weight gain in people. It's clear that obesity occurs when calorie intake exceeding calorie output. Obesity is common in families but seems environmental factors can affect body weight beside genes role. A main factor of life style change is energy balance. We recommend one simple healthy life guideline for managing of environmental factors in obese people that includes a diet and physical activity program. Body weight should be reduced 7-10% during first year by following of this guideline and continued until achieving to optimal body weight. Obese people are visited and monitored some parameters for program adjusting and changed each item basis on individual response. 

Objective: To assess trend and associations between blood sugar level, blood pressure, overweight/obesity and lifestyle among tribe of Northeast India experiencing transition.

Method: Cross-sectional study was carried out among 603 Tangkhul Nagas, aged between 20 and 70 years. Subjects were divided into five decadal age groups to assess age trend in biological and socioeconomic variables. Height, weight, waist circumference, hip circumference, random blood sugar level, BP, BMI, WSR and WHR were evaluated.

Result: The prevalence of prediabetes and diabetes were 9.15% and 2.7% respectively. Diabetes was found among older age groups only. Hypertension was highly prevalent with higher percentage among males (37%) than females (20.8%). Mean BP was higher among males but sugar level among females, which corresponds to their higher adiposity level. Prevalence of overweight/obesity in females was 27.1% while in males, it was 17.6%. Sugar level and BP had positive correlation with age, BMI, WSR and WHR. The prevalence of hypertension and prediabetes/diabetes were higher among centrally obese subjects. Central obesity indices were stronger predictors of diabetes and hypertension than general obesity. Odds ratio showed urbanization, higher socioeconomic status and sedentary lifestyle as significant risk factors for development of overweight/obesity, which in turn was risk factor for development of diabetes and hypertension.

Conclusions: Tangkhul Nagas has been experiencing socioeconomic and lifestyle change which led to the increasing prevalence of overweight/obesity and cardiometabolic health problems, contributing to the escalating global epidemic of obesity and metabolic syndrome. There was close associations between socioeconomic status, age, overweight/obesity, hypertension and blood sugar level.

Background and aims: Trace elements play an essential role in metabolism of carbohydrates, lipids, etc. These results stipulated the present work.

We studied 30 patients (eight females, 22 males, age 40-80 years) with type 2 diabetes mellitus. Duration of the disease varied from 1 month to 25 years. As a control data the hair composition of practically healthy individuals (n = 67) were used. As an analytical method instrumental neutron activation analysis (INAA) was used.

Results: Data obtained shows statistically significant decrease of Cu, Cr, and Zn and increase of Na, Fe, Br, and Sb levels in hair in the group with a blood glucose concentration <7 mmol/l. In the group with a blood glucose concentration more than 7 mmol/l levels of Cu and La were decreased and Na, Fe, Co, Br, and I levels increased. In the group with a blood glucose concentration more than 7 mmol/l glucose concentration correlates with Sc (r = 0.68), Cr (r = À0.55), and Mn (r = +0.64).

Conclusion: It was found that Mn level in blood increases with diabetes. This may be a manifestation of Mn metabolism dysfunction in diabetes and excretory role of hair. It is also confirms the important role of some elements, especially Cr, in diabetes. Concentration of this element significantly decreases especially in the first year of illness. Unexpected are correlations for Sc. Usually Sc is considered as an element that has no biological role. These findings are additional reasons to study the biological role of less studied ultra trace elements. Objective: Investigate the prevalence of hyperglycemia in patients undergoing coronary angiography.

Methods: Six hundered and ninety-five consecutive Brazilian subjects undergoing coronary angiography were assessed for fasting plasma glucose and HbA1c (HPLC) levels and for previous history of diabetes mellitus (DM). We classified those without previous diagnosis in three groups according to HbA1c levels (HPLC): Normoglycemic (N); HbA1c -<5.7%; prediabetes (PD) -HbA1c 5.7% À6.4%; and DM (D) -A1c ! 6.5%. CAD defined by any visible lesion ! 50%. We also classified glycemic status using fasting glucose levels by ADA criteria.

Results: Patients were aged 60.3 AE 10.5 years, 55.4% male. The group had a high prevalence of cardiovascular risk factors: dyslipidemia -93%, hypertension -91%, 70% overweight/obese, metabolic syndrome (IDF) in 72% of subjects. CAD was detected in 69.5% of them. DM was newly diagnosed using HbA1c in 11.1% of the whole sample (77 individuals) and PD in 209 (30%). In those without DM according to HbA1c, 27 (3.8%) had glucose levels ! 7 mmol/l and 196 (28.3%) had glucose ! 5.6 mmol/l.

In this particulary population with coronary artery disease and/or cardiovascular risk factors we observed a high prevalence of undiagnosed hyperglycemia -DM or prediabetes (32-41%) depending on the criteria used for identification/diagnosis (fasting glucose or HbA1c). This finding reinforces the importance of implementing a systematic screening for hyperglycemia in this high risk population. National University of Singapore, Singapore, Singapore, 2 University of Sydney, Sydney, NSW, Australia Objectives: To evaluate associations between metabolic syndrome (MetS) components and mortality and whether these associations change over time.

Methods: Three thousand eighty-six eligible residents aged ! 49 years were prospectively followed in the Blue Mountains Eye Study, west of Sydney, Australia. MetS components were measured at baseline (1992 -1994) , and after 5-years and 10-years (2002-2004) . Using Cox proportional hazards and competing risks models with MetS as a time-dependent covariate, we estimated effects of MetS on all-cause and cause-specific mortality. Receiver operating characteristic (ROC) curve analyses were used to identify which individual or combined MetS components best predicted mortality. . ROC analysis suggested that glucose, body mass index (BMI) and blood pressure (BP) best predicted all-cause and CHDdeath, BMI and BP best predicted stroke-death and glucose and triglycerides best predicted cancer-death. National University of Singapore, Singapore, Singapore, 2 University of Sydney, Sydney, NSW, Australia Objectives: To investigate the effect of metabolic syndrome (MetS) and its components on the incidence of different sub-types of cataract (cortical, nuclear and posterior subcapsular cataract (PSC)) over 10 years and whether these associations change with time.

Methods: A prospective cohort of elderly aged ! 49 years were followed up over a period of 10-years in the Blue Mountains Eye Study, west of Sydney, Australia. MetS components were measured at baseline (1992-1994), 5-years (1997-1997) and 10-years (2002) (2003) (2004) . The incidence of different types of cataract was obtained from standard photographic grading at 5-and 10-year (n = 1997). Using random-effect complementary log-log regression model with cataract status as interval-censored data, we estimated the effect of MetS on the incidence of different types of cataract at different time-intervals.

Results: After taking into account the changes in MetS (components) and controlling for possible confounders, MetS was found to be associated with increased 5-year incidence of cortical cataract [hazard ratio (HR) 1.48, 95% confidence interval (CI) 1.05-2.09] and PSC (HR 1.75, 95% CI 1.01-3.04). Amongst the five components of the MetS, high glucose and obesity predicted the 5-year incidence of cortical cataract and at 10-year, high glucose and low-HDL was associated with increased incidence of PSC and cortical cataract, respectively.

Conclusions: Changes in MetS predicted the 5-year incidence of cortical cataract and PSC. Different MetS components predicted the incidence of different sub-types of cataract at varying time-intervals. Material and method: This study was a done on a sample of Isfahan Cohort Study (ICS) participants. Subjects which met ATPIII criteria, entered in our study. AObesity indices such as body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist to height ratio (WHtR) measurements were done by trained nurses. Serum lipids, fasting blood glucose, Interleukin-6(IL-6) and Interleukin-10(IL-10), adiponectin ghrelin, and CRP were measured. The Mann-Whitney U-test was used for comparisons between the level of inflammatory markers in obese subjects with and without MetS. Then subjects with MetS were selected and correlation between inflammation biomarkers and obesity indices correlation coefficients were obtained by Pearson correlation test.

Results: WC and BMI were significantly higher in subjects with MetS (P < 0.001). The median (IQR) of CRP was significantly higher in subjects with MetS (P < 0.001). The correlation between inflammatory markers and obesity indices was determined by nonparametric analysis. MetS subjects had a significantly positive correlation between IL6 and WHtR (r = 0.367, P = 0.015). No significant relationship found between Il-10, ghrelin, adiponectin and CRP with, BMI, WHtR and waist. Significant negative correlation was observed for adiponectin and the waist (r = À0.367, P = 0.026). Negative correlation between adiponectin with WHR, WHtR and BMI among subjects without MetS (r = À0.509, r = À0.454 and À0.475 respectively).

Conclusion: Present study indicate that the observed inflammatory concentrations cannot be explained by type of obesity. 

Objective: The incretin effect is known to be decreased in type 2 diabetes (T2D). However, no study has directly measured the incretin effect in non-Caucasian subjects. Because Asian patients with T2D are characterized by decreased insulin secretion, this study set out to examine the incretin effect in Korean subjects with normal glucose tolerance (NGT) or T2D.

Research design and methods: We performed 75 g OGTTs and corresponding isoglycemic intravenous glucose infusion (IIGI) studies in subjects with NGT (n = 14) or T2D (n = 16). The incretin effect was calculated based on the incremental area under the curves (iAUCs) of insulin, C-peptide, or insulin secretion rate (ISR). The plasma levels of total glucagon-like peptide-1 (GLP-1) and glucosedependent insulinotropic polypeptide (GIP) were measured by ELISA.

Results: The incretin effect was not different between the subjects with NGT and T2D (43 AE 6% vs. 47 AE 4%, P = 0.575 by insulin; 29 AE 7% vs. 38 AE 4%, P = 0.253 by C-peptide; 28 AE 7% vs. 35 AE 5%, P = 0.372 by ISR, respectively). However, the gastrointestinally mediated glucose disposal (GIGD) was decreased in T2D (28.5 AE 4.2% vs. 59.0 AE 4.3%, P < 0.001). The plasma levels of the total GLP-1 and GIP during the OGTTs were comparable between the two groups.

Conclusions: In Koreans, the secretion of GLP-1 or GIP during OGTTs and the incretin effect were comparable between subjects with NGT and T2D, whereas the GIGD was significantly decreased in patients with T2D.

A.E. Berezin 1 , A.A. Kremzer 2 1 Internal Medicine, 2 Clinical Pharmacology, State Medical University, Zaporozhye, Ukraine

The aim of this study was to evaluate the interrelation between circulating osteoprotegerin (OPG) and coronary vasculature damage in type 2 diabetes mellitus patients.

Methods: One hundred and twenty-six subjects with stable diabetes mellitus 2 type with previously angiographic documented asymptomatic CAD were enrolled to the study. Vessel-wall and plaque geometrical and compositional parameters were measured on contrast-enhanced CT angiography. The volume of intramural calcium of >320 HU in major coronary vessels was measured in 428 coronary segments with a highly standardized method. Coronary artery calcification was quantified by calculating the Agatston' score index and calcification mass measurement. OPG plasma levels were measured with ELISA.

Results: Circulating OPG level was increase in 105 patients [5201 pg/ ml [95% confidence interval (CI) = 3605-6280 pg/ml] and was normal in 21 subjects (880 pg/ml; 95% CI = 745-1140 pg/ml; P < 0.0001). The relationship between coronary artery calcium by Agatston' score index and percent atheroma volume (PAV) was determined by linear regression. PAV and remodeling index were significantly higher in patients with elevation of OPG plasma level when compared with those who have normal OPG [adjusted odds ratio (OR) = 4.60 (95% CI = 2.23-14.50); P = 0.006]. There was significant correlation between Agatston' score index and PAV [r (2) = 0.46, P = 0.008].

In conclusion, we demonstrated that OPG plasma level can associate with vessel-wall thickening, percent atheroma volume, and Agatston' score index value in type 2 diabetes mellitus patients with previously angiographic documented CAD. Along with the prevalence of diabetes continues to grow, the occurrence of microvascular chronic complications caused by diabetes has increasingly become a serious social problem. Diabetic cardiomyopathy, a microvascular disease, results in chronic heart failure and causes a heavy economic burden. Endoplasmic reticulum as an intracellular organelle, which occurs the stress leads to cell apoptosis. Recent studies indicate that Bis(maltolato)oxovanadium can alleviate the endoplasmic reticulum stress to protect cell function. In this study, STZ (50 mg/kg)-induced diabetic rats were divided into two groups, the diabetic control group, and diabetes + vanadium group; the normal group without diabetes were randomly divided into two groups, normal group and the normal + vanadium group. The Bis(maltolato)oxovanadium significantly improve the endoplasmic reticulum stress in STZ-induced diabetic rat heart cells and reduce the cardiac damage. In this study, Bis(maltolato)oxovanadium can reduce the endoplasmic reticulum stress in diabetic myocardial cells delay the development of diabetic cardiomyopathy. It can be a new way to explain the mechanism in the function of bis(maltolato)oxovanadium.

between MetS and type 2 diabetes families without diabetic family related.

Subjects and methodology: Forty-three MetS subjects with type 2 diabetes parental (1st group), 27 MetS subjects without type 2 diabetes parental (2nd group) and 30 no MetS subjects but with type 2 diabetes parental (3rd group). This study was conducted over 12 months at diabetologia department hospital. Diabetes screening was achieved by Oral glucose tolerance testing (OGTT). Metabolic parameters were determined by spectrophotometry, insulin by radioimmunoassay. Insulin sensitivity was also assessed by the homeostasis model assessment (HOMA) approach (glucose 9 insulin/22.5).

Results: In the 1st and the 2nd groups there is a significant hyperinsulinemia and to a lesser extent in the 3rd group (72%, 66% and 57%, respectively). The HOMA model confirms an acute insulin resistance (79%, 75% and 65% increase respectively). Hypertriglyceridemia was observed only in the 2nd group. HDL dyslipidaemia has been identified in women of the 2nd group (<0.39 g/l).

Our study seems to confirm that type 2 diabetes genetic predisposition is not the only factor, but also environmental factors with or without diabetes family. 

Aims: To examine, the predictors of incident chronic kidney disease (CKD) in a community-based cohort of Middle East population, during a mean follow-up of 9.9 years.

Methods: In a sample of 3313 non-CKD Iranian adults ! 20 years the estimated glomerular filtration rate (eGFR) was calculated at baseline and at 3 year intervals during three consecutive phases. The eGFR <60 ml/min/1.73 m 2 was defined as CKD. Multivariate Logistic regression analysis was used to determine the independent variables associated with incident CKD.

Results: The incidence density rates of CKD were 285.3 and 132.6 per 10,000 person-year, among women and men, respectively. Female gender per se was associated with higher risk of CKD, compared with males. Among women, age, eGFR, known diabetes, being single or divorced/widowed, hypertension (marginally significant) and current smoking were independent risk factors for CKD; however the intermediate degree of education and family history of diabetes decreased the risk by 40% (P < 0.05). Among male subjects, independent predictors of developing CKD included aging and hypertension (with significantly higher risk than in women, P for interaction <0.05), eGFR, new diagnosed diabetes, high normal blood pressure; abdominal obesity decreased the risk of CKD about 30% which was marginally significant.

In the Iranian population, >2% of individuals develops CKD each year. Our findings confirmed that sex-specific risk predictors should be considered in primary prevention for incident CKD.

Introduction: Obesity is a silent killer and a forerunner of many complications if persists long. Various studies with animal model have identified the role of leptin, the hormone of adipose tissue; in obesity and its associated complications like diabetes and atherosclerosis inlater stages. The exact mechanism to know how leptin influences insulin action in body and thereby leading to diabetes or post diabetic atherosclerosis is still not completely evaluated. Hypercholesterolemia was only found common to all these three states.

Aim and objectives: The present study, therefore, evaluated the role of obesity on the expression of LDLR receptor, INSULIN receptor and LEPTIN receptor.

Method: Receptor expression was done by immunohistochemistry/ western blot. The serum level of lipids were measured by enzyme based kit method. The serum level of insulin and leptin and its soluble receptor were measured by elisa based kit.

The blot for insulin expression shows no chamge with body weight; the blot for leptin receptor shows decrease expression with weight gain and blot for LDLR shows decrease expression with weight gain. The serum levels of insulin and leptin are increased with weight gain but soluble receptor for leptin did not change significantly. Even the obese group showed decrease tyrosine phosphorylation of insulin receptor. Background: Visfatin and apelin are two new adipokines that recently gained special interest in diabetes research. However, the relationship between them has not been elucidated and their role in coronary artery disease (CAD) complication of diabetes has not been adequately studied.

Objective: This study was conducted to study the interplay between these two novel adipokines and to study their correlation with other inflammatory and biochemical parameters in type 2 diabetic (T2D) postmenopausal women with CAD.

The levels of visfatin, apelin and other parameters were measured in T2D patients without CAD, both nonobese and obese T2D patients with CAD, together with healthy nondiabetic control subjects. Visfatin and apelin were measured by enzyme-linked immunoassay (ELISA).

Results: Visfatin was found to be significantly higher in the following groups: T2D patients without CAD, non-obese and obese T2D patients with CAD, (26.10 AE 0.83, 24.53 AE 0.76 and 31.58 AE 1.04 ng/ml respectively) when compared to control group (12.53 AE 1.82 ng/ml) at P < 0.05. Apelin was found to be significantly lower in both non-obese and obese T2D patients with CAD (27.93 AE 1.07 and 1.36 AE 0.70 ng/ ml respectively) when compared to control group (34.52 AE 0.14 ng/ml) at P < 0.05. Furthermore, visfatin and apelin were found to be significantly associated with each other and with other biochemical parameters in both simple and multiple regression analyses.

The current study provides evidence for the novel interplay between visfatin and apelin through the inflammatory milieu characteristic of T2D and sheds light on their possible role in the pathogenesis of CAD complication of T2D. Aim: The aim of this study was to investigate the relationship between hsCRP, IL-6, and Hcy levels and cardio metabolic risk factors in subjects with and without MetS in a sample of Tehranian population.

In this cross-sectional study, 365 individuals including 134 men and 231 women, aged ! 19 years were selected randomly from among participants of TLGS. The sera of IL-6, hsCRP and Hcy were determined using ELISA method.

Results: Of the total 365 subjects, aged mean 46.1 AE 16.1 year, MetS was presented in 160 (43.8%) individuals. The levels of hsCRP, Hcy, and IL-6 were higher in subjects with MetS compared to normal group. A gradual significant increase just in the level of hsCRP with increasing number of MetS components was found after adjustment for sex and age. A strong linear augmentation in hsCRP levels was observed as the number of MetS components increase from 0 to ! 3 with median hsCRP levels of 6.27, 6.59, and 7.51 (ng/ml) (P trend = 23 9 10 À5 ). Also, an increase of 0.40 in hsCRP levels (CI 95%: 0.17-0.63; P = 69 9 10 À5 ) was observed with an increase in each components of MetS in linear regression analysis adjusted for age and sex. The best predictor for hsCRP, IL-6, and Hcy, in subjects with MetS was hip, WHtR, and height, respectively, compared with WHtR and wrist which were the best predictors for hsCRP and Hcy levels in the subjects without MetS.

Conclusion: Hip and WHtR are significant predictors of the hsCRP and IL-6 elevation associated to MetS, respectively. Methods: In a nested case-control study, conducted on a group selected from participants of the Tehran Lipid and Glucose Study, those cases with new diagnosed type 2 diabetes during the 3.6 year follow-up (191 subjects) were matched to 570 controls for age, sex, body mass index andseason of entrance to study. Multivariate conditional logistic regression analysis was used tocalculate the odds ratio (OR) with 95% confidence interval of type 2 diabetes for vitamin Dcategories, vs. the first quartile ( 11.02 ng/ml) as reference.

Results: The unadjusted ORs of type 2 diabetes were 0.73 (0.74-1.13), 0.54 (0.34-0.85) for the second and third tertiles, respectively. After adjustment for family history of diabetes, systolicblood pressure, triglycerides to high density lipoprotein cholesterol ratio, and fasting plasmaglucose, the corresponding ORs were 0.62 (0.33-1.17) and 0.43 (0.22-0.84) for second and third tertiles respectively. Multivariate cubic spline modeling analysis indicated that 10 ng/ml 25hydroxyvitamin D levels was the optimal cut point for distinguishing those who were at risk ofdeveloping diabetes and those who were not. Also addition of vitamin D to multivariate model, improved the net reclassification by cut-point based NRI of 12%.

Discussion: In a prospective cohort study, we demonstrated a nonlinear independent associationof vitamin D with incident diabetes, with prominent increase in risk at a cut-off <10 ng/ml.

Research Department-AYUSH Projects, SVYASA University, Bangalore, India Type 2 Diabetes Mellitus (T2DM), the seventh leading cause of death, is a biggest challenge for mankind. Despite of fascinating advances in pharmaco-therapeutic agents, the prevalence of T2DM is growing every year. Complementary and Alternative medicine (CAM) as classified by National centre of CAM have documented various positive results of T2DM. Whole ancient medical systems like Ayurveda, Siddha, and TCM etc use natural herbs either as a single drug therapy or in the form of formulations, depending upon principles of respective medical system. Studies done on various herbs and mind body intervention like, yoga, acupuncture etc are found to be beneficial for T2DM. This resulted, large number of physicians either referring to or practicing some of the more prominent and well known forms of CAM.

The concepts proposed and used by these CAM systems (that are kept alive by CAM practitioners for thousands of years) appear very mysterious to the present day biomedical practitioners. These models of therapies seem to have evolved through several phases of internal research just like the present day drug trials that go through four phases of intensive statistical evaluation. It appears that today's scientists need to follow the footsteps of research used by the ancient seers of TCM, Ayurveda, Siddha, Yoga or Homeopathy to unravel these mysterious theories.

This review talks about generating evidence not only for the efficacy of these holistic systems but also in carrying out systematic research by biomedical scientist who have the knowledge of both the western and eastern sciences. 

Background: The epidemic of obesity, over the last two decades, in the middle and high income countries is associated with marked rise in the incidence of metabolic syndrome.

Objective: To measure the prevalence of metabolic syndrome (MS) and determine its association with ratio of omega-6/omega-3 fatty acids in the diet.

Design and methods: Cross-sectional surveys were conducted in 20 urban streets in the city of Moradabad, India. Randomly selected subjects with MS aged 25 years and above were evaluated and graded according to omega-6/omega-3 ratio in the diet. Physical examination, sphygmomanometer, questionnaire and blood tests were done.

Results: The overall prevalence of MS was 19.3% (n = 387) without any gender difference. The prevalence of MS, type 2 diabetes, CAD and hypertension showed a higher rate, in relation to omega-6/omega-3 ratio in the diet. Subgroup analysis showed that subjects eating low omega-6/omega-3 ratio (<5.0) diets had significantly lower prevalence of MS, and related components compared to higher ratio diets, among both sexes. Multivariate logistic regression analysis after adjustment of age showed, that hypertriglyceridemia (odds ratio 0.90 in men, 0.76 in women) was strongly (P < 0.01) associated with MS. Hypertension, HDL-C, and central obesity were weakly associated with MS in both sexes. Hypercholesterolemia was weakly associated with MS only in women.

Conclusion: MS has become a public health problem in India. Higher w-6/w-3 ratio is a major risk factor of MS and CAD. It is possible that a low w-6/w-3 ratio in the diet (<5.0) may be protective against MS. Objective: Investigate the differences in clinical and laboratory features (including some adipocytokines) among hyperglycemic patients with or without CAD.

Methods: Five hundred and sixty-one consecutive hyperglycemic subjects undergoing coronary angiography. Hyperglycemia [diabetes mellitus (DM)/pre-diabetes (PD)] previously known DM or diagnosed at the moment of recruitment by an HbA1c (HPLC) levels-! 5.7-6.4%-PD, ! 6.5%-DM (ADA criteria). CAD defined by any lesion ! 50% on angiography.

Results: 55.4% were men. Age was 60.3 AE 10.5 (mean AE SD), CAD was detected in 64.3% of individuals. Patients with CAD were older (61 AE 10 vs. 58 AE 11 years, P = 0.002), more often male (61% vs. 46%, P = 0.001). Additionally, they showed a worse metabolic profile, with higher HbA1c (7.1 AE 1.8% vs. 6.8 AE 1.4%, P = 0.01), fasting plasma glucose (135 AE 60 vs. 121 AE 41 mg/dl, P = 0.002), triglyceride [135 (101-191 mg/dl) vs. 122 (85-166 mg/dl), (P = 0.004)] and plasma Visfatin/Nampt levels [(5.1 (3.6-9 .8 ng/ml) vs. 4.9 (3.1-8.7 ng/ml), (P = 0.014), median/interquartile range], and lower HDL-cholesterol levels (39 AE 12 vs. 42 AE 11 mg/dl, P < 0.001), even after correction for statin use (except for HDL and Visfatin/Nampt). Diabetic patients with CAD had greater diabetes duration than diabetic individuals without CAD: 6.0 (0.7-10) vs. 3.0 (2-10) years, median and interquartile range, (P = 0.038). Systolic and diastolic blood pressure, HOMA%-S, HOMA-IR, total and high-molecular weight adiponectin levels were similar in both groups.

Conclusions: Patients with hyperglycemia and CAD have a worse glycemic and lipid profile and higher Visfatin/Nampt levels as compared to those without CAD. One hundred and sixty-nine patients (P) with the Mets were studied to find out the incidence of cardiovascular events, especially myocardial infarction and strokes.

The mean age was 60 years. Fifty-five percent were males and 45 females. The mean body mass index was 30 kg/m 2 . The mean fasting blood sugar was 165 mg/dl. Ninety-seven percent were diabetic Type II and 3% diabetic Type I and the lipid profile was normal. The studied population showed a higher incidence of atrial fibrillation, when compared with a comparison group of diabetics (12% vs. 5.9%) P < 0.001. No ventricular tachycardia was observed. The Mets group showed a subnormal ejection fraction (49 AE 4%) when compared with a comparison group (62 AE 12%) P < 0.001. No myocardial infarctions or strokes were detected. Coronary angiography was done in 60% of the (P) all were negative except one. The lower ejection fraction was explained on basis of diabetic cardiomyopathy.

The genetics profile of the Puertorrican, a Hispanic population, is more of an European, Indian and African. Probably, this produces a culture less sensitive to the atherosclerotic factors, producing a less aggressive Mets syndromeless myocardial infarcts or strokes. This suggest that genetics and culture is an important aspect of the expression of Mets, especially in the Hispanic world. Objectives: Controversy surrounds the annual progression from prediabetes (impaired glucose regulation) to Type 2 diabetes. Current UK statistics suggest a 10% progression rate. Our aim was to assess subjects in our locality at high-risk of progression from pre-diabetes to Type 2 diabetes within a 12 month period. This will establish whether current recommendations for follow-up of high-risk subjects successfully identify those with pre-diabetes.

Methods: Analysis was performed on data from 127 high-risk subjects who underwent OGTT with baseline clinical and biochemical measurements. The OGTT and biochemical measures were repeated at 12 months.

Results: Of the 127 subjects, 24 (18.9%) developed diabetes within the 12 month period, significantly higher than the estimated annual progression rate (P 0.001). As expected, baseline fasting plasma glucose was higher for subjects that progressed to diabetes (diabetes vs. no diabetes: 6.4 AE 0.5 vs. 5.7 AE 0.2 mmol/l; P 0.001), as was 2 h post-prandial plasma glucose (diabetes vs. no diabetes: 10.4 AE 2.8 vs. 6.7 AE 1.8 mmol/l; P 0.001). Additionally, baseline HbA1c was higher for those that developed diabetes [diabetes vs. no diabetes: 6.3 (6.0-6.6) vs. 6.0 (5.7-6.3) %; P = 0.017]. Interestingly, both SBP and DBP were significantly higher at baseline in those that developed diabetes (SBP: 150 AE 22.0 vs. 140 AE 17.6 mm Hg; P = 0.019) (DBP: 87 AE 10.1 vs. 80 AE 11.3 mm Hg; P = 0.006).

Conclusions: Within this cohort, progression to Type 2 diabetes was almost twice the current estimated annual rate. Fasting, 2 h-glucose, HbA1c and blood pressure were associated with progression from prediabetes to Type 2 diabetes over 12 months. Methods: Tissue lysates from visceral fat samples of subjects undergoing abdominal surgery (predominantly bariatric and routine non-acute for non-malignant conditions) were collected from 51 subjects categorised as L (19), O (14) or ODM (18). A commercially available Comet assay (Cell Biolabs, Inc) was used to assess cellular DNA damage using a single cell gel electrophoresis method. Additionally, results indicate a greater percentage of DNA migration from the comet "head" to its "tail" within ODM samples (L vs. O vs. ODM: 69.6 vs. 67 .0 vs. 71.9%; P = 0.427). In conclusion, results suggest that visceral fat from obese subjects with Type 2 diabetes are subject to higher levels of oxidative burden resulting in a higher proportion of damaged DNA.

Community Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait Background: The prevalence of overweight and obesity are high in Kuwait. Metabolic Syndrome is associated with both. It is expected to find the syndrome to higher than in other countries.

Objective: To assess the prevalence of MS using two different diagnostic criteria, the International Diabetes Federation (IDF) and the National Cholesterol Education Program-Third Adult Treatment Panel Modified for age (NCEP-ATP III).

Study design: A multi-stage random sample study.

Methods: The analysis of data for this study was based on a sample of 303 male Kuwaiti adolescents, 10-19 years of age selected from intermediate and high schools. Anthropometric measurements and biochemical tests on blood samples were carried out. The IDF criterion requires waist circumference (WC) plus two of the following criteria: triglycerides (TG), high density lipoprotein (HDL), fasting blood sugar (FBS) and blood pressure (PB). The ATP III criterion requires three of the above parameters. The parameters mentioned must show increase in their values except for HDL which must show decrease in either criterion used.

Results: Each of the two criterion revealed that the prevalence of MS was 14.8% and 19.5%, using the IDF and the ATP III criteria, respectively. HDL decreased in each of the two diagnostic criteria and the other four parameters increased, satisfying the diagnostic requirements of either criterion.

Conclusions: Significant implications may be drawn from these results, especially when it comes to being at risk of type 2 diabetes (T2D) and cardiovascular disease (CVD).

M. Saghebjoo 1 , J. Shabanpour Omali 1 , R. Fathi 2 1 University of Birjand, Birjand, 2 Mazandaran University, Babolsar, Iran Background and aims: Resistance training has been shown to be beneficial in older adults. However, very little data exist on the effects of resistance training in older diabetics. Chemerin is a adipokine that has been shown to induce insulin resistance in skeletal muscles. Here we investigate the role of 8 weeks of progressive resistance training (PRT) on plasma chemerin levels in older men.

Methods: A total of 18 sedentary men with type 2 diabetes, aged between 45 and 60 years, were randomized to the 8 weeks supervised PRT (n = 10) and control (n = 8) groups. Chemerin, Insulin, glycosylated hemoglobin (HbA1C), and fasting blood glucose (FBG) were measured before and 72 h after the training period.

Results: Plasma chemerin levels decreased significantly (P = 0.01) in the , and exhibited significant reductions in plasma insulin (P = 0.01) and FBG (P = 0.05). FBG decreased by 28.08% in PRT group.

Conclusion: Reduced plasma chemerin concentration may contribute to improved insulin sensitivity. These results recognize that increased intensity of exercise may produce greater benefits, but may not be appropriate for some individuals. Some studies have demonstrated the presence of metabolic syndrome in children and adolescents, but few have investigated this syndrome in Brazilian children. The aim of this study was to investigate the prevalence of metabolic syndrome in children and its association with gender and nutritional status. This transversal epidemiological study involved 385 children of both genders between 7.0 and 9.9 years old. There were collected sociodemographic, anthropometric, metabolic and hemodynamic data. The nutritional status was obtained according to the body mass index. To diagnose metabolic syndrome was used the criteria proposed by the National Cholesterol Education Program′ s Adult Treatment Panel III adjusted for age. There were used two separate proposals (Cook et al., 2003; Ferranti et al., 2004) . The prevalence of metabolic syndrome ranged from 2.9% to 10.6%, depending on the criterion. The nutritional status showed 72.0%, 18.4% and 9.6% of children with normal weight, overweight and obesity, respectively. Significant association was observed between the metabolic syndrome and nutritional status, but not in relation to gender. Metabolic syndrome was present in different nutritional status of children, especially those with excess body weight, thus indicating the importance of early diagnosis and the adoption of primary prevention measures already in pediatric patients.

Introduction: IFG (FPG 5.6-6.9 mmol/l) is a risk-factor for developing type 2 diabetes and cardiovascular disease. We quantified changes in IFG prevalence (post-hoc analysis) from a double-blind, placebo-controlled trial investigating the effects of liraglutide 3.0 mg on maintenance of diet-induced weight loss (primary endpoint).

Methods: Overweight/obese adults ( ! 18 years, BMI ! 30 or ! 27 kg/m 2 with comorbidities) who lost ! 5% weight after 4-12 week run-in with low-calorie diet (1200-1400 kcal/day) and exercise were randomised to once-daily subcutaneous liraglutide (n = 212) or placebo (n = 210), plus 500 kcal/day deficit diet and exercise.

The full-analysis-set comprised 413 of 422 randomised individuals [age 46.2 AE 11.5 years, BMI 37.9 AE 6.2 kg/m 2 (mean AE SD)]. During run-in, participants lost 6.3 AE 1.6 kg weight and IFG prevalence decreased from 54% (224/413) to 40% (164/413). At week 56, liraglutide-treated participants lost an additional 5.7 kg from randomisation (Table 1) , whereas placebo-treated participants lost no additional weight [treatment-difference À5.9 kg (95%CI À7.3; À4.4); P < 0.0001]. Moreover, the proportion of participants with IFG at week 56 was lower for liraglutide (6.3%) than placebo (28.7%; odds-ratio 6.0 [3.1; 11.6]; P < 0.0001). At week 68, after 12 weeks off treatment, the liraglutide group regained~2 kg lost weight and IFG prevalence increased. Mean weight loss remained greater for liraglutide vs. placebo [treatment-difference À4.0 kg (À5.8; À2.2); P < 0.0001] but IFG prevalence did not differ (odds-ratio 1.3 [0.78; 2.3]; P = 0.30).

Conclusion: Liraglutide decreases IFG prevalence in overweight/obese individuals who have already lost weight by diet and exercise, potentially due to additional weight loss and weight-loss independent mechanisms. Objective: We wanted to explore the association between polymorphisms of IRS1 (rs1801278), TCF7L2 (rs7903146 and rs12255372), ADRB1 (rs1801253), PPARG (rs1801282), and HHEX (rs5015480) genes with insulin resistance, lipid profile and atherogenic risk in MetS patients from the Mexican Social Security Institute.

Methodology and results: Four hundred and thirty-one MetS patients and 547 controls were selected. The association between the SNPs and the atherogenic index was evaluated by multiple linear regression and multinomial logistic regression models. ADRB1 C/G were associated with an increase in LDL-c levels (β = 6.56, 95% CI = 1.35, 11.77 P = 0.014), the HHEX T/C variant were statistically associated with an increase in total cholesterol levels (β = 6.58, 95% CI = 0.85, 12.32 P = 0.024), and with an increase in LDL-c levels (β = 5.88, 95% CI = 0.88, 10.88 P = 0.021). The ADRB1 gene showed a statistically significant association with high-risk atherogenic Index, (OR = 2.58, IC 95% 1.29-5.16; P = 0.007) for the Arg/Gly variant and for the dominant model (OR = 2.66, IC 95% 1.35-5.27; P = 0.005).

Conclusions: The Arg389Gly polymorphism of the ADRB1 gene may be a good biological marker to predict the risk of developing cardiovascular diseases given a high-risk atherogenic index. Aims: Describe the knowledge of major risk factors for type 2 diabetes held by primary health care (PHC) nurses involved in the community management of diabetes.

Methods: Random sample (26%) of PHC nurses in Auckland. Information was collected from postal and telephone questionnaires, on education, experience, knowledge and diabetes management practice.

Results: Responses were received from 287 PHC nurses (86% response) comprising 210 practice nurses (PNs), 49 district or homecare nurses (DNs) and 28 specialist nurses (SNs). Most nurses (96%) were able to identify excess body weight as a major risk factor for type 2 diabetes. Only 54% of SNs and a third of PNs and DNs identified lack of physical activity, and fewer than 30% of SNs and PNs, and only 16% of DNs identified hypertension as risk factors. Even fewer respondents were able to identify individual lipidsalthough significantly more SNs identified elevated triglycerides (14%, P = 0.02) and reduced high-density-lipoprotein cholesterol (11%, P = 0.003) as major risk factors compared with only 1-5% of PNs and no DNs. Risk factors for diabetes-related complicationsapart from hyperglycaemia identified by 86%were not well identified, particularly smoking (17%), hypertension (31%), triglycerides (9%) and reduced high-density-lipoprotein cholesterol (8%).

In general, PHC nurses had a good knowledge of overweight as a risk factor for type 2 diabetes and hyperglycaemia as a risk factor for diabetes-related complications, but poor knowledge of cardiovascular risk factors, particularly smoking.

Yoga and Life Sciences, Swami Vivekanand Yoga Anosandhana Samsthana (S-VYASA University), Bangalore, India Metabolic syndrome is clustering of different metabolic abnormalities which encompass central obesity, insulin resistance and hypertension. It is characterized by an overdrive of the sympathetic nervous system, increased oxidative stress, elevated pro-inflammatory enzymes, and impaired circadian cycle. Lack of physical exercise, improper eating habits, and psychological stress are also common contributing factors to this condition. Thus, life style change which includes adequate exercise, proper diet and stress management are the keys in prevention control and treatment of metabolic syndrome.

Yoga, one of the ancient sciences on earth, is known to bring balance at all aspects of human existence. Its different components like asana (physical postures), pranayama (breathing techniques), meditation and relaxation techniques (yoga nidra) etc have been proven to influence body and the mind towards balance and equanimity. Recent scientific studies on yoga have proven its safety and efficacy in the management of many metabolic disorders which includes diabetes mellitus, obesity, hypertension and atherosclerosis. Yoga therapy has also caused reduction in the pro-inflammatory cytokines in such conditions. Yoga reduces sympathetic tone as well as oxidative stress; it helps in reducing insulin resistance by enhancing secretion of melatonin and hepatic insulin sensitizing substance through bringing the parasympathetic dominancy. Thus, we propose that yoga has an important role in prevention and treatment of metabolic syndrome as a complementary or as an alternative to conventional line of treatment.

S. Debnath 1 , S. Addya 2 1 Medical Laboratory Technology, Women's Polytechnic, 2 Medical Officer, Government of Tripura Health Services, Agartala, India Introduction: Saliva is an excellent biological matrix that offers several opportunities for scientific inference of diagnostic, toxicological and in forensic importance. Numerous salivary metabolites proffer great potential in Clinical and Epidemiological research. Sample collection is non invasive and analysis require simple modifications. Establishing good correlates is the need.

Objective: Our objective was to study the association between Anthropometric Measures (AMs) with salivary metabolites in a subsample (n = 8) of college women in suburban North East India.

Method: Saliva and Blood samples were photometrically analyzed for Glucose, Protein and Urea. AMs as BMI and Waist Circumference (WC) were measured in female students of menstruating age (17-21 years) following WHO guidelines. AMs were correlated (Pearson's Correlation, ′r′) to Salivary Biochemistry. Results are reported with intra assay coefficient of variation (CV < 10% all assays) in the text. ′ Four Day Diet Dairy′ was maintained over the period.

Results: Salivary biochemistry found to be significantly correlated to AMs in the studied subsample. Salivary protein was negatively correlated (′r′ = À0.710) with BMI and with WC (′r′ = À0.604) whereas Salivary Glucose (′r′ = 0.569 with BMI and ′r′ = 0.056 with WC) and Urea (′r′ = 0.612 with BMI and ′r′ = 0.676 with WC) had Positive correlation. All assays performed in triplicates .We observed very good repeatability of results. Medicine -Cardiology, Massachusetts General Hospital, Boston, MA, USA Introduction: Obesity is an independent risk factor for cardiovascular disease. Supine bike stress echocardiography is suggested to be of particular utility for evaluating for coronary artery disease (CAD) in obese individuals given the lack of mechanical impact with this modality.

Database for all recumbent bicycle stress echocardiography examinations performed between January 1, 2006 and July 31, 2009 . All tests performed to evaluate for CAD were reviewed. Two groups were formedpatients achieving ! 85% of maximum predicted heart rate (MPHR) and those achieving <85% MPHR. Medical records of these patients were then reviewed. Comparisons between groups were made using unpaired t-tests and correlations between patient characteristics and HR were assessed using Pearson's correlation.

Results: Four hundred and sixty tests were done to evaluate for CAD. One hundred and eighty-one (39.3%) patients failed to reach 85% MPHR during testing. Forty-three percent of patients failing to achieve 85% MPHR were obese (BMI >30) vs. 36% of all patients referred for stress testing. Image quality among obese patients was not notably worse compared to leaner patients. Those failing to achieve 85% MPHR had a significantly higher BMI (30.2 vs. 28.7; P = 0.044) than those with adequate HR response. BMI exhibited a negative correlation with percent MPHR (r = À0.14, P = 0.006).

Conclusion: Obesity is associated with failure to achieve ! 85% MPHR during supine bike stress echocardiography done to evaluate for CAD. Use of adjunctive pharmacologic agents should be considered when evaluating an obese patient for CAD with stress echocardiography. (8):704-12), though the extent to which body weight may act as a confounder or as mediator in this relationship is uncertain. The aim of this study was to analyze whether the association between CRF and MetS risk is mediated by body mass index (BMI).

Methods: Cross-sectional study including 1158 schoolchildren, 8-11 years old from the province of Cuenca, Spain. We measured height, weight and CRF (20-m shuttle run test). A validated MetS index (Diabetes Care 2010;33:1370-2) was estimated by summing standardized z scores of waist circumference, triglyceride-to-HDL-c ratio (TG/HDL-c), mean arterial pressure (MAP), and fasting insulin. To test whether the association between CRF and MetS index and its components was mediated by BMI, linear regressions models were estimated according to Baron and Kenny procedures for mediation analysis (J Pers Soc Psychol. 1986; 51:1173-82) .

Results: In girls, BMI acts as a fully mediator for the relationship between CRF with MetS index and all its components, except for TG/ HDL-c ratio. In boys, BMI acts as a fully mediator for the relationship of CRF with TG/HDL-c ratio and MAP; and partial mediator for the relationship between CRF with MetS index and the rest of components.

The obesity mediates the association between CRF and MetS in schoolchildren. Good levels of CRF are associated with lower MetS risk, but only when accompanied by weight reduction. Pre intervention measurement was applied. No statistical differences were found for Prediabetes knowledge, physical activity, eating habits, BMI, Weight, waist circumference and clinical parameters (Glucose, Triglycerides and Total Cholesterol) between both groups in basal measurement.

The control group received the usual care from health centers. In the study group, the intervention was developed during 6 months per patient (received usual care plus remote care model′s components).

The RCT will end at January 2013, and the final results will be presented. chronic conditions. This study compares the prevalence of the metabolic syndrome (MetS) between genders in the workplace.

Methods: As part of the established "Prosiect Sir Gâr" initiative in South Wales, UK, 459 female and 313 male employees from either the local steel works or local health board were screened and their data analysed. Anthropometric data, blood pressure, self-reported physical activity (GPPAQ) and smoking status were all recorded. In addition, blood samples were obtained and analysed for high-densitylipoprotein cholesterol (HDL-C). Presence of the MetS was determined based on the following IDF criteria: central obesity (females waist circumference: ! 80 cm; males waist circumference: ! 94 cm), reduced HDL-C levels (females: <1.29 mmol/l; males: <1.03 mmol/l) and either systolic ( ! 130 mmHg) or diastolic ( ! 85 mmHg) hypertension.

Results: A higher proportion of males were diagnosed with MetS than females (25.9% vs. 18.7%; P < 0.001) despite the males being more physically "active" or "moderately active" (85.3% vs. 60.8%; P < 0.001). Rates of central obesity and systolic hypertension were comparable between genders (P > 0.05), however prevalence of diastolic hypertension, reduced HDL-C levels, current smokers and individuals either overweight or obese were higher in the male cohort (P < 0.05).

Conclusion: Despite being more physically active, males were more susceptible to the MetS than females, likely due to a higher percentage of smokers and either overweight or obese. Conclusions: The addition of GLP1 analogues to Insulin therapy seemed to be superior to the enhancement of insulin therapy regarding to weight loss, decreases of HbA1c, hypoglycemic episodes and requirements of Insulin. It was also observed a significant improvement in insulin sensitivity and in beta cell function. Background and aims: Type 2 diabetes is often associated with nonalcoholic fatty liver disease (NAFLD). Patients with NAFLD may be at greater risk for CVD than those without. The relationship between NAFLD and metabolic syndrome (MS) is very well recognized. The aim: to determine the association of NAFLD and CVD between type 2 diabetic patients with and without MS.

Materials and methods: One hundred and thirty type 2 diabetic patients (M: 71, F:59, mean age 59.32 + 11.94), were studied. All subjects were assessed for diabetes duration, the obesity degree, CV risk factors, HbA1c, C reactive protein and lipid profile. NAFLD was assessed by patient history and ultrasound. MS was defined based on NCEP-ATP 3 criteria. The previous and current CVD (myocardial infarction, angina or revascularization) was assessed. We categorized four groups: MS (À) and NAFLD(+), MS(À) and NAFLD(À), MS(+) and NAFLD(+), MS(+) and NAFLD(À).

Results: The prevalence of CVD in type 2 diabetic patients with NAFLD was higher than in those without NAFLD (44.2% vs. 38.1%). The prevalence of CHD in type 2 diabetic patients with MS was higher than in those without (40.1% vs. 35.8%). The risk of CHD in patients with MS was significantly increased by the presence of NAFLD (53.4% vs. 32.3%). In type 2 diabetic patients with MS(+) and NAFLD(+) the number of components of MS, BMI, and systolic BP were positively associated with CHD.

Conclusions: What this study suggests to us is that the presence of NAFLD increases the risk of CVD in type 2 diabetic patients with MS. 2007 and to determine associations between the levels of fasting blood sugar and its comorbid conditions. This is a retrospective study and uses chart review in the outpatient section of the Family Medicine Clinic. It also uses percentages, means and its standard deviations, and chi square to detect associations. There were 302 patients with impaired fasting glucose aged between 18 and 84 years old (mean age 55.94 AE 13) and all were of Filipino ethnicity. There were more females than males. The mean body mass index was 23.87 AE 4.44 kg/ m 2 and the mean fasting blood sugar (FBS) was 111.6 AE 7.23 mg/dl. There was no association between the FBS level and obesity (P > 0.5) and hypertension (P > 0.2) in this study. However, FBS >113 mg/dl was associated with the presence of family history of diabetes in this population (P < 0.01). It seemed that IFG can occur to young, nonobese patients with family history of diabetes. This study recommends that screening for IFG among Filipinos should be done to all patients with a strong family history of diabetes regardless of age, gender, BMI status or presence of hypertension.

H. Hasan, V.L. Raigangar, A.R. Abdullah

Methods: A cross-sectional study of 80 young females (Mean age 21.0 AE 2.4 years. Leptin, insulin, high sensitivity C-reactive protein (hs-CRP), C-peptide, UA, BG, HDL-Cholesterol and triglycerides were estimated from a fasting blood sample. Anthropometric parameters (WC, height and weight) and BP were measured. HOMA-Insulin resistance was also calculated.

Results: Mean WC of the studied population was 76.6 AE 11.7 cm, 30% (n = 24) had WC >80 cm. For the 80 subjects, all studied parameters were within normal limits except leptin which was high; 30.1 AE 15.4 ng/ml. UA showed highly significant positive correlation with WC (r = 0.55, P < 0.001), significant positive correlations with Cpeptide, hs-CRP and leptin with (r = 0.26, P = 0.02), (r = 0.032, P = 0.003) and (r = 0.027, P = 0.017) respectively. UA demonstrated significant negative correlation with HDL only (r = À0.24, P = 0.034).

Multiple linear regression revealed that WC was the only significant predictor of UA levels (B = 0.04, P = 0.00, CI 95%: 0.01-0.06).

Conclusion: This study stresses the importance of UA levels in CVD particularly due to its strong association with WC, the main indicator of abdominal obesity in MetS that is often missed. UA may hence be considered a valuable biomarker for early prediction/detection of Mets in young females. Background: Adipocyte-secreted cytokines are associated with inflammation and metabolic disturbances but it is unclear how their SNPs interfere on the response to lifestyle interventions. We assessed associations of selected SNPs with the changes induced by interventions.

Methods: This 9-month intervention on diet and physical activity included 134 Brazilians at cardiometabolic risk (prediabetes or metabolic syndrome without diabetes). Changes in clinical variables were analyzed according to the presence of the TNFa-308G/A, IL-6-174G/C and AdipoQ45T/G SNPs; individuals with at least one variant allele were grouped and compared with the reference genotype. Afterwards, individuals carrying simultaneously the 3 genotypes associated with no glycemic response were grouped and compared to the remainder sample.

Results: The entire sample (56.5 AE 11.6 years) had lower energy intake, higher physical activity, and improved anthropometric and metabolic variables after intervention. Carriers of the TNFa variant allele but not the reference group decreased plasma glucose. IL-6 and AdipoQ variant allele carriers had worse glucose, lipid and inflammatory responses. Grouping the subset of 49 carriers of TNFa-308G + IL6-174C + AdipoQ45G, they showed a significant increase in mean fasting glucose after intervention. This increment differ significantly from the behavior of the remainder sample (+2.8% vs. À3.8%, P = 0.025).

The TNFa-308G/A but not the AdipoQ45T/G and IL-6-174G/C may predispose a better response of glucose metabolism to a lifestyle intervention. The combination of three worst genotypes can maximize the adverse effect on glucose metabolism in at-risk Brazilians. Further studies are needed to direct lifestyle interventions to specific subgroups of individuals.

Obesity is a metabolic disorder, which is associated with an increased risk of various conditions, including sexual dysfunction.

Objective: To investigate anthropometric indicators of body fat in postmenopausal women influencing their quality of life.

Material and methods: The study was performed at the Scientific and Clinical Study of Endocrinology, Uzbekistan Public Health Ministry. A total of 230 women (mean age of 44 years) was examined. BMI, waist circumference and waist to hip ratio were obtained for anthropometric evaluation. Lipid specters, glycemia and insulin were the parameters to evaluate. We have used a menopause quality of life questionnaire and female sexual function Index questionnaire (FSFI). The quality of life of the obese and overweight patients was compared by age, education, marriage and matched with healthy normal weight controls.

Results: Overweight and obesity were observed in 120 of women. Values of WC >81 cm were above normal levels in 55%, 47.8%, respectively, and HDL was normal in 85.2%. HOMA -IR was measured in 31.3% of the women. Women with overweight and obesity had worse general health-related quality of menopausal symptoms, life and psychological and sexuality scores than athletic and lean women (BMI ! 25). In FSFI it was significant differences in such as scales as desire and orgasmic disorders in women with metabolic syndrome (MS) in comparison with the controls (P < 0.05). Aim: To determinate groups of high cardiovascular risk and start early hypolipidemic therapy due to genetic polymorphism of lipoproteidlipaseone of the main enzymes of lipid metabolism in metabolic syndrome and NAFLD patients, treating with combined therapy of statins and ursodeoxycholic acid (UDCA). Background: Health staff receive more health messages and information in working hours than others. Moreover, they are supposed to be healthy models for the community. We conducted a screening of metabolic syndrome on Shahid Beheshti University Health Department staff (who are responsible for health affairs of more than 10 million people in Tehran province, Iran) to assess their health level.

We invited all of the health staff for screening on "the world heart day". Weight, height, waist circumference, systolic and diastolic blood pressure were measured and a fasting blood sample was taken for lipid and glucose level testing.

Results: Fifty percent of the staff (85 person) participated in the screening. The mean age was 41.3 AE 7.3 years. Only 36% were in normal weight range. Overweight, obesity class 1 and class 2 rates were 36%, 25.8% and 2.2%, respectively. 37.1% of all and 6.3% of normal BMI cases had a high waist circumference. Metabolic syndrome was identified in 8.3% of men and 10.2% of women. High blood pressure was detected in 4.5% of the cases. In 3.4% of all and 3.5% of overweight or obese cases fasting blood glucose was elevated. These rates for blood total cholesterol level were 50.6% and 60.4%, for triglyceride were 34.1% and 37.7%, and for LDL were 75.3% and 84.9%, respectively.

Conclusions: Contrary to our expectations, a high rate of metabolic syndrome was identified in this group. It seems that interventional programs targeting nutritional habits and physical activity of the staff are needed along with routine educational programs. Introduction: Physiologically, brain natriuretic peptides (BNP) and lipolysis are closely linked. Obesity is been identified as a major risk factor for the development of cardiovascular diseases (CVD) and has been reported to have an impact on BNP in apparently healthy subjects but also in CVD patients. Thus, we speculate that BNP could play an important role in lipid metabolism and may affect the pathophysiology of obesity in CVD patients.

Methods: Serum samples were obtained from CVD elderly patients distributed in two groups: I-non-obese and II-obese. The plasma mature form of brain natriuretic peptide (NT-proBNP) was measured by a sandwich enzyme immunoassay with spectrophotometric detection at 450 nm. Conclusion: Overall, these data demonstrates that obesity is an important and independent determinant of BNP expression in patients with CVD. Inverse relationship between BNP and body mass index may suggest "beneficial" effects of obesity, but clearly lower levels did not confer a more favourable prognosis. The precise mechanisms linking obesity to CVD remain unsolved and may be due either to release attenuation or increases in clearance receptors. These effects should be taken into account for appropriate BNP reference values, so lower cut-points should be used for obese patients and a higher cutpoint for lean patients to increase specificity.

V. Mladenovic 1 , A. Djukic 1 , S. Djukic 1 , N. Arsenijevic 2 , S. Zivancevic Simonovic 2 Aim: The aim of this study was to investigate dynamic of changes of oxidative stress during acute myocardial infarction depending on development phases of Metabolic syndrome X.

Method: The research included 29 patients; inclusion criteria were diagnosed Metabolic syndrome and acute myocardial infarction. According to the movements of glycemia and insulinemia all patients were divided in four development phases of Metabolic syndrome X. To evaluate oxidative status we determinated: lipid peroxids (malonyldialdehide), total antioxidative status, as well as oxidative stress coefficient.

Results: During hospitalisation in patients with acute myocardial infarction concentration of lipid peroxids increased, with maximum in the day 7th of hospitalisation, mostly in hyperinsulinemic phases of Metabolic syndrome. At the 1st day of myocardial infarction total antioxidant status increased, and decreased during next 7 days. These changes are independent on the phase of Metabolic sindrome X. As result of inverse dynamic changes of these parametars, during period of exam came to progressive increase of oxidative stress coefficient, particularly in patients in hyperinsulinemic phase of Metabolic syndrome X.

Conclusion: During first 7 days after acute myocardial infarction lipid peroxids concentration progressively increased, with decrease of total antioxidant status, that results in increase of oxidative stress. These changes are most distinctive in patients with hyperinsulinemic phases of Metabolic syndrome X.

Introduction: GLP-1 (Exenatide -Lilly) is a good therapy for overweight or obese type 2 diabetic patients, but bid administration might not be effective over 24 h.

Aim: We intended to evaluate 24 h effectivness of this drug in our outpatients using continuous glucose monitoring (GCM-Medtronic).

Methods: We asked our outpatients to undergo a continuing glucose monitoring for 4 days. Twelve of them accepted [3F and 9 mol/l, median age 62 (range 39-74), median disease lenght 10 years (range 2-20)] and signed an informed consense; they had stable metabolic control with HbA1c <50 mmol/mol and had been on therapy with exenatide for 8 months at least.

Results: Glycemic profile demonstrates that no patient had experimented prolonged hypoglycemia and all subjects, expept for one, had mainteined a long period of euglycemia in range 70-160 mg/ dl during the blood glucose monitoring.

Conclusions: It′s our opinion that these data demonstrate exenatide can be surely used in type 2 patients to obtain a good and stable metabolic control during all 24 h inspite of the BID somministration and, moreover, the age or the disease lenght are not to be considered a contraindication to its use. Several parameters of vascular function and structure have a predictive value for cardiovascular morbidity-mortality and for the presence of associated target organ damage in diabetic and hypertensive patients. Superoxide dismutase (SOD) is an intracellular antioxidant defense mechanism, which catalyses the dismutation of superoxide radical into H 2 O 2 and oxygen, and it is easily detectable in human plasma; oxidative stress is associated with cardiac and vascular defects leading to hypertension and atherosclerosis and with diabetic cardiomyopathy. On the other hand, osteoprotegerin (OPG) is an indicator of diabetes-associated vascular pathologies as hypertension, endothelial dysfunction and cardiovascular risk.

We have assessed the relationship between serum levels of SOD, OPG and parameters of vascular function and structure as well as cardiovascular risk in type 2 diabetic patients with and without hypertension.

There are negative correlations between SOD and endothelial dysfunction (evaluated by pressure wave velocity, peripheral and central augmentation index and ambulatory arterial stiffness index), pulse pressure, diastolic and systolic night/day ratio, serum OPG and plasma HDL-cholesterol, as well as positive correlations between SOD and plasma uric acid, liver enzymes GOT, GPT and GGT, triglycerides and haemoglobin. On the other hand, serum OPG is correlated to endothelial dysfunction, intima media thickness, pulse pressure, systolic night/day ratio and D′Agostino cardiovascular risk index.

Our study shows that both SOD and osteoprotegerin plasma levels are indicators of cardiovascular events and target organ damage associated with diabetes and hypertension. Objective: We investigated the future coronary artery disease (CAD) event rate in diabetic patients with and without chest pain in a prospective cohort study performed in a Korean population. We also investigated the impact of chest pain on CAD risk according to the presence or absence of diabetes mellitus.

Research design and methods: The Ansung-Ansan cohort was established for a prospective large-scale community-based epidemiologic study to investigate chronic diseases in Korea. The data from a baseline survey performed from 2000 to 2001 and two subsequent prospective biennial surveys were analyzed.

Results: Among 9810 subjects (4632 men and 5178 women) without a history of CAD, 0.8% and 2.2% of non-diabetic and diabetic subjects, respectively, reported newly developed CAD events during 4 years of follow-up. Diabetic patients had a significantly higher risk of future CAD events (age-and sex-adjusted odds ratio, 1.998; 95% confidence interval, 1.277-3.125; P = 0.002). Although the presence of chest pain at baseline was also significantly associated with an increased risk of CAD of more than 2-fold in both non-diabetic and diabetic subjects (P < 0.01), the hazard ratio for CVD event in asymptomatic diabetic patients compared to non-diabetic subjects with chest pain was not significantly different from 1.0 (hazard ratio, 0.875; 95% confidence interval, 0.470-1.632).

Conclusions: Diabetes and the presence of chest pain are independently and significantly associated with future CAD event risk. Asymptomatic subjects with diabetes have a comparable risk of CAD events to non-diabetic subjects presenting chest pain. Aim: The aim of the study was to select and analyze patients with diabetes mellitus and acute STEMI or NSTEMI myocardial infarction from all patients hospitalized in Cardiology Department in 2010.

Results: More patients with NSTEMI underwent PCI in the history than patients with STEMI (n = 32, 37.7% vs. n = 8, 17.8%); P = 0.0195 and more PCI and CABG (n = 10; 11.8% vs. n = 0; 0%); P = 0.0166. Concentrations of CPK (NSTEMI vs. STEMI) (U/l) (436 AE 854 vs. 1286 AE 1616) P < 0.001, CKMB (U/l) (55 AE 84 vs. 135 AE 149), P < 0.001, glucose on admission (mg/dl) (182 AE 125 vs. 217 AE 82), P < 0.0011. Patients with NSTEMI had less critical changes in the left anterior descending artery (LAD) (43.5% vs. 62.2%); P = 0.0426, less bare metal stents (BMS) implanted to the LAD (8.2% vs. 26.7%one stent), and (0% vs. 4.4%two or more stents), P = 0.002. Management of this patients shows Figure 1 .

Patients with STEMI require more intensive treatment of more advanced concomitant metabolic disturbances. Revascularization should by performed urgently because of higher death rate. During qualification for invasive diagnostic and treatment (PCI and/or CABG), not only the risk of death and cardiovascular events should be taken into account, but also a history of revascularization modalities (PCI and CABG). Methods: A total of 150 diabetic patients both sexes aged 41.58 AE 11.33 years were studied. The levels of total cholesterol (TC), triglycerides (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), VLDL-cholesterol (VLDL-C), HbA 1c and renal function tests were assessed. Patients were classified as normoalbuminuric (albumin excretion rate <30 mg/24 h, n = 38), microalbuminuric (albumin excretion rate 30-300 mg/24 h, n = 79) and proteinuric (albumin excretion rate >300 mg/24 h, n = 33).

Results: The duration of diabetes was 15.70 AE 8.81 years. The level of TC was significantly highest in proteinuric (6.90 AE 0.36 mmol/l), followed by microalbuminuric (5.38 AE 1.29 mmol/l) and followed by normoalbuminuric (3.22 AE 0.66 mmol/l), (P = 0.002, P = 0.0006, respectively).

Patients with proteinuria had significantly higher level of LDL-C compared to the patients with normoalbuminuria (4.14 AE 0.95 vs. 1.71 AE 0.47 mmol/l, P = 0.001). Patients with microalbuminuria had significantly higher level of LDL-C compared to the patients with normoalbuminuria (3.48 AE 1.19 vs. 1.71 AE 0.47 mmol/l, P = 0.015), as well.

The level of HbA1c in normoalbumiuric patients was significantly lower than in microalbuminuric (7.83 AE 1.12 vs. 10.40 AE 1.59%. P = 0.004).

There were no significant differences in levels of TG, HDL-C, VLDL-C between patients with normoalbuminuria, microalbuminuria and proteinuria.

Conclusion: We showed that higher levels of LDL-cholesterol and TG were associated with microalbuminuria and proteinuria in patients with type 1 diabetes. Lowering atherogenic lipids may retard nephropathy progression in these patients.

S. Bonakdaran 1 , B. Kharaqani 2 1 Endocrine Research Center, 2 Mashhad University of Medical Sciences, Mashhad, Iran Background: The relationship between elevated serum uric acid level and metabolic syndrome (MS) has been debated. We aimed to determine the prevalence of hyperuricamia and its association with MS in type 2 diabetes mellitus (DM).

Methods: This was a cross-sectional study in 1978 diabetic patients. Hyperuricamia was defined as uric acid ! 7 and ! 5.5 mg/dl for men and women respectively. Diagnosis of metabolic syndrome was based on ATPIII criteria. Clinical and biochemical parameters in hyperuricaemic and normouricaemic patients compared with other.

Results: The prevalence of hyperuricaemia and metabolic syndrome was 12.7% and 65.5% respectively. The prevalence of MS significantly increased in the highest quartile of uric acid levels compared with lowest quartile (55.9% vs. 74.4%, P < 0.001). Serum uric acid had positive association with cholesterol, triglyceride, non-HDL cholesterol and a negative association with fasting blood sugar (FBS), glycosylated hemoglobin (HbA1C) and HDL cholesterol. Possible biochemical predictors of hyperuricamia were cholesterol, triglyceride, creatnine and FBS.

Conclusion: The prevalence of MS and its components increase with increasing levels of uric acid in type 2 diabetes. Regular assessment of uric acid could give information for predicting of MS and prevention of atherosclerosis in type 2 diabetes. Materials and methods: In 75 subjects (aged 53.0 AE 8.3) who have received recommendations on hypotensive and hypoglycemic therapy at diabetes school. Psycho-correctional work has been carried out with 37 people (Group 1) in order to increase treatment motivation and the work has not been carried out with 38 people (Group 2). The effect has been evaluated after 3 months according to the results of 24-h blood pressure monitoring (24-h BPM).

Results: According to Moriski-Green Test 65% appear to be nonadherent to treatment. As a result only in group 1 there has been recorded reduction in variability indices sBP (mm Hg) at night (10.4 AE 1.8 vs. 12.0 AE 2.1; P = 0.031), daily index sBP (7.0 AE 1.3 vs. 12.0 AE 2.1%; P < 0.001) and dBP (8.7 AE 7.2 vs. 16.5 AE 6.6%; P = 0.003), rate in morning increase sBP (7.9 AE 2.1 vs. 15.4 AE 3.4 mm Hg; P = 0.004) and dBP (5.9 AE 2.0 vs. 19.9 AE 4.6 mm Hg; P < 0.001), which are high risk indicators of cardiocerebral catastrophe. After 3 months 19 of 37 patients have become adherent to treatment in Group 1 (P = 0.002), only 2 patients of 38 in group 2 (P = 0.821) (Moriski-Green Test).

Conclusion: Psycho-correctional training improves adherence to treatment, which is accompanied by positive dynamics of 24-h BPM indicators. 

Introduction: Quality of life is particular decreased in elderly with diabetes mellitus (DM), even not associated with other chronic illness. The purpose of the study was to analyze the quality of life in a group of elderly diabetic patients without major complications.

The study group consisted of 58 patients, males and females, aged over 65 years old [65] [66] [67] [68] [69] [70] [71] [72] [73] [74] [75] [76] [77] [78] [79] [80] [81] , diagnosed with type 2 DM. They had no severe DM complication, nor other debilitating chronic diseases. The Romanian version of the SF-36 questionnaire was used to measure quality of life (QOL). Diabetic subjects were compared with age-and gender-matched controls from a random standard population sample of the Romanian population.

Results: Reliability of scales by coefficient alpha Cronbach was >0.7 for all scales except social functioning. QOL scores for study group were significantly lower compared with controls. There are no significant differences between patients following insulin therapy and patients with other therapeutic protocols. Role limitations due to emotional problems correlate with disease duration and female gender. There is a significant correlation between energy/fatigue scores and female gender, HbA1c, fasting plasma glucose and obesity. There are no other statistically significant correlations between SF-36 scores and analyzed variables.

Discussions and conclusions: Patients with DM have statistically significant impairment of all aspects of QOL. DM put a substantial burden on affected individuals. Insulin use didn't seem to have a negative impact upon QOL. Glycemic control is crucial in preventing long terms complications and provides better QOL for diabetic patients. 

The study involved 85 patients with NSTEMI and 91 with UA hospitalized in Cardiology Department in 2010. The data obtained from patients were statistically analyzed to determine the significance of the differences between the groups.

Results: Glucose on admission was lower in patients with UA (148 AE 65 mg/dl) than with NSTEMI (182 AE 125 mg/dl), P = 0.0092. Treatment of DM in patients with NSTEMI and UA shows Figure 1 .

Patients with NSTEMI presented lower left ventricular ejection fraction (45 AE 12%) vs. UA (54 AE 10%); P < 0.001 and higher mortality during hospitalization. Seven patients (7.1%) with NSTEMI died, whereas no patient died in UA group (P = 0.0099).

2. To determine whether AAA patients found to be at higher risk of OSA were also at increased risk for cardiometabolic disease, compared to those at low or no risk of OSA.

Design: The Berlin Questionnaire to estimate OSA was administered to 318 elderly patients with or at increased risk of AAA disease along with several measures of cardiometabolic risk, including the Lipid Accumulation Product (LAP), a measure that combines triglyceride levels with central obesity (waist circumference), also known as hypertriglyceridemic waist.

Results: In this sample (N = 318), 184 subjects (57.3%) scored clinically positive for risk of OSA on the Berlin Questionnaire. Next, individuals were separated into groups based upon the three subclasses of the Berlin Questionnaire: SNORE (frequent loud snoring), EDS (excessive daytime sleepiness), and HTN-BMI (hypertension and high BMI). The combination of SNORE + EDS subclasses, when used to differentiate subject's risk levels for OSA, was highly accurate for discriminating low, moderate, and high cardiometabolic risk, based upon significant differences in BMI, Insulin (lU/l), waist circumference (cm), waist/hip ratio, Low Density Lipoprotein Cholesterol (LDL-C mg/dl), and LAP (ANOVA; P < 0.05).

Conclusions: These results give credence to the clinical use of the Snore + EDS portions of the Berlin Questionnaire to provide simple estimates of increased risk of T2DM and CVD and/or need for further evaluation such as polysomnography or oral glucose tolerance. Materials and methods: From 2007 to 2009, 2642 T2DM were cumulatively collected for study. Accordingly, anthropometric and biochemical data, lifestyle measurements (lifestyle I : no smoking, no alcoholic and regular exercise; lifestyle II : smoking and/or alcoholic and/or no exercise), total daily caloric intakes and macronutrient consumptions were recorded. The eating habits were classified by fat consumption, high fat diet (fat >35%) and low fat diet (fat 30%). The MetS defined was based on the ATP III criteria. Patients were obligatorily classified into six groups, MetS with waist component, waist required and non-waist required; MetS without waist component, with two and more than two components; Non-MetS with waist and without waist component. Each component of MetS in these six groups with different combination of lifestyle and eating habit, were presented by case number and percentage distribution. OR for the clustering of each metabolic component in these six groups were analyzed.

Results: The case number, percentage distribution and corresponding OR for the clustering of each metabolic component in these six groups were shown in Table 1 and 2. The clustering of metabolic components of TG, HDL-C and BP were significantly higher in lifestyle II, lifestyle I and high fat diet eaters respectively. Objectives: Early detection of metabolic syndrome is important in minimizing morbidity and motility. We conducted a study to detect wether serum leptin can be used as a biological marker to detect metabolic syndrome.

Methods: A group of 128 healthy pre-menopausal females, aged 25-50 years was selected from the local community, randomly, stratified according to their BMI. Leptin was assessed by the ELISA method and, blood pressure was measured using digital blood pressure monitor and chemical analysis for fasting blood, glucose and lipid level were conducted using colorimetric method. Body weight and height, hip and waist circumferences were measured, using standard protocols. In subjects with and without metabolic syndrome mean serum leptin values were 10.15 (AE3.45) and 8.46 (AE3.66) ng/ml respectively. Compared with subjects without metabolic syndrome, subjects with metabolic syndrome had a higher serum leptin level (Mean difference À1.68, and 95% confidence interval À3.14 to À0.22, P = 0.024).

Conclusion: Subjects with metabolic syndrome had a higher serum leptin level in comparison with subjects without metabolic syndrome therefore leptin can be utilized as a surrogate marker to predict metabolic syndrome.

conducted a study to detect relationship between serum leptin and cardiovascular risk factors in obese and non obese individuals.

Methods: A group of 128 healthy pre-menopausal females, aged 25-50 years was selected from the local community, randomly, stratified according to their BMI. Body weight and height were measured, using standard protocols. Serum leptin was assessed by ELISA and, blood pressure was measured using digital blood pressure monitor and chemical analysis for fasting blood, glucose and lipid level were conducted using colorimetric method.

Results: There was a statistically significant inverse correlation between serum leptin level and mean blood pressure in obese (BMI ! 30) individuals and subjects with systolic blood pressure >140 mmHg. Corresponding r values were r = À0.32 and r = À0.45 (P < 0.05 for both). In subjects with BMI <30 or in normotensive subjects, there were no statistically significant correlations between serum leptin and mean blood pressure. Correlations between serum leptin and total cholesterol, triglycerides, HDL, LDL, CHO/HDL and fasting plasma glucose were 0.15, 0.13, 0.16, 0.07, 0.05, 0.13 respectively and not statically significant (P 0.001 for all).

Conclusion: Due to the presence of inverse correlation between serum leptin and mean blood pressure in obese, and individuals with high systolic blood pressure, it can be concluded that serum leptin may play a different role in pathogenesis of cardiovascular diseases in such individuals.

R. Irzma nski, J. Błaszczyk, L. Pawlicki, J. Kowalski

The aim: The aim of our study was to assess the influence of Metabolic Syndrome (MS) risk factors on vascular complications in patients with MS.

Material and methods: The study comprised 108 patients (72 women and 36 men, avg. age 57.0 AE 8.5 years) with MS, which was diagnosed according to IDF criteria 2005.

Results: The prevalence of micro and macrovascular complications was assessed: vascular changes in the fundus of the eye -72%, ischaemic heart disease -54.9%, eGFR <90 ml/min -38.9%, diabetic foot -5.55%, cerebro-vascular accident -3.7% of patients. The negative correlation between HDL concentration, creatinine levels and level of vascular changes in the fundus of the eye was found. Moreover the level of obesity and fasting glucose level had positive correlation with the intensitz of vascular changes in the fundus of the eye. Objectives: To estimate malnutrition prevalence among newly hospitalized overweight/obese patients; to characterize malnutrition by body weight category; and to assess associations between BMI, duration of hospitalization and in-hospital death in malnourished patients.

Methods: This cross-sectional survey assessed nutrition status in all adults newly admitted to internal medicine and surgical departments at the E. Wolfson Medical Center, Holon, Israel. Data were recorded during the 5-week data acquisition period and screening for malnutrition risk was performed using the NRS 2002. An age-adjusted score of ! 3 on the NRS 2002 defined malnutrition. Malnutrition was compared across body weight categories: underweight (BMI <18.5 kg/m 2 ), normal (BMI 18.5-24.99 kg/m 2 ), overweight (BMI 25-29.99 kg/m 2 ) and obese (BMI ! 30 kg/m 2 ). Overweight/obese subjects were compared by malnutrition status.

Results: A total of 431 individuals were analyzed, of whom 243 were overweight/obese (BMI ! 25 kg/m 2 ). Of these, 58 (23.9%) were malnourished. Compared to adequately nourished overweight/obese subjects, malnourished overweight/obese patients had significantly prolonged duration of hospitalization: 11.7 AE 18.9 (median 5, 1-123 days) vs. 5.3 AE 6.7 (median 4, 0-65 days), (P = 0.001). In-hospital mortality was 6.9% among malnourished vs. 0.5% among adequately nourished overweight/obese patients, P = 0.003.

Malnutrition increased duration of hospitalization and in-hospital mortality risk in both overweight/obese and normal weight patients.

Discussion: Malnutrition is a frequent finding in newly hospitalized overweight/obese adults. Elevated BMI does not affect duration of hospitalization. In-hospital mortality rates are similar for normal weight and overweight/obese individuals. Background: The purpose of this study was to examine differences in RMR in lean and obese subjects and to determine correlation between RMR and cardio metabolic risk factors.

Methods: Ninety nine healthy subjects (47 normal; 52 obese and over weights) participated in this case-control study. Sex and physical activity were matched. Blood pressure, plasma insulin, glucose, HOMA-index, lipid profile, uric acid and C-reactive protein concentrations, anthropometric measurements, Body composition, RMR and macronutrient intake were measured.

Result: FPG (P = 0.016), uric acid (P = 0.043), CRP (P = 0.002), insulin (P < 0.001), HOMA index (P < 0.001), systolic and diastolic blood pressure (P = 0.008; P = 0.003), anthropometric measurements (except height and WHR) (P < 0.001) and body composition (P < 0.001) were significantly higher in case group. There were no significant differences between both groups by the means of dietary intake. In obese and overweight group, RMR was statistically higher than control group (P = 0.001). There were no significant difference between both groups in adjusted RMR for FFM and FM (P = 0.484).

With multiple linear regression, RMR was significantly associated with FFM (P < 0.001) and uric acid (P < 0.001) and negative significant correlation was observed between RMR and waist circumference (P = 0.028) and HDL (P = 0.046).

The finding of a similarly specific metabolic rate in obese and lean subjects at first sight contradicts the idea that a low RMR is a main cause of obesity. One reason for the undetected association between low RMR and obesity may be that obesity-related metabolic risk factors mask the lower metabolic rate that initially contributed to weight gain. Background: Pain may cause some patients to avoid self-monitoring, which could impair glucose control. Cooling the fingertip prior to puncture may reduce pain.

Objectives: To examine the efficacy of CoolSense, a device designed to cool the fingertip prior to puncture for glucose self monitoring.

Methods: Adults with type 2 diabetes treated at the E. Wolfson Medical Center Diabetes Unit outpatient clinic were randomized to treatment with the CoolSense device or a sham device which appeared identical to the active intervention but did not cool the fingertip. Patients completed a demographic and medical history interview and were asked to rate the device for discomfort and satisfaction.

Results: A total of 180 patients were recruited and randomized to intervention group (CoolSense vs. sham, n = 90 in each group). Participants were 55 AE 5.9 years of age, had been diagnosed with diabetes 6 AE 6.4 years prior to study onset and had mean HbA1c of 7.3 AE 0.4%. Patients reported performing 1.3 AE 1 blood glucose checks per day. The extent to which glucose checking caused pain was rated at 1.96 AE 0.8 out of a possible five points, one being most severe. The CoolSense device was a significant independent predictor of pain reduction, even after controlling for age, sex, HbA1c, aspirin, neuropathy and baseline rating of pain associated with glucose check.

Conclusions: Cooling the fingertip with the CoolSense device significantly reduced pain at the puncture site compared to a sham device. It is possible that this reduction in pain will increase glucose self monitoring events in patients with diabetes.

F. Saad 1,2 , A. Yassin 3,4 , G. Doros 5 1 Results: After 5 years the following changes were observed: weight (kg) decreased by 7.77 kg from 100. Introduction: Testosterone treatment in hypogonadal men is standard therapy, particularly in younger men with congenital forms of hypogonadism.

Methods: Three hundred thirty-three patients (147 with primary hypogonadism including 38 patients with Klinefelter's syndrome, 100 with secondary hypogonadism and 87 with late-onset ("mixed" or "metabolic") hypogonadism aged 15-72 years (mean 42 AE 15 years) received intramuscular injections of 1000 mg of testosterone undecanoate during a maximal treatment time of 15 years, overall corresponding to 1403 treatment years. Hypogonadism was defined as total testosterone below 12 nmol/l and occurrence of symptoms. Physiological functions of bile salts include modulation of cholesterol and triglyceride metabolism, insulin sensitivity, the intestinal endocrine response to meals and energy homeostasis. Several of these functions are mediated via the membrane G-protein coupled receptor TGR5 (also called GPBAR1 and GPR131) which has been shown to promote release of glucagon like peptide-1 from enteroendocrine cells and increase energy expenditure in brown adipose tissue.

Methods: Based on comprehensive discovery platform developed at SatRx several in vivo active TGR5 inhibitors were discovered. Active scaffolds were identified during the high throughput screening campaign of 50,000 TGR5 biased small heterocyclic molecules library that was optimized for medchem parameters and cell permeability. Confirmed selective hits were evaluated for functional activity of GLP1 secretion in NCI-H716 endocrine cell line. In vivo activity was confirmed in db/db mice diabetes model. Active compounds were administered chronically at doses 30, 3 and 0.3 mg/kg and produced stable and statistically significant anti-diabetic effect.

Results: The most active compound showed efficacy comparable to 10 mg/kg doses of sitagliptin. The actual activity data and experimental details will be provided. The interaction between excess of body fat (total and abdominal) and increased cardiovascular risk is well established in all age groups [3, 9] . However, there are few studies that analyze the pattern of body fat distribution and its association with cardiovascular risk factors (CRFs) in a population with more advanced age.

Objective: To analyze the presence of CRFs according to the pattern of body fat distribution, in Brazilian aged 80 years or older.

Methods: One hundred and thriteen subjects, randomly selected, 83.4 AE 2.9 years, of both sexes. The percentage of total and abdominal body fat, hypertension and lipid profile were used for characterization of CRFs. The chi-square test was used to assess proportions of CRFs and Mann-Whitney test was used to compare the results between distributions of adiposity.

Results: Eutrophic subjects showed lower triglycerides (P = 0.017), total cholesterol (P = 0.001) and prevalence of hypertension (P = 0.003) and hypertriglyceridemia (P = 0.007). Subjects with higher abdominal adiposity showed higher total cholesterol (P = 0.026) and prevalence of hypertriglyceridemia (P = 0.011) and hypercholesterolemia (P = 0.026) than no excess of abdominal adiposity. Higher value of one outcome already reflects the higher prevalence of hypertension (P = 0.039) and, the higher values of both outcomes reflect the high values of total cholesterol (P = 0.028) and triglycerides (P = 0.001).

Conclusion: That obesity, whether abdominal or total, is associated, in the same way, with dyslipidemia and hypertension in the subjects aged 80 years. 

Background/aim: There is growing consensus in the literature that inflammation plays a central role in the pathophysiology of obesity and type 2 diabetes mellitus (T2DM) and cardiovascular complications. Neutrophil-to-lymphocyte ratio (NLR) provides a simple method for assessment of inflammatory status and it is a new, inexpensive marker. The aim of the present study was to investigate the predictive value of preprocedural (before the OGTT) NLR on development of prediabetes (PD) and type 2 diabetes (T2DM) in morbid obesity patients (MOP).

Methods: 220 MOP and 85 normal weight patients with normal OGTT [Fasting plasma glucose (FPG) <100 mg/dl. Two-hour glucose during OGTT < 140 mg/dl] were evaluated in this study.

Results: The mean AE SD NLR of MOP were significantly higher than that of patients with normal weight healthy patients (4.23 AE 1.65 vs. 2.36 AE 0.95, P < 0.001, respectively). In receiver operating characteristics curve analysis, NLR >3.61 had 80% sensitivity and 75% specificity in predicting PD and NLR >3.84 had 61% sensitivity and 68.1% sepesifity in predicting T2DM. Logistic regression analysis showed that elevated NLR (OR: 3.883, 95% CI: 2.524-7.258, P < 0.001) was an independent variable for predicting T2DM in MOP.

Conclusion: MOP have higher NLR than healthy controls. High NLR is a powerful and independent predictor of PD and T2DM in MOP. Elevated NLR levels are usually considered as an inflammatory marker. The results of this study suggested that inflammation plays a role in the pathogenesis of PD and T2DM with MOP. Division of Human Nutrition, Wageningen University, Wageningen, 2 General Surgery, Rijnstate Hospital, Arnhem, 3 Gastroenterology, Rijnstate Hospital, Arnhem, The Netherlands

Objective: Endoscopic implantation of a Duodenal-Jejunal Bypass Liner (DJBL), or EndoBarrier, is a novel bariatric technique to induce weight loss and remission of type 2 diabetes (T2D). Placement of the DJBL mimics the duodenal-jejunal bypass component of the Roux-en-Y gastric bypass (RYGB) procedure. As gut hormones are known to change substantially after RYGB surgery, in our study we now evaluated gut hormone responses after implantation of the DJBL.

Methods: Fourteen (eight male, six female) obese T2D subjects (BMI 33.7 AE 0.9 kg/m 2 , duration of type 2 diabetes 8.0 AE 1.4 years) were selected for implantation of a DJBL. Fasting plasma levels of glucose, C peptide, HbA1c and gut hormones ghrelin, GIP and GLP-1 were analysed before and at 7 and 28 days after DJBL implantation.

Results: Plasma HbA1c levels were significantly decreased after DJBL implantation and a 40% reduction was found in diabetes medication usage (P < 0.05). Ghrelin was found significantly elevated, with the highest induction in the first 7 days post-implant. Although the GIP response showed high variation between subjects, GIP tended to decrease 28 days after implantation (P = 0.09). GLP-1 levels showed a significant "dip" at day 7 post-implant, which correlates with the intake of solely pureed/liquid food in the first week post-implant.

Conclusions: Implantation of a DJBL results in an early substantial remission of T2D, comparable to results seen after RYGB surgery. Interestingly, in contrast to RYGB surgery, implantation of the DJBL seems to preserve normal physiological responses of gut hormones that are related to nutritional status. Conflicting data exists as to the association between body mass index (BMI) and the rate of chronic kidney disease (CKD). In a cross sectional analysis of database from a screening center in Israel we assessed the rate of CKD defined as estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m 2 in relation to increasing BMI subcategories. The study population included 21,880 subjects, 32% women aged 20-80, out of whom 167 men and 45 women had CKD. Subjects with a BMI of 25-29.9 (kg/m 2 ) compared to subjects with BMI <25 (kg/m 2 ), had an odds ratio (OR) [95% confidence intervals (CI)] for CKD of 1.8 (1.2-2.7) and 3.4 (1.5-7.7) for men and women respectively. For subjects with a BMI of 30-35 (kg/m 2 ) the OR were 2.5 (1.6-4.0) and 4.5 (1.7-11.7) for men and women respectively. For subjects with BMI >35 (kg/m 2 ) the OR rose to 2.7 (1.3-5.5) and 15.4 (6.4-36.7) for men and women respectively. This association became insignificant in men after multivariate adjustment for age, hypertension and diabetes mellitus but persisted in women even after multivariate adjustment. The correlation between BMI and CKD in women was attributed to the subcategory of severely obese women with BMI above 35 (kg/m 2 ).

Our study suggests that for both men and women a positive correlation exists between the degree of BMI and the rate of CKD. This correlation persisted in severely obese women even after multivariate adjustment, suggesting that in women, obesity may be an independent risk factor for developing CKD. The enteroendocrine cell line pGIP/Neo STC-1 was used to evaluate the effects of GSPE on GLP-1 secretion in different nutrient conditions. A cytotoxicity Detection Kit (LDH) and BrdU Labelling and Detection kit III (Roche) were used to determine cytotoxicity and cell proliferation, respectively. GLP-1 levels in cell culture medium were determined using a GLP-1 (active) ELISA kit (Millipore).

Cytotoxicity and proliferation cell assays (n = 3) demonstrated that the maximum non-toxic GSPE treatment for these cells was 150 mg/l GSPE over a period of 3 h. Surprisingly, after 3 h of GSPE treatment, GLP-1 secretion (n = 6) was significantly inhibited. This inhibitory effect was observed at concentrations as low as 5 mg/l. Furthermore, inhibition of GLP-1 was also observed when STC-1 cells were co-incubated GSPE and 100 lmol/l dihomo-ϒ linoleic acid.

In conclusion, acute GSPE incubation decreases GLP-1 secretion in cultured enteroendoncrine cells. Interestingly the effect occurs under either on basal or nutrient (fatty acid) stimulated conditions.

C. Higa 1 , F. Novo 2 , M.S. Donato 2 , N. Rizzo 2 , G. Ciambrone 2 , E. Korolov 2 , P. Comignani 2 1 Coronay Unit, 2 Hospital Aleman, Buenos Aires, Argentina Introduction and aim: There is no data available respect of the prognostic value of Albumin:creatinin ratio (ACR) in Non-ST-Segment Elevation Acute Coronary Syndrome (NSEACS). The purpose of our study was to evaluate the long term prognostic value of ACR in patients with NSEACS.

Methods: We analyzed a prospective cohort of NSEACS in whom ACR was determined at admission. ROC curves were constructed to determine best cut off value associated with primary end-point of death or nonfatal myocardial infarction (D/AMI). Independent variables for D/AMI were assessed by a Cox regression model.

: Seven hundred ten patients with NSEACS were analyzed. Thirty percent were female and median age was 63 years. Median follow up time was 24 months. Best cut-off point of ACR for primary end point was 20 mg/g. Thirty-four percent of patients had ACR ! 20 mg/g. ACR correlated with higher incidence of primary end point both in diabetics and in non-diabetic patients: OR 3.5 (IC 95 2.3-14), P = 0.001 and OR 5.4 (IC 95% 2.4-11), P = 0.02, respectively. By multivariable Cox regression analysis, ACR was an independent predictor of D/AMI at long-term follow up: HR 5.8 (CI 95% 2-11), log Rank 2 P < 0.0001 in a model that included age, female gender, diabetes mellitus, serum creatinine, creatinine clearance, glucemia at admission a, elevated cardiac markers and ST segment deviations.

Conclusions: ACR was an independent predictor of adverse outcomes in NSEACS. This simple and accesible marker should be considered for risk stratification in this high risk setting. Aim of the work was to examine possible connection of methabolic syndrome with endothelium dysfunction in pre and postmenopausal women with and without ischemic heart disease (IHD).

Methods: Hundred and eight-nine pre and postmenopausal women with IHD were examined and 83 in same age without IHD. All women were measured arterial pressure using Korotkov method (according to JNC-6 recommendations). Vasa regulating function of endothelium examined with ultrasound in triplex scanning using reactive hyperemia probe (method by D. Celermajer). Willebrant factor determined in blood plasma.

Results: In group of women with IHD 126 (24%) had arterial hypertension: among them 47 (24%) in pre and 79 (40%) postmenopausal. Among women without IHD 23 (28%) had hypertension: 6 (7%) were pre-and 17 (21%) postmenopausal. During reactive hyperemia probe diameter of radial artery was: women with IHD 4.29 AE 0.05 mm; speed of blood flow 0.56 AE 0.05 m/s, Willebrant factor 177.45 AE 10.91; women without IHD corresponding 4.55 AE 0.09 mm (P < 0.05) and 0.69 AE 0.05 m/s (P < 0.05), Willebrant factor 128.15 AE 10.8 (P < 0.01) where there significant difference was noted.

Findings allows us to suppose, that women with IHD have higher abundance of arterial hypertension, that in connection with other components of metabolic syndrome, specify development of endothelium dysfunction, in comparison with women without IHD, which have arterial hypertension, endothelium dysfunction infrequently. Objective: Recently, incretin-related drugs are widely used for improving blood glucose level in clinical practices. In this study, we tried to examine the efficacy and safety of these drugs of the Japanese approved dose. We compared the efficacy and safety of the human GLP-1 analogue liraglutide (the approved dose 0.9 mg) with the dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin (the approved dose 50 mg) once daily in the obese adults with type 2 diabetes, over 52 weeks.

Methods: Japanese obese out-patients whose glycemic control was inadequately controlled with oral hypoglycemic agents received either maximum 52 weeks of treatment with 0.9 mg lilaglutide (n = 120) or 50 mg sitagliptin (n = 154) once daily within the period from March 2010 to October 2012, at Chubu-Rosai Hospital. The primary endpoint was change in body weight. Other measurements were HbA1c, lipid profiles, body weight, body mass index, serum creatinine, estimated GFR, and adverse events before and at 4, 12, 24, 52 weeks after liraglutide or sitagliptin administration.

Results: At the Japanese approved dose, the greater reduction of mean body weight was achieved with liraglutide than with sitagliptin (À6.2 kg, P < 0.001, +0.2 kg, P = N.S. vs. baseline). The degrees of lowering HbA1c (both 7.6% at baseline) were À0.80% for liraglutide and À0.53% for sitagliptin (both P < 0.001 at baseline). The eGFR of the sitagliptin group worsened from 74.0 to 67.8 ml/min/1.73 m 2 (P < 0.001 at baseline). The most common adverse events were gastrointestinal symptoms (24 (19%) patients on 0.9 mg liraglutide).

Conclusion: Liraglutide provides greater body weight reduction over 52 weeks even at the Japanese approved dose of 0.9 mg.

Objective: To examine prevalence of cardiovascular risk factors in patients with type 2 diabetes and stroke in primary care setting.

Methods: Study was conducted at Primary Health Center Tuzla and included all patients with type 2 diabetes and stroke who were registered in one family medicine team. We also calculated absolute cardiovascular risk according to the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice.

Results: Prevalence of stroke in diabetic patients was 24.1%. Significantly more women had stroke than men (65.1% vs. 33.9%; P = 0.001). Mean age of patients was 70.58 AE 8.44 years. Men were significantly older than women (72.22 AE 8.10 vs. 69.74 AE 8.60; P = 0.002). Majority of participants belonged to age group >70 years (57.4%). Mean duration of diabetes was 10.15 AE 5.41 years. More than half of patients (66%) had diabetes 5-10 years, 28.3% had diabetes 11-20 years, and 5.7% patients had diabetes >20 years. Family history for diabetes had 43.4% patients. The most prevalent cardiovascular risk factors were hyperlipidemia (88.7%) and hypertension (86.8%). Obesity was present in 49% patients, and 47.2% patients had family history for premature cardiovascular disease. Unhealthy diet had 30.2% patients, 30.2% were physically inactive, and 17% diabetic patients were smokers. Mean absolute cardiovascular risk was 5.49 AE 3.57%; 7.72 AE 3.80% in men, 4.34 AE 2.88% in women. Men had significantly higher absolute cardiovascular risk than women (P = 0.001).

Conclusion: Prevalence of cardiovascular risk factors in patients with type 2 diabetes and stroke were very high. It indicates more effective strategies in primary care setting to reduce risk of macrovascular and microvascular complications.

The prevalence of metabolic syndrome was determined as a crosssectional study among 600 healthy Saudi adults (52% males and 58% aged 35-50 years) attending National Guard clinics using the definition proposed by NCEP ATPIII. The prevalence of metabolic syndrome was 21%. Only one third of the participants had normal weight (BMI = 18.5-24.9). Central obesity based on waist circumferences was noted in 21% of males and 22% of females. Low HDL-C showed the highest prevalence (29%) followed by high TG (24%). About 14% of participants had impaired fasting blood glucose ( ! 110 mg/dl). Only 6% had high blood pressure ( ! 130/85 mmHg). More than three quarters (77.3%) of the respondents had ! 1 component of metabolic syndrome. In conclusion, metabolic syndrome needs to be addressed as an important health problem in the Gulf region. Background/aim: Adequate treatment and monitoring of diabetes can significantly improve quality of life and extend life expectancy in diabetic subjects. Aim of this study was to examine metabolic control in patients with type 2 diabetes in primary care setting.

Methods: Study was conducted at Primary Health Center Tuzla and included 107 randomly selected patients with type 2 diabetes, aged 40 years and over, from one family medicine team. We evaluated parameters of metabolic control in patients with type 2 diabetes according to the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice.

Results: There were significantly more women than men (63.6% vs. 36.4%; P < 0.0001). Mean age of patients was 68.06 AE 8.84 years. Mean duration of diabetes was 10.06 AE 5.43 years. Only 25 (23.4%) patients had blood glucose <6.0 mmol/l, and 39 (36.4%) patients had HbA1c <7.0%. Controlled blood pressure 130/80 mmHg had 47 (43.9%) patients. Only 18 (16.8%) patients had total cholesterol <4.5 mmol/l, while 35 (32.7%) patients had triglycerides <1.7 mmol/l. Normal body mass index (BMI) <25 kg/m 2 had 12 (11.21%) patients and recommended waist circumference 33 (30.8%) patients. Mean blood glucose was 8.34 l AE 2.78 mmol/l, HbA1c 7.77 AE 1.47%, systolic blood pressure 134.49 AE 17.68 mmHg, diastolic blood pressure 78.83 AE 9.75 mmHg, total cholesterol 5.76 AE 1.38 mmol/l, triglyceride 2.6 AE 2.07 mmol/l, BMI 29.96 AE 4.08 kg/m 2 , waist circumference 99.07 AE 9.97 cm.

Conclusion: Metabolic control of type 2 diabetes in family medicine practice was inadequate which indicates more effective interventions in order to achieve appropriate metabolic control of diabetes and reduce risk of complications. Aim: The aim of the study was to determine the metabolic responses to two different liquid milk protein diets in prediabetic and healthy volunteers. The diets were composed of 1. 50 g whey or casein protein, 50 g maltodextrin 19 and 10 g lactulose or 2. 50 g maltodextrin 19 and 10 g lactulose (control).

Procedures: Fifteen prediabetic and 15 healthy volunteers consumed all liquid test diets with blood sampling over a 4 h time period. Blood glucose, incretin hormones, NEFAs, hydroxybutyric acid and plasma amino acids were analyzed. The feeling of hunger was determined using a visual analog scale.

Results: In both, prediabetic as well as healthy volunteers, postprandial blood glucose levels were significantly decreased and plasma insulin levels were significantly elevated with the protein diets compared to the control diet. GIP and GLP-1 levels also increased after the protein-contaning test-diets. In the prediabetic volunteers, changes in glucose, insulin, amino acids, non-esterified fatty acids and hydroxybutyric acid displayed time delayed changes. A reduced feeling of hunger was reported in the prediabetic compared to the control group.

Conclusion: Both protein components elevate insulin secretion and cause reduced blood glucose AUC and these effects are more pronounced in prediabetics. However, despite differences in the amino acid composition, casein and whey protein did not reveal significantly different effects. Postprandial changes in plasma metabolites in prediabetics suggest more metabolic pertubations than just impaired glucose disposition. Methods: INS-1E cells or freshly isolated rat islets were incubated for 48 h in the presence of either leptin or TNF-a at lower (0.5 nmol/l or 2 ng/ml) or higher concentration (10 nmol/l or 20 ng/ml) individually or in combination. Proinsulin mRNA was detected by real time-PCR, insulin by radioimmunoassay kit, β cell proliferation were tested with MTT assay and β cell apoptosis was determined with Annexin V-FITC/PI by fluorescent activated cell sorting.

Results: Higher leptin (10 nmol/l) or TNF-a (20 ng/ml) significantly suppressed GSIS (P < 0.05) and reduced the intracellular proinsulin mRNA level and insulin content (P < 0.01) in INS-1E cells and primary islets. Whereas, lower leptin (0.5 nmol/l) or TNF-a (2 ng/ml) did not show such effects. However, the inhibition effects were compromized when two factors were simultaneously administrated in either cultured INS-1E cells or pancreatic islets. Similarly, higher leptin or TNF-a was able to inhibit INS-1E cell proliferation and promote cell apoptosis. Again, these effects were alleviated in the presence of both factors. Furthermore, Western blotting showed that TNF-a inhibited leptin receptor (OB-Rb) expression, decreased the phosphorylation of STAT3.

Conclusion: TNF-a exerts antagonistic effects on leptin actions in pancreatic β cells by interfering with OB-Rb/JAK/STAT3 signaling pathway. Increased TNF-a level may contribute to the pathogenesis of hyperinsulinemia and disturbed glucose metabolism in people with obesity. Aims: Identifying socioeconomic factors associated with the metabolic syndrome (MetS) is useful to target preventive measures. Our objective was to estimate, in France, the prevalence of metabolic syndrome (MetS) and to investigate the association between socioeconomic position and MetS.

Methods: The French National Nutrition and Health Survey (ENNS) cross-sectional national multistage sampling was carried out from February 2006 to March 2007. Data included waist circumference and blood pressure measurements, blood sample and sociodemographic and medication information. The prevalence of MetS was assessed using several definitions, including the most recent Joint Interim Statement (JIS). Association with sociodemographic covariates was assessed using logistic regression models.

Results: Among the 1856 participants 18-74 years of age, MetS prevalence was found to vary from 14.6% according to the National Cholesterol Education Program definition to 21.1% according to the JIS definition, without difference between genders. After adjustment for other covariates, risk of MetS increased with age in both men and women (for 1 year: ORa = 1.07, P < 10 À3 and ORa = 1.05, P < 10 À3 ; respectively). In women, MetS risk was inversely associated with education level; women with the lowest education level facing a six fold greater risk of MetS (ORa = 6.3, P < 10 À3 ). In men, risk of MetS was higher in men born outside of France (ORa = 3.01, P = 0.003) than in French-born males.

Conclusions: MetS prevalence is lower in France than in most industrialized countries. Lifestyle modifications, targeted to migrants and persons living in low socioeconomic conditions, should contribute to further reducing MetS.

folate. Patients were divided into two groups: group 1 (homocysteine <15 lmol/l) and group 2 (homocysteine ! 15 lmol/l).

Results: The mean age was 53.11 AE 8.80 years. Homocysteinemia was 12.55 AE 3.47 mmol/l. A significant correlation was found between homocysteine levels and the number of criteria for MS (P = 0.009). Besides, a significant decrease of hyperhomocysteinemia (from 26.7% to 3.3%, P = 0.039), systolic blood pressure (from 136.71 AE 19.82 mmHg to 126.77 AE 28.80 mmHg, P = 0.035), uric acid (from 271.18 AE 90.93 lmol/l to 250.08 AE 81 841 lmol/l; P < 0.001) and a significant improvement of HDL levels (1.06 AE 0.22 mmol/l to 1.14 AE 0.24 mmol/l, P < 0.05) were reported. A non significant improvement was observed for the other parameters. Furthermore, a correlation was noted between the variation of homocysteine and HDL levels (P = 0.023).

The association found between homocysteine and the severity of MS suggests a reflection on the cardiovascular risk caused by such association and on the importance of hyperhomocysteinemia screening in patients with MS. Object of study and method: The 151 patients with MS: 88 of them presented with the recurrent form of AF, 63 had no arrhythmia. The groups were comparable in terms of age, concomitant disorders, arterial hypertension duration, arterial pressure, and severity of chronic heart failure. Patients with permanent AF, hemodynamically significant heart disease, myocardial infarction with wave Q in the medical history, were excluded from the study. In a review of the diagnostic efficiency parameters showed statistically significant differences in the two groups, with the evaluation of their specificity (Se), sensitivity (Sp) and OR (odds ratio).

Results: Patients with MS having abdominal obesity and arterial hypertension over 10 years (Se 0.81; OR 2.8 (95% 1.3-5.6); x 2 = 6.6; P = 0.01); HOMA IR index more than 2.77 (Se 0.82; OR 5.48 (95% 2.2-12.8); x 2 = 13.4; P < 0.00001); reduced HDL cholesterol level below 1.1 mmol/l (Se 0.71; OR 3.73 (95% 1.8-7.2); x 2 = 13.4; P < 0.001); left atrial dilation (Se 0.81; OR 3.68 (95% 1.7-7.4); x 2 = 11.4; P = 0.001); albuminuria more than 60 mg/day (Sp 0.85; OR 7.9 (95% 3.1-18.6); x 2 = 19.7; P < 0.001); waist circumference more than 104 cm (Sp 0.71; OR 3.13 (95% 1.6-6.1); x 2 = 9.86; P = 0.002) were at high risk of AF.

The duration of abdominal obesity and hypertension for 10 years, insulin resistance index >2.77, reduced HDL <1.1 mmol/l, an increase in albuminuria >60 mg/day, an increase in waist circumference >104 cmrisk factors for AF in MS. Patients and methods: Fifty-three patients with MS over 60, comparable in duration AF, comorbidity and treatment. Patients with permanent AF, hemodynamically significant heart disease, myocardial infarction with wave Q in the medical history, were excluded from the study. Following a successful cardioversion all patients assigned amiodarone. Group 1 (n = 16) in the adjuvant therapy prescribed Metformin over 1700-2000 mg/day; Group 2 (n = 20) Metformin <1700 mg/day, Group 3 (n = 17) Metformin is not assigned. The observation period is 6 months.

Results: In Group 1 HOMAIRind decreased to 2.04 AE 1.08 (P < 0.05 compared with baseline), in the 2nd to 2.88 AE 1.2 (P > 0.05) and 3rd to 3.04 AE 1.2 (P > 0.05) (p1-3 < 0.05), and improvement of lipid profile and increased GFR (60.1 AE 15.3 (P < 0.05 compared with baseline), 51.3 AE 9.2 and 51.7 AE 8.2 ml/min, in the 1st, 2nd and 3rd Groups, P = 0.04 between groups); decreased volume of the left index atria (37.05 AE 8.96 (P < 0.05 compared with baseline), 38.1 AE 10.4 and 41.9 AE 9.4 ml, in the 1st, 2nd and 3rd); reduction in waist circumference (103.3 AE 6.3 (P < 0.05 compared with baseline), 109.1 AE 8.1 and 108.3 AE 7.5 cm, in the 1st, 2nd and 3rd). Patients in Group 1 was maintained SR for much longer (163.4 AE 39.4 days) than in patients of the 2nd (120.9 AE 47.7) and the 3d Group (124.5 AE 50.9) (P = 0.01; p1-2 <0.05; p1-3 <0.05). 

Aims: Metabolic syndrome (MetS) is the serious health problem worldwide and is associated with increased risk of cardiovascular disease. MetS has a significant genetic component which is estimated on 30-60%. Apolipoprotein A5 (APOA5, OMIM acc. No 606368) gene and its variants have been associated with the plasma lipids, mainly triglycerides and its role in MetS development is recently discussed. We have analyzed, if there is the association between the APOA5 gene haplotypes (based on the rs662799 and rs3135506 variants) and MetS in middle European -Slavic population.

Methods: APOA5 haplotypes based on the presence of either common or at least one minor APOA5 allele (rs662799, C-1131 and rs3135506, G56) and the presence of MetS were analysed in 2559 adults (1191 males and 1368 females, 25-65 years old) selected according the MONICA protocol and examined at 1998/7 and 2000/2001. The presence of MetS was analysed according the NCEP-ATP III criteria.

Results: In females with at least one minor APOA5 allele, the prevalence of MetS was significantly higher both at 1997/8 (38.3% vs. 32.6%, P < 0.04) and at 2000/1 (36.9% vs. 30.4%, P < 0.02). In males, association between APOA5 gene and MetS was not detected neither at 1998/7 (48.1% vs. 45.1%, P = 0.29) nor at 2000/1 (45.7% vs. 42.2%, P = 0.41).

A. Blazquez 1 , O. Garcia-Sanchez 1 , Y. Quiros 1 , V. Blanco-Gozalo 2 , M.J. Montero 1 , J.M. Lopez-Novoa 1 , C. Martinez-Salgado 3 , F.J. Lopez-Hernandez 3 1 Universidad de Salamanca, 2 IBSAL, 3 IECSCYL-IBSAL-University of Salamanca, Salamanca, Spain Diabetes commonly causes a type of chronic nephropathy, namely diabetic nephropathy (DN). Diagnosis of DN is presently accomplished late in the course of disease. Microalbuminuria anticipates progression towards DN only in a subset of patients. Another subset of diabetic, microalbuminuric patients never develop DN. Accordingly, new biomarkers are necessary to more accurately identify diabetic patients progressing towards DN. NGAL has also been associated to progression to DN. On the other hand, hypertension is a well-known factor of co-morbidity in diabetic nephropathy. We decided to study the capacity of NGAL to detect the additive effect of hypertension on progression to diabetic nephropathy. In the present work we aimed at unraveling the origin of the increased urinary NGAL. Spontaneously hypertensive rats (SHR) or normotensive Wistar rats were rendered hyperglycemic by a single administration of streptozotocin, or not (as controls). Renal function was monitored and NGAL was measured in urine, plasma and tissue samples. Their kidneys were perfused in situ with Krebsdextran solution (containing or not exogenous NGAL), and urine was collected. Plasma and renal tissue NGAL was also measured by Western blot, and renal NGAL expression was determined by RT-PCR. Our results suggest that the urinary NGAL is increased by the coexistence of diabetes and hypertension, but not by each of these conditions. NGAL excretion results from its altered tubular handling. This subtle and primary renal alteration might be studied further as an early marker of the increased risk of chronic renal disease posed by the co-morbidity of hypertension and diabetes.

The increasing prevalence of obesity is a major public health concern. More than 1.4 billion adults, 20 and older, were overweight, over 200 million men and nearly 300 million women of whom were obese in 2008. Large-scale studies have demonstrated that overweight and obesity increase the risk of developing several forms of cancer, including several that are not classically viewed as hormonedependent. In both men and women, increasing BMI is significantly associated with higher death rates from cancers of the oesophagus, colon and rectum, liver, gall bladder, pancreas and kidney, as well as non-Hodgkin lymphoma and multiple myeloma. The associations between obesity and particular maignancies may be affected by body fat distribution, and may result from diverse factors including diet and abnormal levels of hormones and inflammatory cytokines. Recently, there is more and more sufficient evidence that excess body weight is an avoidabl e cause of excess cancers including gastrointestinal, endometrial, esophageal adenocarcinoma, colorectal, postmenopausal breast, prostate, and renal cancers. The mechanism that obesity association with cancer is remains not well understood. There are some most studied hypothesized mechanisms such as, high levels of insulin and free levels of insulin-like growth factors (IGFs), sex hormones, adipocytokines, inflammatory cytokines, c-Myc oncogenic transcription factor, obesity-induced hypoxia and Warburg effect, and so on. In the Future, the potential mechanisms and conclusions in obesity associated with increased risk for developing cancer, and the underlying cellular and molecular mechanisms will be studied. Results: Among 76 patients with MS (mean age: 58 years; 67% male), 65 (86%) had abdominal obesity, 56 (74%) had A1C > 5.6%, 53 (70%) had FPG > 100 mg/dl and 25 (33%) had HOMA > 2.6. If we consider as IR indicators:

1. Presence of prediabetes criteria (FPG > 100 mg/dl and/or A1C > 5.6%); and/or 2. HOMA > 2.6, 60 patients (79%) met at least one marker of IR, but 36 of them (60%) had HOMA <2.6 [11 (31%) of them were on therapy with metformin, an insulin-sensitivity drug].

In the multivariate analysis, presence of type 2 diabetes (HR 1.2; P < 0.05) and presence of prediabetes criteria (HR 1.3; P < 0.05) were associated with HOMA > 2.6

Discussion: Although most of the patients with MS have clinical markers of IR (FPG > 100 mg/dl, A1C > 5.6%), only a third part of them have HOMA levels associated with IR. These observations suggest that: of Spilberger's test. From 1995 to 2010 women were followed for the incidence of AH.

Results: High level of anxiety (HLA) in studied cohort revealed in 60.4% of women. Women with HLA more often tried unsuccessfully to quit smoking compared to lower levels of anxiety (10.7% and 3.9%, respectively; x 2 = 11.25, P < 0.05). Women with HLA in twotimes less likely to follow the diet (x 2 = 20.87, P < 0.001) and assess their physical activity more passive (x 2 = 18.13, P < 0.01).

Relative risk (HR) of development of AH in women with HLA during the first 5 years of study was in 2.38-fold higher (95.0% CI: 1.137-4.993; P < 0.05), over 10 years it was 1.85 (95.0% CI: 1.075-3.194; P < 0.05) and HR was 1.46 (95.0% CI: 1.023-2.079; P < 0.05) over 16 years of follow-up compared to those with lower anxiety levels.

Depending on age groups the risk of AH incidence within 10 years was highest in older group with HLA aged 55-64 years (HR = 10.2; 95.0% CI: 1.244-83.609, P < 0.05).

Conclusions: There is high prevalence of HLA in Russian female population aged 25-64. During 16 years of follow-up women with HLA have significantly higher risk of AH especially in older age groups. Material and methods: Under the third screening of the WHO "MONICA-psychosocial" (MOPSY) program random representative sample of women aged 25-64 years (n = 870) were surveyed in Novosibirsk. D was measured at the baseline examination by means of test "MMPI". From 1995 to 2010 women were followed for 16 years for the incidence of AH.

Results: The prevalence of D in women aged 25-64 years was 55.2%. Women with major D (12%) significantly extended negative behavioral habits: smoking and unsuccessful attempts to give it up, low physical activity, they were less likely to follow a diet.

Relative risk (HR) of AH in women with D during the first 5 years of study was higher in 1.6-time compared to women who had no D (95.0% CI: 0.86-2.98; P < 0.05). With regard to age groups HR was significant in oldest age category 55-64 years (HR = 1.86; 95% CI: 0.44-7.8; P < 0.05). HR of incident AH in persons with D within 10 years was 1.74 (95.0% CI: 1.01-3.01; P < 0.05) and there were no significant differences in age groups. We did not have risk of AH over 16 years of follow-up in women with D (P > 0.05).

The prevalence of D in women aged 25-64 years is more than 50%. Women with D had unfavorable lifestyle and higher relative risk of AH over the first 5-10 years of the study. Purpose: Study the association of high level of anxiety (HLA) with VNTR polymorphisms D4 and DAT genes; determine the relative risk (HR) of arterial hypertension in men with HLA.

The WHO " MONICA-psychosocial" in 1984 MONICA-psychosocial" in , 1988 MONICA-psychosocial" in , 1994 surveyed a random representative sample of men aged 25-64 years (2149 men). To assess the level of anxiety was used Spielberger's test. Cox proportional regression was used for HR assessment.

Results: The HLA in an open population of men aged 25-64 years was 50.9%. Since HLA genotype was significantly associated 4/6 DRD4 gene and genotype 9/9 gene DAT. For 24 years HLA maximizes the HR of hypertension in the first 5 years.

Conclusion: There is high prevalence of HLA at male aged 25-64 in Russian. HLA were significantly associated with certain VNTR polymorphisms of genes DRD4, DAT; HLA increases the HR of hypertension in the first 5 years.

inhibiting beta cell proliferation and promoting its apoptosis which concomitantly leads to decreased β cell mass.

Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt

Background: Psoriasis is a disorder with genetic and immunologic background. Leptin can regulate the T-helper response.

Objective: Our primary goal is to study the functional polymorphism (G-2548A) of the leptin (LEP) gene in the genetic predisposition of psoriasis, and our secondary goal is to examine factors affecting plasma leptin levels in psoriasis, and to compare patients with and without metabolic syndrome (MS).

Methods: The study involved 94 psoriatic patients and 100 healthy controls. Analysis of G-2548A polymorphism of the LEP gene was made by the PCR and restriction fragment length polymorphism technique. The relationship between LEP gene polymorphism and the clinical features of the patients was analyzed. Plasma leptin levels and proportions of comorbidities in patients vs. controls were compared.

Results: In controls the GA, AA and GG frequencies were 50%, 30% and 20% respectively, while in patients the distribution of genotypes was 42.5%, 20.2% and 38.3% respectively, with significant difference (P = 0.014) between patients and controls. In patients with MS the GG, GA and AA frequencies were 61.5%, 23.1% and 15.4% respectively, while in patients without MS the distribution of genotypes was 29.4%, 50% and 20.6% respectively, with significant difference (P = 0.014) between both groups. Plasma leptin showed a significant higher levels in the patients vs. the controls (P < 0.001), and among the different LEP genotypes (P < 0.001) in the patients′ group.

Conclusion: LEP G-2548A polymorphism could be a predictor for higher plasma leptin and increased risk of psoriasis and could be used as a marker for psoriasis-related comorbidity risk. 

Introduction: Contractile dysfunction, associated with disturbances in excitation-contraction coupling, has been widely demonstrated in diabetic heart.

Aims: The aim of this study was to investigate the pattern of mRNA encoding cardiac muscle proteins that are involved in the process of excitation-contraction coupling in early onset type 2 diabetic Goto-Kakizaki (GK) rat.

Methods: Experiments were performed in GK and Wistar control rats aged 8-10 weeks. Gene expression was assessed in ventricular muscle with real-time RT-PCR, shortening and intracellular Ca 2+ were measured in ventricular myocytes with video edge detection and fluorescence photometry, respectively.

Results: Expression of genes encoding some membrane pumps and exchange proteins were unaltered (Atp1a1/2, Atp1b1, Slc8a1) whilst others were either upregulated (Atp1a3) or downregulated (Slc9a1) in GK ventricle compared to control. Expression of genes encoding some calcium (Cacna1c/1 g, Cacna2d1/2d2, Cacnb1/b2), sodium (Scn5a) and potassium (Kcna3/5, Kcnj3/5/8/11/12, Kchip2, Kcnab1, Kcnb1, Kcnd1/2/3, Kcne1/4, Kcnq1, Kcng2, Kcnh2, Kcnk3, Kcnn2) channel proteins were unaltered whilst others were either upregulated (Cacna1 h, Scn1b, Hcn2) or downregulated (Hcn4, Kcna2, Kcna4, Kcnj2) in GK ventricle compared to control. The amplitude of ventricular myocyte shortening and intracellular Ca 2+ transients were unaltered however, the TPK shortening was prolonged and THALF decay of the Ca 2+ transient was shortened in GK myocytes compared to controls.

Conclusions: Early changes in expression of genes encoding various cardiac muscle proteins are associated with disturbances in myocyte shortening and intracellular Ca 2+ transport. Results: Analysing level of TNF-alpha, we found that in group 1, there were significantly higher values than the control group by 6.1 times (90.4 AE 1.7 pg/ml: 14.9 AE 0.8 pg/ml, respectively), and significantly higher than patients without insulin resistance (76.4 AE 2.1 pg/ml). Analyzing level of IL-4, the presence of IR, level of this cytokine increases by only a factor of 2 (61.2 AE 2.9 pg/ml) relative to that of the control group (30.2 AE 1.7 pg/ml). In the second group, the level of IL-4 (101.4 AE 3.3 pg/ml) was significantly higher than in group 1 and exceeded the performance of control group by 3.4 times. Analyzing the ratio of the level of TNF-alpha and IL-4, we have detected a significant increase in the coefficient TNF-alfa/IL-4 in group 1 (1.48 AE 0.12) compared with group 2 patients (0.76 AE 0.09). That is, IR in CHC patients gives a significant shift in balance of cytokines toward proinflammatory interleukins, which can be observed by increase of TNFalfa/IL-4 over 1.37 (P < 0.001 by Mann-Whitney).

Conclusions: Progression of IR in patients with CHC is accompanied by an increase in ratio TNF-alfa/IL-4 serum. Beyond the value of 1.37, CHC patients will an require in-depth study for carbohydrate metabolism.

Cardiovascular Medicine, International University of Health and Welfare Sanno Hospital, Tokyo, Japan

Background: Hyperglycemia has been suggested as a significant factor in coronary microangiopathy in patients with type 2 diabetes (T2DM), but whether it can be reversed through treatment of hyperglycemia is unknown.

Aim: To clarify whether glycemic control can improve coronary microangiopathy in T2DM.

Methods: Subjects were 34 T2DM who underwent coronary angiography and 17 age-matched controls. Myocardial segments perfused by angiographically normal coronary arteries were studied. Baseline myocardial blood flow (MBF, ml/min/100 g) and MBF during dipyridamole administration (0.56 mg/kg/min) were measured using positron emission tomography (PET). Myocardial flow reserve (MFR) was calculated by the ratio of MBF during dipyridamole administration to the baseline MBF. After the first PET study, patients were subdivided into an additional intensive therapy group (ATG) and no-additional therapy (NATG) group. Second PET scan was performed 6-9 months later.

Results: Baseline MBF was comparable among the ATG (87.5 AE 24.1), NATG (87.2 AE 16.9) and controls (78.2 AE 33.3). However, MBF during dipyridamole administration was significantly lower in both the ATG (170 AE 52.0) and NATG (192 AE 52.6) than in controls (293 AE 159, P < 0.01) as was the MFR (ATG, 1.96 AE 0.52; NATG, 2.27 AE 0.63; controls, 3.69 AE 1.09; P < .01 respectively). MFR was significantly improved in the ATG (2.51 AE .77; P < .05), but not in the NATG (2.14 AE 0.69; P = ns). There was a significant inverse relationship between percent change in MFR and percent change in glycemic control. However, no significant relationships were seen between the percent change in MFR and percent change in plasma lipid fractions.

Conclusion: Coronary microangiopathy in T2DM can be reversed by intensive therapy for hyperglycemia.

L. Drimba, R. S ari, J. Né meth, Z. Szilv assy, B. Peitl

Background: Our aim was to investigate the effect of "sui generis" hyperinsulinaemia on proarrhythmogenic electrophysiological changes and on cardiac arrhythmias.

Methods: Euglycaemic hyperinsulinaemia was induced in chronicallyinstrumented conscious rabbits equipped with a right ventricular pacemaker electrode catheter. Hyperinsulinaemia was induced by either 5 or 10 mU/kg/min insulin infusion and a variable rate of glucose infusion ensured the maintenance of euglycaemia (5.5 AE 0.5 mmol/l). The effect of hyperinsulinaemia on cardiac electrophysiological parameters and arrhythmia inducibility was studied by means of 12-lead surface ECG recording and by programmed right ventricular stimulation (PRVS). The role of adrenergic activation was investigated by determination of plasma catecholamine level and by intravenous administration of beta adrenergic blocking agent, propranolol.

Results: Both 5 and 10 mU/kg/min insulin infusion prolonged the PQ and the Tpeak-Tend intervals and shortened the rVERP, but no significant changes on other measures of ECG (HR, QT, QTc) were observed. The incidence of PRVS-induced ventricular premature beats and non-sustained ventricular tachycardia was higher during euglycaemic hyperinsulinaemia than that of fasting state. We found that higher plasma level of insulin was occurred, the more inducibility of arrhythmias was seen. No change in plasma catecholamine level was observed, but the propranolol restored the prolonged Tpeak-Tend interval.

Our results indicate the "sui generis" proarrhythmic effect of hyperinsulinaemia due to reduction of the repolarization reserve in otherwise healthy rabbits. Propranolol can be used safely for prevention of arrhythmia in patient with hyperinsulinaemia. Euglycaemic hyperinsulinaemia is suitable method to induce acquired long QT syndrome in healthy rabbits. 

Objective: This study investigated the prevalence of metabolic syndrome (MetS) and its association with demographic, socioeconomic and behavioral factors in shift workers.

A cross-sectional study was conducted on a sample of 902 shift workers of both sexes in a poultry processing plant in Southern Brazil. The diagnosis of MetS was determined according to the recommendations from "Harmonizing the Metabolic Syndrome". The distribution of each of the components of MetS was evaluated according to the demographic, socioeconomic and behavioral characteristics of the sample. The multivariate analysis followed a theoretical framework for determining MetS on shift workers.

The prevalence of MetS on the sample was 9.3% (IC 95% : 7.4-11.2). The most frequent altered component was waist circumference (RP 48.4 ; IC 95% 45.5-51.2). After adjustment, the prevalence of MetS was positively associated with women (RP 2.16; IC 95% 1.28-3.64), workers of over 40 years of age (RP 3.90; IC 95% : 1.78-8.93) and those who reported sleeping five or less hours per day (RP 1.70; IC 95% : 1.09 -2.24). On the other hand, MetS was negatively associated with higher educational level (RP 0.55; IC 0.29-1.06) and having more than three meals per day (RP 0.43 IC 95% 0.26-0.73). In addition, most of the altered components of MetS were associated with sociodemographic characteristics, whereas only waist circumference and altered blood pressure were associated with behavioral characteristics.

Conclusion: Sex, age, educational level, eating habits and duration of sleep appeared as independent risk factors for MetS.

Arab world covers a vast geographic area, consists of 23 countries with an approxiimate population of about 358 million people. Geographically, Arab world is variable ranging from dry desert areas to heavily raining green land. This part of the globe is also unique for its wide cultural, social and ethnic variations. Most of the countries are well-heeled with significant natural resources including oil, gas and are benefited from high income. The socio-economic progress has brought benefits in the region such as improved access to health care, education, and safe drinking water. This rapid economical change has also set the scene for the modern lifestyles activities, people are eating more and exercising less. These changes in the lifestyle cause variuos metabolic syndromes including obesity, Diabetes mellitus. In spite of marvelous advancement in medical sciences, the most of the metabolic syndromes are still an incurable life-long disease and swiftly increasing in all over the world. Presently, six countries including Saudi Arabia, Bahrain, United Arab Emirates, Kuwait, Oman and Egypt are among the world's highest for the prevalence of metabolic syndromes especially the diabetes mellitus. Metabolic syndromes placed a great burden on the public health and clinical practice in the region.

V. Negrean 1 , O. Mislea 1 , I. Cheta 1 , T. Alexescu 1 , I. Chisalita 2 1 Internal Medicine, UMF Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, 2 UMF 'Victor Babes' Timisoara, Timisoara, Romania

Introduction: It is known that type 2 diabetes is a major cardiovascular risk factor, but the relationship between impaired fasting glucose (IFG) and the occurrence of cardiovascular events is still undefined.

Objectives: To determine whether the IFG is a risk factor for cardiovascular disease.

Results: Twenty-four percent of the patients with IFG progressed to diabetes and 8% from the control group were diagnosed with this condition. Twenty-one percent of the patients with IFG and 9% from the patients in the control group were diagnosed with HBP. Sixty percent from the patients with IFG and 20% of the patients in the control group were obese, 51% from the subjects with IFG and 26% from the subjects in the control group show ischemic heart disease. Fifty-five from the patients with IFG and 20% from the patients in the control group declared that they practice no physical activity. There was a significant correlation between the presence of IFG and the HBP (OR = 3, P < 0.05), the absence of physical activity (OR = 5, P < 0.05), obesity (OR = 6, P < 0.05), ischemic heart disease (OR = 3, P < 0.05).

Conclusions: Our study shows that IFG is correlated with the cardiovascular risk: patients with IFG have three times higher risk to develop HBP, six times higher risk to be obese and three times higher risk to have ischemic heart diseses. Introduction: : The most common investigated factors in chronic inflammation in type 2 diabetes are increased C-reactive protein level, erythrocyte sedimentation rate. The matrix metalloproteinases are a family of proteolytic molecules which contribute to adipose tissue abnormalities. Metalloproteinase 2 (MMP-2) has a significant contribution to development of complications of diabetes.

Aim: : The assessment of the inflammation intensity in patients with type 2 diabetes mellitus and the examination of mixed meal influence on MMP-2 plasma level.

Materials and methods: : Twenty subjects were qualified to this study. All of them were diabetics on insulin treatment. Concentrations of MMP-2 were estimated at fasting state and after mixed meal challenge (ELISA). We also measured body mass, BMI, systolic and diastolic blood pressure and: ESR, CRP, daily average glucose, HbA1c.

Results: : MMP-2 concentration values were higher in fasting state in comparison to in postprandial state. MMP-2 correlates with ESR, CRP, BMI, average daily glucose level and body weight. However, there are no significant correlations between MMP-2 and HbA1c.

Conclusions: : There was a statistically significant positive correlation between serum metalloproteinase 2 and exponents of inflammation, such as erythrocyte sedimentation rate, C-reactive protein. After the mixed meal we observed a significant decrease of metalloproteinase 2 concentration in relation to its concentration in the fasting state. It was shown that the concentration of metalloproteinase 2 depends on short-term metabolic control of type 2 diabetes, not depending on long-term control of the disease. 

Background: Several studies suggest increased oxidative stress and reduced endothelial function in obstructive sleep apnoea syndrome (OSAS). We assessed the association between OSAS, endothelial dysfunction and oxidative stress. The effect of nasal continuous positive airway pressure (nCPAP) on oxidative stress and arterial dysfunction was also evaluated.

We studied 138 consecutive patients with heavy snoring. Patients underwent overnight home polysomnography. Ten patients with severe OSAS were revaluated after 6 months of nCPAP therapy. Oxidative stress was assessed by measuring urinary 8-iso-PGF2a and serum levels of soluble NOX2-derived peptide (sNOX2-dp). Serum levels of nitrite/nitrate (NOx) were also determined. Flow-mediated brachial artery dilation (FMD) was measured to asses endothelial function.

Results: Polysomnographic indices were correlated with the metabolic score, insulin levels and central obesity indices. Severe OSAS had higher urinary 8-iso-PGF2a (P < 0.001) and serum NOX2 and lower NOx. A negative association was observed between FMD and OSA severity. Apnea/hypopnea index was correlated with urinary 8isoprostanes (r = 0.298, P < 0.001). Metabolic syndrome (t = À4.63, P < 0.001) and urinary 8-isoprostanes (t = À2.02, P < 0.05) were the only independent predictors of FMD. After 6-months of nCPAP treatment, a significant decrease of serum NOX2, (P < 0.005) and urinary 8-iso-PGF2a (P < 0.01) was observed, while serum NOx showed only a minor increase. A statistically significant increase of FMD was observed (from 3.6% to 7.0%).

Conclusions: Our study indicates a strong association between OSAS and metabolic syndrome. Patients with OSAS and cardiometabolic comorbidities have increased oxidative stress and arterial dysfunction that are partially reversed by nCPAP treatment. Pendyffryn Medical Group, Prestatyn, 2 Diabetes Centre, Royal Liverpool University Hospital Trust, Liverpool, UK Introduction: Metabolic syndrome (MetS) and low testosterone levels are independently associated with increased all-cause and cardiovascular mortality. Low testosterone levels are associated with obesity, insulin resistance and an adverse lipid profiles in men and the metabolic syndrome and type 2 diabetes have a high prevalence of testicular hypogonadism. The relationship and interaction between these conditions and the potential affect they have on each other is not fully understood.

Method: This study examined the correlation between testosterone and the criteria of the metabolic syndrome in 552 subjects (age 56.7 years, AE15.4,(18-90.4) (mean, SD (range)), Total-Testosterone 14.6 nmol/l, AE7.3,(0.1-52), Free-Testosterone 0.23 nmol/l, AE0.09, (0.04 -0.63), sex hormone-binding globulin level 37.2 nmol/l, AE19.5, (7-170). Correlation and significance statistical testing used the Pearson correlation coefficient.

Results: Diabetes was present in 22.6% and a further 24.1%(104/431) had the metabolic syndrome. Total-Testosterone, Free-Testosterone and SHBG had significant and the strongest correlations with age (r = À0.24, À0.38.0.34 respectively, P < 0.05). SHBG had the strongest negative correlations with triglycerides (r = À0.31), waist circumference (r = À0.21) and HbA1c (r = À0.14), (Total-Testosterone, triglycerides (r = À0.19), WC (r = À0.17)), all significant P < 0.05. There were positive correlations with HDL (r = 0.29 SHBG, r = 0.11 TT, P < 0.05). There were no significant correlations with blood pressure and Free-Testosterone had no correlation with MetS criteria.

Conclusion: Lower testosterone levels have the greatest correlation with ageing but are also associated with detrimental changes in central adiposity and dyslipidaemia. SHBG rises with age, however lower levels have a stronger association with cardiovascular risk. This study suggests that cardiovascular risk and androgen abnormalities might be Methods: Group 1 (gr1) was composed of 30 normal subjects (age = 54.50 AE 2.03; means AE SEM). Group 2 (gr2) consisted of 20 non-obese type II DM pts with hypertriglyceridaemia (type IV HLP) and ATH (age = 53.19 AE 1.91). Group 3 (gr3) consisted of 23 nonobese type II DM pts with mixed hyperlipidaemia (type IIB HLP) and ATH (age = 56.73 AE 1.96).

Following have been determined in serum, in fasting state: total cholesterol (CH), HDL-cholesterol (HDL-CH), atherogenicity coefficient (HAC), triglycerides (TG), lipolytic activity (LA), lipoprotein fractions, prostaglandins A1 and E1, prostaglandins F2alpha (PGF).

Following have been determined in plasma, during standard OGTT: glucose, insulin, insulin/glucose index (IGI), glucagon, C-peptide, STH, somatostatin, ACTH, cortisol, aldosterone, beta-endorphin.

Results: Both gr2 and gr3 pts, compared to gr1, had higher body mass, CH, TG, HAC, and lower HDL-CH, LA, insulin (at OGTT hour 1), IGI, STH (hour 2), basal aldosterone. Gr2 pts, compared to gr1, had lower STH (hours 1 and 2). Gr3 pts, compared to gr1, had higher glucagon (hour 2), somatostatin (hours 0 and 1), cortisol (hours 1 and 2), PGF, and lowerC-peptide (hour 1), STH (hours 0 and 2).

Conclusions: Altered hormonal-metabolic patterns have been observed in non-obese type II DM pts with ATH and dyslipidaemias, including decreased STH and elevated cortisol. Hyperlipidemia has been indicated as an important factor of contributing to diabetes progression. However, whether native LDL or modified LDL causes dysfunctional effect of insulin secretion in islet cells is still elusive. The present study aims to identify the mechanisms of electronegtive LDL (L5) and L1 (less electronegtive LDL) acting on the insulin secretion of pancreatic β-cells. RIN-m5F cells, were cultured in the complete medium with human native L1, L5, or oxLDL. The intracellular concentration of Reactive Oxygen Species (ROS) measured by use of DCFHDA was significantly increased after loading L5 (50 lg/ml) or oxLDL (50 lg/ml), but not effected after loading L1 (50 lg/ml). The cell viability assayed by PrestoBlue TM reagent was suppressed to 50% after loading L5 or oxLDL; however, L1 did not inhibit the cell viability. The insulin release of RIN-m5F cells was determined by ELISA kit. Our results demonstrated that 40% decrease of secretion ratio in the phase of high glucose-induced response after the β-cells were exposed in L5 for 48 h as comparison with in normal medium. We also found that phosphor-c-Jun was activated after loading L5 or oxLDL, but not after loading L1. The activation of c-Jun may modulate the gene expression or the process of insulin secretion. Thus we suggest that L5, not L1, is the main subparticle which induces oxidative stress and then lead to dysfunction of insulin secretion responding to high glucose stimulation in β-cells. target group for diet and physical activity interventions due to their increased risk of post-natal weight gain, type 2 diabetes and related health problems. Postpartum weight gain and/or retention, particularly in the first 12 months are commonly due to lack of nutrition knowledge, poor dietary habits and physical inactivity. Mothers are also integral to the shaping of attitudes and eating and activity behaviours of their children. The proposed study will evaluate whether an individualized weight management program with nutrition and physical activity advice and support enhances weight loss compared with standard care in overweight and obese women and women with a history of GDM. It is hypothesized that, compared with individuals given standard diet and physical activity advice, overweight and obese women, and women with a history of GDM prescribed exercise energy expenditure targets and using heart rate (HR) and dietary intake monitoring with electronic reminders, are better able to achieve a target weight loss (5% reduction from prepregnancy weight for overweight or obese pregravid ( ! 26.5 kg/m 2 ), for overweight women (25.1-26.5 kg/m 2 ) to achieve a weight loss that places them in the healthy-weight range, and for women who were in the healthy-weight range pregravid to return to their prepregnancy weight) through changes in eating and activity behaviours.

Objective: Diabetes is associated with moderate cognitive deficits and neurophysiological and structural changes in the brain, a condition that may be referred to as diabetic encephalopathy. We used high-fat and sugar diet and streptozotocin induced diabetic rats to observe the changes of proteins of insulin signaling which closely correlate with learning and memory. We try to illuminate the possible mechanisms of learning and memory decreased in T2DM.

Methods: A total of 24 rats were randomly divided into two groups: Control group (C), diabetes mellitus group (DM). After 8 weeks, Morris water maze was used to perform training trial and probe trial in order to detect spatial learning and memory abilities. And we detected proteins of insulin signaling such as IR, IRS-1, AKT, p-CREB and Bcl-2 in the hippocampus of the rats by Western blot and immunohistochemistry staining.

Results: 1. Water maze experiment: Compared with the C group, the escape latency increased significantly in DM from the 2nd day. In the Spatial probe experiment, the first time passing hidden platform prolonged significantly and the distance swimming in the quadrant of hidden platform decreased significantly in the DM.

2. Immunohistochemistry staining: Compared with the C group, the positive neurons of IR, IRS-1, AKT, p-CREB, Bcl-2 increased in the DM group.

3. Western blot: Compared with the C group, the expression of IR, IRS-1, AKT, p-CREB, Bcl-2 increased in the DM group.

Conclusions: The learning and memory ablities decreased, while the expression of IR, IRS-1, AKT, p-CREB, Bcl-2 abnormal increased in T2DM model rats. The results indicate that insulin signal transduction were impaired in T2DM. Objectives: Niacin, a widely used lipid-modifying drug, is known to induce hyperglycemia during prolonged and high-dose treatments.

However, its potential mechanism (s) whereby the islets are involved remains to be determined. We thus aim to investigate the potential role of niacin and its receptor GPR109a involved in regulating islet beta-cell function and insulin resistance.

Methods: HFD-induced obese mice were employed to study the in vivo effects of niacin. Blood glucose/serum insulin levels, oral glucose tolerance test (OGTT)/insulin tolerance test (ITT), and homeostasis model of assessment-insulin resistance (HOMA-IR) were performed to assess glucose homeostasis. Real-time PCR, Western blot and immunefluorescent assays were used to study the expression of genes of interest. Cyclic adenosine monophosphate (cAMP) and glucosestimulated insulin secretion (GSIS) from isolated islets and INS-1E beta cells were determined. Knockdown of the GPR109a in INS-1E cells was also examined and compared.

Results: Eight-week treatment with niacin increased blood glucose levels by 25% in HFD-induced obese mice while the areas under curve of OGTT and ITT, and HOMA-IR index were consistently enhanced. In addition, niacin treatment significantly decreased GSIS in isolated pancreatic islets. Ex vivo and in vitro studies showed niacin decreased GSIS, increased mRNA expression of UCP2 and GPR109a as well as inhibited intracellular cAMP accumulation in INS-1E cells. In corroboration, the decrease in GSIS and cAMP levels were abolished by the knockdown of GPR109a.

Our data indicate that niacin treatments leads to hyperglycemia and impaired pancreatic islet function, which is probably via the activation of islet niacin receptor GPR109a-induced pathway. A once daily GLP-1 analogue, liraglutide, is emerging world-wide as a drug for the treatment of diabetes and also, potentially, obesity. This agent not only acts on glycemic control, but also exerts an effect on body weight control, because liraglutide inhibits gastric emptying, resulting in appetite reduction and lower energy intake. Herein, we treated 60 type 2 diabetic obese subjects with 0.9 mg/day liraglutide and examined glycemic control and body weight changes over a 6month period. Glycemic control was markedly improved (baseline HbA1c 9.1 AE 0.2%, endpoint HbA1c 7.6 AE 0.2%) with liraglutide. Based on subgroup analysis, the good responders to liraglutide were (1) BMI <25.

(2) diabetes duration <10 years.

(3) postprandial CPR <3.0 ng/ml.

While liraglutide-induced gastric symptoms, specifically nausea, occurred in nearly all patients at baseline, it had disappeared in about half by the end of the study. Unexpectedly, the HbA1c improvement was not associated with the presence of nausea. While acute body weight loss (1.0 AE 0.2 kg) was observed at 1 month, there were no significant body weight changes at the end of the study. Individual body weight change was associated with the presence or absence of nausea at the end of the study. In conclusion, the effects of liraglutide on body weight loss lasted only a short period and no chronic effects were observed. Thus, the HbA1c lowering effect of liraglutide is not due to reduced energy intake, but rather, to recovery from defects in postprandial insulin secretion.

Background and aims: Durability of good glycaemic control may delay development of diabetic complications. Early initiation of combination treatment with oral anti-diabetic drugs (OADs) having complementary mechanisms of action may increase durability of glycaemic control compared with stepwise addition of OADs. DPP-4 inhibitors such as vildagliptin are good candidates for early use in combination with metformin as they are weight neutral with no additional risk of hypoglycaemia.

Materials and methods: About 2000 drug-na€ ıve patients with type 2 diabetes mellitus (T2DM) with HbA1c between 6.5 and 7.5%, will be randomised in VERIFY, a 5-year, multinational, double-blind, parallel group study. The study will test the hypothesis whether early combination therapy with vildagliptin/metformin will result in lower treatment failure rate or in lower rate of loss in glycaemic control over time than with metformin alone. Other objectives include evaluation of rate of fasting plasma glucose progression, change in HbA1c over time, time to insulin initiation, development/progression of diabetic complications, changes in weight, changes in HOMA-β/IR, safety and tolerability. Insulin secretion rate and insulin sensitivity will be assessed in annual standard meal-test. Patients will also be evaluated for early changes in the vasculature, microalbuminuria and retinal microaneurysms.

Results and conclusions: VERIFY is the first study to investigate the long-term clinical benefits of early combination treatment vs. the standard-of-care metformin followed by addition of OADs. VERIFY will provide valuable data on the durability of glycaemic control, βcell function, insulin resistance, safety and tolerability and explore early changes in the vasculature of patients with T2DM. Patients with metabolic syndrome are at high risk for developing atherosclerosis. Recent studies have suggested glucagon-like peptide-1 (GLP-1) signaling to exert anti-inflammatory effects on endothelial cells, although the precise underlying mechanism remains to be elucidated. On the other hand, PPARc activation was demonstrated to inhibit the transcription of factors, such as NFjB, resulting in atherosclerosis prevention via suppression of the expressions of cytokines and adhesion molecules in endothelial cells. We investigated whether PPARc activation is involved in the GLP-1-associated antiinflammatory action in endothelial cells. We constructed an adenovirus expressing the PPRE (+)-Luc reporter gene for use with the reporter assay system. When we treated HUVEC cells with 0.5 nmol/l exenatide, endogenous PPARc translational activity was significantly elevated by 30% as compared with control cells. The maximum PPARc activity enhancing effect of exenatide was observed 12 h after the initiation of exenatide incubation and was approximately 30% of that induced by 1 lmol/l pioglitazone. When incubated with exenatide and pioglitazone simultaneously, PPARc activity was additively promoted, suggesting that these two agents synergistically stimulate PPARc activity. As H89, a PKA inhibitor, abolished GLP-1 induced PPARc enhancement, the signaling downstream from GLP-1 cross-talks with PPARc activation. In conclusion, our results suggest that GLP-1 has the potential to induce PPARc activity, partially explaining the anti-inflammatory effects of GLP-1 on endothelial cells. Cross-talk between GLP-1 signaling and PPARc activation would confer major impacts on treatment of patients at high risk for CVD events. in the rat hypothalamus by adenovirus-mediated gene transfer and then examined phenotypes of the rats. DnLKB1 significantly inhibited the Thr 172 phosphorylation of AMPK alpha2 subunits, while wtLKB1 did not alter phosphorylation, suggesting that hypothalamic AMPK is activated in basal states and negatively regulated by dnLKB1. DnLKB1-overexpressing rats exhibited body weight gain and slight insulin resistance as compared with wtLKB1-overecpressing or sham operation-rats. Taking into consideration that food intakes did not differ among these rats, this effect was probably due to reduced energy expenditure. In fact, the adipose tissue in dnLKB1-overexpressing rats produced smaller amounts of PGC1alpha and UCP1, resulting in increased adipose tissue weights, as compared with wtLKB1overexpresing rats. Neither hepatic fatty acid synthesis nor gluconeogenesis was significantly altered. The phenotypes observed in dnLKB1-overexpressing rats appear to be like those of AMPK alpha2deficient POMC neuron mice. In conclusion, our findings demonstrated inhibition of hypothalamic LKB1 to lead to reduced energy expenditure and body weight gain, suggesting that central LKB1 is involved in bodyweight regulation probably via AMPK modification.

Material and method: Anthropometric variables and lipid related factors concentration were measured. PCR and RFLP were performed. The distributions of a polymorphic site and its relationship with mentioned factors were examined.

Result: In normal subjects there wasn't any relationship between these three polymorphism and studied profile, but in females with Mets, presence of G allele in rs2075291 significantly increase diastolic blood pressure, low density lipoprotein and apolipoprotein A1 (APO A1) level and the C allele in rs662799, increase waist circumference, triglyceride and APO A1 level.

While previous studies in adults demonstrated that SNPs in APOA5, have primarily been associated with plasma lipoprotein levels and associated downstream consequences, such as weight gain and heart disease risk, In present study we find that there are some relation between this variation and lipid profile in female with metabolic syndrome and this relationship is sex dependent. Tryglicerides mean value was 155 mg/dl and cholesterol 142 mg/dl; the mean value was slightly elevated but inside the lot of the patients the variations were wide probably due to liver inssuficiency (low values) and alcooholic etiology of underlying liver disease (higher values).

Serum uric acid had a mean value of 6.9 mg/dl. No large variations inside the lot.

Medium level of serum creatinine 1.3 mg/dl; higher values in Child C cirrhosis and HCC.

Conclusions: Most of the metabolic disturbancies in HCC are correlated with the underlying liver disease. In a few cases of small lesions but mostly in large and complicated HCC these are significant and require specific treatment. Background: A significant inter-individual variability in statin treatment efficacy is likely to have a strong genetic background. Gene for SLCO1B1 belongs to the candidates with potential to influence the statin treatment efficacy. SLCO1B1 codes for solute carrier organic anion transporter, which has been shown to regulate the hepatic uptake of statins and some other drugs.

Materials and methods: SLCO1B1 rs4149056 (T>C) polymorphism was successfully analysed in the group of 253 patients with dyslipidemia (treated with simvastin or atorvastatin, 10 or 20 mg per day) and 470 healthy normolipidemic controls. The polymorphism was analysed using nested PCR-RFLP. Lipid values (total-, LDL-and HDL-cholesterol, triglycerides) were analysed before and after 10-13 weeks of treatment.

Results: After treatment, as expected, there was a significant decrease both in total (7. Self-care Management), were applied to all patients at baseline and 3month follow-up. T-test and Chi-square test were used to analyze the data. After 3 months, 55 (out of 74) and 30 (out of 48) patients remained in the study. Main findings revealed, a significant difference in A1c level between the groups (P < 0.001). The self-care management score increased in both groups, but the increase was significantly higher in the intervention group (P < 0.001 Methods: After the treatment decision was final, patients were assigned to either vildagliptin or other OADs (sulphonylurea, thiazolidinedione, glinide, a-glucosidase inhibitor or metformin except dipeptidyl peptidase-4 inhibitor or glucagon-like peptide-1 mimetic/ analogue). Demographic data and patient history, especially risk factors and macro-and microvascular complications, were collected and reported by the investigators.

Results: In total, 45,868 patients were enrolled in 27 countries across the world. Baseline characteristics are presented in the table. HbA1c was better controlled in East Asia and Europe than in India, Latin America or Middle East. Patients in Europe had higher BMI and longer duration of diabetes than patients in East Asia and India. Prevalence of risk factors such as hypertension and lipid disorders was high overall, but particularly higher in Europe. Macro-and microvascular complications were reported in 7.3% and 12.4% of the overall study population, respectively, and their prevalence was higher in Europe.

Conclusions: Data from EDGE study show that the HbA1c goal of 7% as recommended by international guidelines is not achieved worldwide and metabolic control varies remarkably between regions. In addition to the high prevalence of concomitant risk factors, complications were reported already after 5 years of diabetes in a substantial proportion of patients. Aim: Sudomotor dysfunction due to small fiber neuropathy can be observed very early in pre-diabetes. The aim of this study was to assess the predictive power of EZSCAN, a non invasive, quick and simple measurement of sudomotor function to identify glucose impairment.

Research design and methods: The study was performed in 76 German subjects at risk of diabetes. Glucose metabolism was assessed by using, oral glucose tolerance test (OGTT) at baseline and after 2 year follow-up. Sudomotor function was evaluated by measuring hand and foot electrochemical sweat conductances to calculate a risk score.

Results: At baseline, 38 patients had normal glucose tolerance (NGT), 34 had pre-diabetes (impaired fasting glucose, IFG and/or impaired glucose tolerance, IGT) and four had newly diagnosed type 2 diabetes. The AUC values for FPG, 2 h-OGTT glucose, 1 h-OGTT glucose, HbA 1C and EZSCAN score to predict pre-diabetes were 0.50, 0.65, 0.64, 0.72 and 0.76 respectively. Subjects having a moderate or high EZSCAN score (>50) at baseline had a substantially increased risk for having IFG and/or IGT at follow-up visit presented by an odds ratio of 12.0 [1.4-100.5 ], the OR for having 1 h-OGTT ! 8.6 mmol/l at follow-up was 9.8 [1.0-92.8 ] and for having HbA 1C ! 5.7 % was 15.7 [1.9-131.5 ] compared to subjects with low EZSCAN risk.

Conclusions: This preliminary study, which must be confirmed in a larger population, shows that EZSCAN measurement is associated with diabetes progression which may have implications for prevention and disease management. Methods: Two groups are involved to the studies -the group of 50 patients with metabolic syndrome (MS) and control group (C)-20 healthy, age matched volunteers. Volunteers were expose to 3-h OGTT (according to WHO) and 8-h OLTT (contained 80 g of fat: 50% saturated, 40% monounsaturated and 10% PUFA). During both tests the blood GLP-1, GIP, glucose, insulin and free fatty acids (FFA) levels were assessed.

Results: Fasting level of incretins do not statistically differ between MS vs. C participants. Only FFAs were elevated during whole OLTT, when the glucose concentrations decreased in early postprandial period. Secretion of GIP was activated by OGTT as well as by OLTT, however concentration of GIP in OLTT was higher. Output of GLP-1 during whole OGTT was significantly lower in patients with MS. In patients with MS amount of GIP released during OLTT was lower compared to control patients.

Conclusion: Low level of incretins during oxidative stress connected with fat food intake, may not provide the protective effect for metabolically stressed pancreatic beta-cells. Background: WHO estimates that 7.5 million deaths worldwide are due to hypertension, approximately 12.8% of all deaths. This is an important risk factor forcardiovascular disease. Argane oil is an integral part of the Moroccan diet. Several studies showed that an argane oil supplemented diet decreased systolic and diastolic blood pressure measurments in animals and suggested that consumption of argan oil may have a beneficial effect in preventing cardiovascular disease.

Objective: To study the effect of a regular consumption of argane oil on hypertension in healthy postmenopausal women.

Methods: Seventy-seven postmenopausal women (55.49 AE 6.17 years) were assigned to consume 25 ml of argane oil during 8 weeks of nutritional intervention. Anthropometric (weight, height and BMI) and clinical profile (blood pressure) have been determined at 0 and 8 weeks.

Results: Showed that systolic blood pressure was significantly reduced (125.1 AE 13.4 to 119.6 AE 15.1 mmHg) after 8 weeks (P = 0.0212). Diastolic blood pressure underwent a slight decrease (81.5 AE 8.6 to 79.8 AE 8.8 mmHg) but not significantly (P = 0.2307).

Conclusion and perspective: These results suggest that consumption of argane oil can be relevant to prevent cardiovascular disease into postmenopausal women and help to decrease cardiovascular risk. The positive impact on blood pressure recorded by a significant decrease in SBP and hypertension is a significant result, however, the mechanisms involved in obtaining this result need to be defined more accurately, focusing mainly on the effects of certain constituents of argane oil as gamma-tocopherol on the mechanisms regulating blood pressure. The epidemic of obesity is associated with multiplication of prediabetic patients. Recognition of them is essential as this state is considered to be the last chance to prevent the manifestation of diabetes.

Our aim was to determine metabolic alterations in healthy men with (DR: n = 14) or without (H: n = 14) first degree 2DM relatives.

Volunteers were adjusted according to age and BMI, insulin resistance was determined with hyperinsulinaemic-normoglycemic clamps and ßsejt function by iv glucose tolerance test.

Fasting glucose, insulin and FFA values were not different among the groups, but at the and of ivGTT, glucose levels were higher (H:5.8 AE 1.5, vs. DR: 7.2 AE 1.4 mmol/l, P < 0.05), injected glucose did not suppressed FFA levels (H: 0.17 AE 0.1 vs. DR:0.36 AE 0.2 mmol/l, P < 0.001) and first phase insulin secretion was decreased in DR group (H:104 AE 63 vs. DR:59 AE 33; P < 0.01).

There were no differences among the groups in total body-, muscle and fat tissue glucose disposal, leptin and resistin levels, but the adiponectin levels were significantly lower in DR group (H: 5.28 AE 2.3 vs. GD:2.86 AE 1.7 mg/ml, P < 0.001) and the FFA/adiponectin ratios were higher (H: 0.10 AE 0.08 vs. GD: 0.29 AE 0.2, P < 0.01).

In conclusion the impairment of insulin secretion and fatty acid metabolism are the earliest sign of diabetes risk in men with first degree 2DM relatives.

The measurement of FFA/ adiponectin ratio could be a simple parameter to screen adult male relatives of diabetic patients for identification of genetic risk of diabetes.

The original Reaven′s definition from 1988, which has been revised in 1993, missed the abdominal obesity.

The definition accepted by WHO in 1999 was not applied due to difficult evidence of the insulin resistance.

A new definition of the MS formulated by IDF and EAD was published in 2005. In this case, the abdominal obesity was the necessary condition of the MS diagnosis.

In order to unify the criteria, five essential parameters of the MS were put on the same level by the international medical organizations in 2009.

It is not easy to define the MS. It cannot be identified as a single disease, as it consists of a complex of problems. That is why the definitions of the MS were rearranged several times during past years and the used parameters are much stricter. We can assume that in the future this process will proceed. Aims: The Metabolic Syndrome (MS) represents an obesity-related severe health problem, and its prevalence is world-wide increasing in parallel with the growing obesity epidemiology. GWA studies have shown that many single nucleotide polymorphisms (SNPs) in several genes are involved in common obesity. The aim of this study was to look for associations between SNPs in the MC4R (rs12970134, rs477181, rs502933), SIRT1 (rs3818292, rs7069102, rs730821, rs2273773, rs12413112) and FTO (rs1421085, rs9939609, rs9930506, rs1121980) genes and obesity and/or MS in a Southern Italy population.

Methods: One-thousand unrelated non diabetic severely obese patients (mean BMI 46.9 kg/m 2 , mean age 32.8 years) and 100 controls (mean BMI 23.2 kg/m 2 , mean age 29.9 years) entered the study. MC4R, SIRT1 and FTO were genotyped by Real Time Taqman assay. Anthropometric, clinical and biochemical data were collected for all enrolled subjects. MS was diagnosed according to the American Heart Association criteria.

Results: Metabolic syndrome was diagnosed in 37.2% of our patients. The four FTO SNPs were significantly associated with the obese phenotype (0.0001 < P < 0.007). At binomial logistic regression analysis, only SNP rs9930609 was significantly associated to obesity after correction for sex and age (OR/95%CI: 2.5/1.4-4.4 and 3.8/1.9-7.5, for the heterozygous and the homozygous mutated genotypes, respectively) and to MS presence (OR/95%CI: 2.5/1. 1-5.5) .

Conclusions: This study confirms that FTO is a susceptible gene for obesity risk, and patients bearing the polymorphic allele in the rs9939609 SNP could be at high risk of MS insurgence, possibly to be addressed toward preventive programs. Results: Number of patients who achieved HbA1c goals according age and presence of CVD are shown in Table 1 .

Conclusion: T2D patient of middle age reached HbA1c goals in lowest percentage of cases. Among different treatment groups percentage of patients reached HbA1c goals were the lowest in group treated by insulin with OAD. 

The prevalence of diseases arising mainly due to the bad lifestyle is increasing. It is necessary to find optimal tools to lower the prevalence of the metabolic syndrome (MS). There is no network of institutions that systematically cooperate in the field of education and treatment of the MS. For students and academics the possibility of establishing (18) and deepening the cooperation in this scientific field is therefore limited.

The role of the project is to strengthen relations between the institutions in the form of cooperating network, which will meet the essentials principles of the primary, secondary and tertiary prevention of the metabolic syndrome. The key role of the project is to open an professional discussion and deepen the communication and professional relationship across the cooperating institutions which are realized primarily through internships of students (bachelor and doctoral degree), academic staff, roundtable discussions with experts and partners from the collaborating institutions, organizing workshops and doctoral and scientific conferences.

Czech Society of Sports Medicine ( CSTL) is a professional guarantor of creating a network of cooperating institutions in terms of the objectives and scientific credibility. Background and aims: Tissue AGEs accumulation is thought to be a specific marker of long-term glycaemic control, oxidative stress and cardiovascular risk. Prediabetes -impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), are considered as risk categories for the development of both type 2 diabetes and cardiovascular disease. The aim of the present study was to assess advanced glycation end products (AGEs) in prediabetes and their relation to anthropometric and glycaemic control parameters.

Material and methods: 185 subjects (mean age 51.6 AE 11.6 years, mean BMI 30.4 AE 5.2 kg/m 2 ) were enrolled. According to glucose tolerance they were divided into two age-matched groups -91 subjects with NGT and 94 with prediabetes (IFG and IGT). Glucose tolerance was studied during OGTT applying 2006 WHO criteria. Plasma glucose was measured by a hexokinase method, HbA1c was assessed immuno-turbidimetricaly. Tissue AGEs accumulation was assessed non-invasively measuring the skin fluorescence of ultraviolet light on the ventral side of the lower arm (AGE-Reader-DiagnOpticsTM). Antropomethric measurements -weight, height, waist circumference, were performed. Visceral fat area was estimated by bioimpedance method (InBody720).

Results: No significant difference in AGEs accumulation was found between the groups with prediabetes and NGT. Significant positive correlation was observed between AGEs accumulation, age (r = 0.0001) and visceral fat area (r = 0.014).

The non-invasive assessment of tissue AGEs accumulation probably is not a sensitive enough method for identifying subjects with prediabetes and increased cardiovascular risk. At the early stages of glucose homeostasis impairment AGEs accumulation appears to be related to age and visceral obesity rather than to glucose tolerance. This study is an observation study for mild diabetic males with BMI of 30 or higher with subsequent 6 month-follow-up based on single administration of exenatide and dietary and exercise intervention.

Method: Subjects were 19 cases of male patients (age: 42.3 AE 11.1, BMI 36 AE 6.1) with apnea hypopnea index (AHI)≧30/hr and 7.5>HbA1c>6.5%. Based on polysomnography and measurements of CT Abdominal visceral fat area and various biomarkers before and 3 and 6 months after exenatide administration, the observation study was conducted for 6 months.

Results: Decrease in bodyweight was observed by 9.7 AE 6.8 kg on average during the 6 months with no cases to gain in bodyweight and BMI.

AHI was significantly improved from 39.6 AE 8.4/h to 18.3 AE 9.6/h. Improvement was observed in HbA1c, 8-OHdG, pro-BNP, high molecular weight adiponectin and visceral fat areas but not in hs-CRP and subcutaneous fat area.

Conclusion: Not only diabetes but also sleep apnea syndrome was improved by exenatide administration in Japanese mild diabetes patient. Weight reduction may have played the primary role.

Effect of weight reduction provided by the pharmacological property of exenatide is useful to improve sleep apnea syndrome. Currently, changes in individual calorie intake and nutrient composition during the study period have been analyzed. [1.064-8.100 ], P = 0.049 in IGT group. No significant association was found between baseline fasting insulin level and progression from either IFG or IGT to type 2 diabetes.

Conclusions: Individuals with IFG or IGT identified through high-risk strategies in a Bulgarian population, have a rather high risk of developing diabetes within 1 year. Baseline proinsulin and proinsulin: insulin ratio, known to reflect beta-cell dysfunction, appear to be independent predictors for progression to diabetes in both IFG and IGT. Introduction: The insulin receptor substrate 1 (IRS-1) seems to be an important factor involved in the modulation of insulin signalling in adipose tissue. In this study we want to check the expression of IRS-1 in visceral and subcutaneous adipose tissue, its relationship with insulin resistance and with the metabolic syndrome.

Material and methods: We measured IRS-1 expression in visceral and subcutaneous adipose tissue from 30 morbidly obese patients. We have determined the level of insulin resistance with the HOMA-IR index. Patients were classified into two groups based on whether or not to have metabolic syndrome (according to the IDF 2005 criteria)

Results: IRS-1 expression in subcutaneous adipose tissue is significantly higher than in visceral adipose tissue (P = 0.002). HOMA-IR was significantly correlated with the IRS-1 expression in subcutaneous adipose tissue (r = À0.449, P = 0.041), but not in visceral adipose tissue (P = 0.198, P = 0.223). The morbidly obese patients with metabolic syndrome have significantly lower IRS-1 expression levels in subcutaneous adipose tissue than those without metabolic syndrome (P = 0.012). In visceral adipose tissue, the levels of IRS-1 are lower but not significant (P = 0.200) in the morbidly obese patients with metabolic syndrome.

The presence of metabolic syndrome in morbidly obese patients is associated with a lower IRS-1 expression level in subcutaneous adipose tissue. In the general population and in HIV+ subjects the Hypertension is the major risk factor worldwide for cardiovascular morbidity and mortality. This condition has been accompanied by several complication, including dyslipidemia and impaired glucose metabolism. For all these reasons identification of hypertension is of pivotal importance in HIV infected patients. Aim of this study was to evaluate the incidence of hypertension and comorbidity in male HIV+ patients.

We enrolled only male patients attending two clinics of the Infectious Diseases in center of Italy (Chieti and Ancona). Three hundred and four patients accepted to participate at the study. Viroimmunological, lipid and metabolic parameters, including triglycerides, cholesterol, HCV/HBV co-infection, tabacco use were measured at the time of enrollment.

The study has shown an incidence of hypertension (ESH guidelines) 36% (109/304 patients), dyslipidemia 55% (167/304), diabetes 7% (22 / 304), HCV or HBV co-infection 23% (78/304) and tobacco use 49% (150/304). Patients with hypertension showed dyslipidemia in 53% of cases (58/109)and diabetes in 12% (13/109). Remarkable that only 49% of patients with hypertension were treated for hypertension. In addition, the average age of the patients in the study was 46.7 AE 10.3 years.

The study has shown a high incidence of hypertension in HIV+ men, even considering the young age of the patients. Furthermore, hypertension is associated with a high incidence of co-mobility. Hypertension is associated with evidence of under treatment, it showing a poor perception of the problem in this context. Method: This study was a 4-weeks', prospective trial in subjects with metabolic syndrome. Metabolic syndrome was defined as the presence of at least three out of five risk factors according to the NCEP-ATP III with the Asian criteria of abdominal obesity (abdominal circumference; >90 cm in men, >80 cm in women). All participants received individualized education by skilled personnel with information about TLC. Blood chemistry including lipoprotein profiles and anthropometric data were collected before and after 4 weeks' TLC.

Result: Eighty-six subjects were screened, and 67 subjects with metabolic syndrome were enrolled. Body weight was not significantly changed after TLC. Fasting blood glucose levels were not significantly changed (from 111.8 AE 11.7 to 110.1 AE 18.4 mg/dl, P = NS). Therapeutic lifestyle change did not result in significant changes in total cholesterol (from 229.6 AE 21.1 to 226.5 AE 26.3 mg/dl, P = NS) and triglyceride (from 177.0 AE 56.6 to 168.2 AE 73.4 mg/dl, P = NS). But, 4 weeks' TLC resulted in significant reduction in LDL-cholesterol levels (from 161.1 AE 21.2 to 147.6 AE 25.1 mg/dl, P < 0.001), increase of HDL cholesterol levels (from 37.7 AE 6.8 to 41.8 AE 8.4 mg/dl, P = 0.001).

Conclusion: Four weeks' therapeutic lifestyle change improved lipoprotein profile (especially LDL-C and HDL-C) in metabolic syndrome. Our findings indicate that the importance of TLC with education should be emphasized for the control of metabolic syndrome.

Nutrition, Hasanuddin University, School of Medicine, Makassar, Indonesia Obesity in major public health and economic problem of global significance. The prevalence of obesity in children has increased significantly, although less rapidly in Indonesia. From the public health view, it is disconcerting that the prevalence of adolescent obesity has increased by nearly 40% in the past two decade.

Case and Control study design was done in Makassar, the participant is senior high school students. The study aim to identify the risk factors of adolescent obesity to premetabolic syndrome by measuring Body mass index, waist circumference, lipid profile (cholesterol, Trigliceride, HDL, LDL and apo B) and fasting oral glucose.

Data was analyzed using SPSS program, the relationship among variables was calculated with Pearson correlation and regression test. The indicators for obesity using waist circumferences and BMI, energy intake using 24 h Food recall and was analysed using WFOOD2.

The study showed, a positive correlation between waist circumference and small density LDL, apo B, cholesterol (P < 0.007, P < 0.000, P < 0.01). Student with abnormal waist circumference tend to have abnormal biochemical markers (OR 0.34, 5.76, and 2.99 ) as a risk premetabolic factors Conclusion: Nutrition education and food balance diet should be given to adolescent obesity to prevent metabolic syndrome in later of life.

L. Mundbjerg 1 , G.F. Thomsen 2 , R. Holst 3 , C. Juhl 1 1 Department of Endocrinology, 2 Department of Occupational Medicine, Hospital of South Western Denmark, Esbjerg, 3 Institute of Regional Health Research, Region of South Denmark, Odense, Denmark Introduction: Severe obesity is associated with reduced worker productivity and chronic absence from work. Gastric bypass surgery is the most effective treatment of severe obesity. The objective of this study was to measure employment status in Danish gastric bypass patients before and after surgery. Methods: The study is a nation-wide retrospective case-control register study. Data were extracted from three sources: 4927 cases were identified in the Danish National Patient Register according to the operational code for laparoscopic gastric bypass surgery and matched on a 1:2 basis with respect to age, gender and residence municipality with control subjects. The employment status was calculated from The Danish National Labour Market Authority's databasedatabase (DREAM) which includes information on all public transfer incomes. By linking the databases we achieved a valid measure of the amount of working days.

Results: The amount of working days was significantly lower in cases compared to controls. There was a significant decline in employment status during the observational period in both groups. This decline corresponded with the timing of the financial crisis (Employment data collected over the period January 1st 2007 to December 31st 2011). There was no significant difference in the decrease of employment status between groups.

Conclusion: Gastric bypass surgery patients are affected by the economic recession in a similar degree as the general population. Thus, the patients do not seem to benefit from the operation nor do they appear particularly vulnerable in periods of recession.

Excessive accumulation of fatty tissue in obesity associated with fat and glucose metabolism. Fish oil contains n-3 PUFAs EPA and DHA had been demonstrated in several studies had effects on the expression of genes PPAR-a and SREBP-1c, the pathomechanism still controversial. This study aims to determine the effect of fish oil on insulin resistance in mice obesity. Clinical trials using C57Bl/6j mice was conducted in Animal Laboratory Medical Faculty Of Hasanuddin University. The mice was giving a normal diet (ND) or high fat diet (HFD) for 12 weeks. Mice was divided by Four groups; normal diet (ND), high-fat diet (HFD), HFD + 3 g/100 g fish oil (HFD-FO), HFD + metformin 3 g/kg diet (HFD-MET) as a positive control for 8 weeks. Gene expression of PPAR-a and SREBP-1c from the liver were measured by RT-PCR. The study showed, HFD mice had significantly higher body weight compared to ND. HFD-FO have higher blood glucose levels than other groups. PPAR-a expression in liver was lower in HFD than ND, but increased in the HFD-FO and HFD-MET compared with HFD alone. SREBP-1c expression decreased in HFD-FO and HFD-MET, glucose metabolism of HFD_FO tended to decrease, while the HFD-MET is likely to increase. We conclude, fish oil improved insulin resistance, decreased expression of SREBP-1c and increased expression of PPAR-a in the liver tissue through decreasing lipogenesis and increased fat oxidation in the liver. Methods: Total 541 subjects were divided into two groups having WHR >0.85 as obese and WHR <0.85 as non-obese. Circulating IL-6 and resistin level, fasting blood glucose, insulin and lipid profile were estimated. Insulin resistance was calculated by the homeostasis model assessment (HOMA) index. The genotype and allele frequency of IL6 -G174C gene polymorphism was determined by PCR-RFLP method in 269 obese and 272 non-obese adult women from North India.

Results: The genotype distribution of IL6 -G174C gene polymorphism was statistically significant in obese women (P = <0.001; OR = 9.428; 95% CI = 4.56-19.492) compared to non-obese women. The circulating level of serum resistin was highly significant in obese women (15.11 AE 8.95 vs. 7.74 AE 4.86 , P = <0.001) compared to nonobese. Significant association was found with CC + GC genotype of IL6 -G174C promoter gene polymorphism in case of waist circumstance, serum triglyceride, HOMA index and serum resistin level (P = 0.031; OR = 0.498, 95% CI = 0.262-0.953).

Conclusion: Serum resistin is associated with the disorder of metabolism of glucose and lipid in metabolic syndrome. The relationship between this hormone with CC + GC genotype of IL6 -G174C promoter gene polymorphism suggests that they may take part in the development of metabolic syndrome in north Indian adult women. The comorbidities associated with excessive weight are major causes of morbidity and mortality, thus causing further reduction in quality of life. The dysfunction of excessive fat and its peculiar distribution plays a decisive role in the development of metabolic disorders. The aim of the study was to estimate the prevalence and the correlates of obesity and dysglycemia in a rural community. Overweight and obesity were defined according to World Health Organization criteria, considering both the value of body mass index (BMI) and waist circumference (WC). Dysglycemia (impaired fasting glucose -IFG and diabetes) was established based on ADA recommendations. The study included 3248 people, 41.28% men and 58.71% women, with the mean age of 50.58 AE 18.26 years. More than half of them (52%) had an excessive weight: 66.66% were overweight and 33.33% were obese. The crude prevalence of overweight and obesity was 33.9% and 12.2% respectively for men, and 35% and 21.3% respectively for women. The prevalence of diabetes was 5.2% and for IFG of 3%. The prevalence of dysglycemia increased with the BMI value, with the highest frequency in the grade III obesity group (16.7% prevalence of diabetes, IFG 8.3%). Large WC was identified in 74.9% of the studied population (53.5% in men, 89.9% women). The individuals with diabetes had a significant higher mean WC (106.23 cm vs. 96.6 cm, P < 0.001). These results show that excessive weight and abdominal obesity could become a public health problem in Romania, thus requiring national screening and educational programs. Objective: Hyperuricemia is associated with obesity; however, few studies reported the effects of surgery types on uric acid metabolism for severe obesity. The current study was aimed to explore the effects of gene and bariatric surgery on uric acid reduction and to identify the potential pathways.

Subjects: All participants were Han Chinese, aged from 20 to 50 years old. A total of 508 severely obese patients with at least body mass index (BMI) of 35 were recruited in the beginning of the study, where 164 cases received laparoscopic adjustable gastric banding (LAGB) and 344 cases received laparoscopic mini-gastric bypass (LMGB). A 12-month follow-up was ensued after surgery to identify the effects of bariatric surgery and estrogen receptor-a (ESR1) gene on serum uric acid reduction.

Results: A tagSNP (rs712221) of ESR1 could influence serum uric acid reduction. Bariatric surgery effect on serum uric acid reduction was greater in LMGB as compared with LAGB at the 12th month of post-surgery (À2.3 AE 2.1 mg/dl vs. À1.2 AE 1.1 mg/dl, P = 0.002). Obese patients carrying risk genotype (TT) on rs712221 and exhibiting better glycemic control had a greater serum uric acid reduction at the 12th month of post-surgery. Synergic effect of rs712221 and LMGB exhibited the highest serum uric acid reduction at the 12th month of post-surgery (À2.7 AE 1.4 mg/dl).

Conclusion: For severely obese Han Chinese, bariatric surgery appears to reduce serum uric acid levels by mediating different factors, including ESR1 gene and gender, ameliorating glycemic control, and changing dietary patterns.

remained significantly lower. Compared to MgC, MgR but not MgRC male offspring had higher body fat % and visceral adiposity at 6 months of age. Results: The average age of patients was 56.36 years, more dominant were females with 83.08%. Patients with MS characterizes increased values of BMI (32.22 kg/m²), which is statistically significantly more that in the control group, where is average value of BMI 24.67 kg/m², waist 107.33 cm in the study group, and 89.09 cm within control group (P < 0.001), blood pressure 139.4/84.9 mmHg, HOMA index 5.16, average value of insulinemia 18.56 (lU/ml), (within control group HOMA1 index was 1.60), the average value of insulimenia 7.37 (lU/ml), average values of: total cholesterol 6.47 mmol/l, HDL cholesterol 1.34 mmol/l, LDL cholesterol 3.38 mmol/l, triglycerides 2.77 mmol/l, relation between LDL/HDL 2.74. Arterial hypertension was present in 93.08%, hypercholesterolemia in 46.15%, reduced HDL in 14.62%, increased LDL in 66.15%, trigliceridemia in 89.23%.

Conclusion: Abdominal obesity is characterized by manifested insulin resistance and distinct hyperinsulinemia. Arterial hypertension as one of the components of metabolic syndrome represents significant cardiovascular risk factor, increased level of triglycerides represents significant risk factor which favors atherosclerosis, in our study the presence of this parameter was 89.23%.

Introduction: Diabetes is the most feared disease because it leads to a variety of complications including end-stage vascular disease, cardiovascular damage and retinal abnormalities. The increased risk of atherosclerotic disease in diabetic subjects may be due to enhanced foam cell formation following an increased susceptibility of low density lipoprotein to oxidative modification. Cardiovascular disease (CVD) is the most prevalent complication of diabetes mellitus.

Methods: The aim of this study was to assess the LDL susceptibility to lipid peroxidation (LDL ox) in two study groups of elderly patients (aged 67 AE 13 years): a group of patients with cardiovascular disease and a group of patient with cardiovascular disease associated with type 2 diabetes mellitus. The LDL susceptibility to in vitro induced lipid peroxidation was evaluated following its incubation with a prooxidant system.

: Results obtained showed the susceptibility of LDL to in vitro oxidation was increase in diabetic group (14.58 %) compared with a cardiovascular disease group.

Conclusion: This study indicates that low-density lipoprotein from diabetic subjects is more susceptible to oxidation. Patients with diabetes have a greatly increased relative risk of developing cardiovascular disease when compared with patients without diabetes. Much of this risk is related to insulin resistance and is associated with both traditional and nontraditional cardiovascular risk factors. Therefore, measurement of LDLox may be helpful for identifying high-risk patients with type 2 diabetes and CVD.

Janus kinase (JAK) and signal transducer and activator of transcription-3 (STAT3) in several cell lines.

Objective: We sought to determine the role of hypothalamic S1PR1 in the control of JAK2/STAT3 signaling and food intake in vivo.

Materials and methods: Western blot, immunohistochemistry, gas analyzer, dissection of the hypothalamic nuclei and intrecerebroventricular (ICV) infusion of S1P (50 ng), Leptin (10 À6 ) and Cucurbitacin (50 lmol/l) were combined to evaluate the role of S1PR1 on leptin signaling and on food intake in lean and obese Wistar rats and in ob/ob mice.

Results: High expression of S1PR1 was found in the hypothalamus when compared to other peripheral tissues. S1PR1 is mainly expressed the arcuate nucleus of the hypothalamus, in the same neurons that possess STAT3. ICV infusion of S1PR1 activator, S1P, increased Jak2 and STAT3 phosphorylation and the energy expenditure and reduced the food intake in lean rats. In addition, S1P potentiated the effects of leptin in the reduction of food intake. Conversely, the pharmacological inhibition of STAT3, blocked the anorectic effect of S1P. Interestingly, low expression of S1PR1 was observed in the hypothalamus of ob/ob mice and Wistar rats fed on high fat diet, whereas, S1P infusion reduced the food consumption and increased leptin signaling and action in obese rats.

These results indicate that hypothalamic S1PR1 has a key role in the control of leptin signaling and on food intake. Aim: The ADIFIT program is an intensive 12-week multidisciplinary treatment program which promotes weight reduction among obese. During the first 6 weeks behavior change, physical exercise, and nutritional counseling is offered three times a half a day per week, thereafter once a week half a day. The aim was to evaluate efficacy of the ADIFIT program in weight reduction, and its effect on eating behavior, and body image.

Methods: Patients were evaluated at baseline (T0) and after 3 month (T1). BMI was assessed. Psychometric instruments such as the German versions of the Eating Behavior Questionnaire (FEV), and the Body Image Questionnaire were used at both time points. Paired-sample t-test and Wilcoxon Signed Rank test were used for statistical analyses.

Results: Fifty patients participated, 86% were female. BMI was significantly reduced from T 0 to T 1 (mean AE SD: 41.1 AE 6.6 vs. 39.8 AE 6.6; t = 7.68, P < 0.000). Results discerned significant improvements from T 0 to T 1 in FKB scale 1 (negative attitudes towards one′s own body) (34.6 AE 6.0 vs. 32.2 AE 6.1; t = À3.68, P < 0.000), and scale 2 (restricted body dynamics) (28.2 AE 7.0 vs. 31.2 AE 6.3; t = À3.86, P < 0.000). On the other hand, FEV scale 1 (cognitive restraint of eating) improved significantly from T 0 to T 1 (8 vs. 15, z = À5.72, r = À0.57, P < 0.000). FEV scale 2 (disinhibition) was significantly lower at T1 (11 vs. 6, z = À5.84, r = À0.58, P < 0.000) as was FEV scale 3 (hunger) (8 vs. 4; z = À4.98, r = À0.49, P < 0.000).

After 12 weeks patients showed significant reduction in weight, improvements in body image and eating behavior. 

Metabolic peptides in serum and plasma samples contain status information for diabetes. Previously, we have demonstrated that intrinsic protease activity caused instability of plasma and serum peptides. Other reports have described that metabolic peptides, including GLP-1, GIP, Glucagon, and Oxytomodulin, are subject to instability caused by proteolytic and other enzymatic degradation intrinsic to plasma. The variability may result in inaccurate quantitative measurements of the peptides creating challenges when interpreting pharmacokinetic and pharmacodynamic data.

Using both mass spectrometry and ELISA based detection methods; we investigated the instability of metabolic peptides in whole blood, serum, and plasma under a variety of routine clinic conditions. First, the same subjects blood was drawn into different blood collection devices including serum and EDTA, Citrate, Heparin, and an EDTA tube containing enzyme inhibitors. The metabolic peptides of interest were spiked into plasma for time incubation at different temperatures. Samples were quenched and processed for both MALDI-TOF MS and ELISA analyses. Quantitative analysis of each marker was used to characterize the kinetics of the peptide digestion ie stability (halflife). Further a blood collection tube was developed to minimize degradation using enzymatic inhibitors specifically for the stabilization of GLP-1, GIP, Glucagon, and Oxytomodulin.

The addition of specific enzyme inhibitors for stabilization of each peptide reveals more insight regarding enzymatic degradation and stabilization of the peptide biomarkers. Our data clearly demonstrates the need of enzymatic inhibitors for peptide stabilization, especially in a clinical setting. (198.55 AE 70.43 mg/dl) . 105 subjects underwent a standardized meal test: 50 g of bread, a boiled egg, 100 g of apple, in the morning after 10 h fasting. Venous blood glucose samples:before meal test (sample 0), 1 h (sample 1)and 2 h (sample 2) after ingestion of standardized meal. neuropathy (P = 0.007). Women had higher prevalence of neuropathy (P = 0.014). People with sensory neuropathy had lower weight and BMI than those with autonomic neuropathy and those without neuropathy (P = 0.060). Fasting blood glucose was higher in subjects with neuropathy (P = 0.037). Value of Sample 1 was increased in people with neuropathy (P = 0.063). Other parameters cardiometabolic risk factors were not associated with diabetic neuropathy at onset of T2D.

Conclusions: Diabetic neuropathy is a frequent complication at diagnosis of T2D. People with higher fasting or postprandial glycemia may associate more frequently diabetic neuropathy at onset.

M. Metalla 1 , M. Carcani 2 , G. Qirjako 3 , E. Demiraj 4 1 Durre Regional Hospital, 2 Endocrinology, Durre Regional Hospital, Durres, 3 Statistical, Mother Teresa University Hospital Center, Tirana, 4 Internist, Durre Regional Hospital, Durres, Albania Background: Metabolic syndrome is a risk factor for cardiovascular diseases and is associated with abnormal cardiac structure and function.

The aim of the study: To evaluate the left ventricular structure and function in patients with metabolic syndrome, without installation of diabetes mellitus or arterial hypertension.

Material and methods: It was analyzed a total of 40 consecutive adults (10-{25%} males and 30-{75%} females) with metabolic syndrome and 20 healthy (10-males and 10 females) without metabolic syndrome. Metabolic syndrome was defined using the ATP lll Criteria. Assessment is done with classic echocardiography, pulsed wave Doppler and tissue Doppler.

Results: There was difference in two groups in BMI, in waist circumference, in systolic and diastolic arterial presure in total colesterol, in level of triglicerid and HDL colesterol P < 0.001. There was no diference in age, fasting serum glucose level, LVEDD, SW, PW, LVM, LVMI, LAV, LVEF, early trans mitral inflow (E), late trans mitral inflow (A) and in the rate E/A (P = 0.2). Echokardiografic measurements by TDI in peak mitral anular velocity in early diastole Ea were 9.1 AE 2.4 vs. 11.9 AE 1.7 cm/sec (P < 0.001) in the metabolic syndrome and controll grups respectively. Average values of Sa were significantly lower in the MS than in controll group, 3.1 AE 0.2 vs. 4.3 AE 3.0 (P < 0.001). The rateE/Ea mitral was 8.4 AE 2.2 vs. 6.7 AE 1.6 (P < 0.01) in metabolic syndrome and controll group respectivly.

The early identification of isolated syndrome in non diabetic, non hypertensive adults may be an indication of an aggressive preventive measure. The fasting Glycaemia altered and hyperinsulinemia are strong predicting factors of type 2 DM (DM2) and sedentary habits can lead to this disease, mainly associated with obesity.

Objectives: Verify the influence of physical activity, VO 2max and anthropometric measurements on glycaemia and insulin fasting in active military over the age of 35 of the Brazilian Army (BA) serving in Rio de Janeiro.

Methods: Two hundred and fifty subjects (aged 42.6 AE 4.8 years), in active duty in the BA, volunteered to participate in the study. The insulin and glycemic levels were measured as well as body mass, stature and waist circumference. Body fat (BF) was measured by hydrostatic weighing, when body density was obtained. VO 2max was measured by maximal cardiopulmonary treadmill exercise test (CPET) using an individualized ramp protocol. Oxygen consumption and carbon dioxide production were measured using a CPX-D metabolic cart.

Results: The prevalence of type 2 DM found was 0.8% and AFG was 14.4%. VO 2max showed an inverse correlation (P < 0.001) with insulin levels, HOMA-IR and fasting glycaemia and also with anthropometric measures and %BF. The BMI and %BF presented direct correlation (P < 0.001) with insulin, HOMA-IR and fasting glycaemia. Subjects in the highest quartiles of VO 2max and in the lowest quartiles of WC and of %GC also presented lower levels of fasting glycaemia and insulin and HOMA-IR.

The data suggest that VO 2max was an inverse and nutritional state a direct relationship between glycaemia and fasting insulin. Subjects with an active lifestyle have less prevalence of alterations in glycaemia and fasting insulin levels. The increase in prevalence of cardiovascular conditions, and metabolic syndrome (MS) observed in the last decades was accompanied by increase in dietary fructose (Fr) consumption (also as sucrose).

The Aim was to assess the prevalence of fructosemia in cardiovascular patients with or without MS and to investigate the possibility of treatment of hyperfructosemia and other components of MS with oral acarbose.

Material and methods: Fasting serum Fr concentration in 245 cardiovascular patients with metabolic syndrome (group 1) and in 69 cardiovascular patients without MS (group 2) was measured by colorimetric method with commercially available BioVision set. 33 patients of the first group were treated with acarbose (Glucobay, Bayer) increasing the dose from 150 to 300 mg per day to normalize the glucose metabolism. Fasting and post oral sucrose load (150 g) serum levels of glucose, Fr, insulin, NEFAs and uric acid (UA) were measured at baseline and in 6 days.

Results: Fasting serum fructose concentration varied widely and among patients in both groups, and was significantly higher in group 1 (390.0 AE 81.2 vs. 349.1 AE 67.7 lmol/l). The data after 6 days and 4 weeks of acarbose use is presented in the Conclusions: Dyslipidaemia is found to be the risk factor for ischemic stroke in diabetic subjects, with statistically significant differences compared to nondiabetics. HDL-cholesterol was found as a protective factor for haemorhagic stroke in nondiabetic subjects. Agave tequilana Weber variety azul is an economically important in mexican people because it is the sole plant allowed for tequila production but because it is a potential source of prebiotics, The Inulin-type agave are nondigestible/fermentable carbohydrates which are able through the modification of the gut microbiota, the POS content of agave inulin differs from inulin extracted from chicory root.

The aim was to assess the efficacy and safety of inulin type agave on lipid profile in dyslipidemic obese subjects.

A clinical trial, open was carried out in 30 obese, hypertrygliceridemic and hypercholesterolemic subjects between 18 and 60 years old. All the subjects received 15 g/day of inulin in the morning, during 60 days. Biochemical and metabolic profiles before and after pharmacological intervention were performed. After inulin administration, there was a significant reduction of the trygliceride concentrations (197.5 AE 72.9 and 179.1 AE 37.0 mg/dl; P = 0.042). Glucose serum (83.0 AE 13.4 and 77.6 AE 12.9 mg/dl; P = 0.007), and HbA1c (5.8 AE 0.4 and 5.7 AE 0.3 % P = 0.007). There was not a significant reduction of total cholesterol, low density lipoprotein and very low density lipoprotein. Anthropometric parameters did not change in the group and soluble fiber intake did not produce any gastrointestinal adverse effect.

The increase of fiber intake (inulin type agave) are efficacy and safety to reduced trygliceride concentrations levels in dyslipidemic obese patients. Stress and strain have long been associated with the work people do. We aimed to investigate occupational stress index and influence of several different work stressors on cardiometabolic risk factors: diabetes, lipid levels in hypertensive workers in South Serbia Methods: We studied 817 persons (professional drivers, construction workers, production line workers and bankers): 504 composed group with hypertension (40-60 years of age, majority males), 313 were age and sex matched controls without hypertension. Clinical examination was performed and blood was sampled. We analyzed work stressors by using questioners with 79 different factors and Occupational Stress Index (OSI) was calculated with permission of dr Belkic. Comparison was made regarding total burden and the nature stress burden (Underload, High demand, Strictness, Extrinsic Time Pressure, Aversive/Noxious Exposures, Threat-avoidant vigilance/disaster potential, Conflict/uncertainty) Results: Diabetes was highly present in bankers (46%) and glucose levels were significantly higher in this subgroup. The incidence of diabetes in construction workers was 15%. Total cholesterol, LDL, triglycerides were higher and HDL lower in bankers and contraction workers (P < 0.001) and linearly correlated with OSI (P < 0.001). Previous myocardial infarction suffered 17.3% of bankers. Total OSI was significantly higher in diabetic hypertensive bankers and construction workers (P < 0.001), as well as high demand, strictness and extrinsic time pressure (P < 0.001).

Conclusion: Hypertension appearance in working population is related to high OSI, especially when other cardiometabolic risk factors added. Further steps are needed to reduce the level of work stressor and provide a better quality of live in individuals. Background and aim: Plasma levels of adipocytokines in healthy individuals or diabetes mellitus patients have been previously reported as well as salivary levels of many adipocytokines. Nevertheless, salivary levels of some adipocytokines in patients with metabolic syndrome have not been investigated. The aim of this study was to evaluate salivary and plasma levels of leptin and adiponectin in patients with metabolic syndrome.

Results: Compared with healthy individuals, leptin levels in patients with metabolic syndrome were significantly increased, both in plasma (6.624 AE 0.774 vs. 15.123 AE 1.396 ng/ml, P < .001) and in saliva (26.053 AE 4.644 vs. 41.523 AE 5.320 pg/ml, P = .036). Whereas plasma adiponectin levels were decreased significantly in patients with metabolic syndrome (31.164 AE 3.331 vs. 17.084 AE 1.802 lg/ml, P = .001), salivary adiponectin levels were inversely increased (2.003 AE 0.438 vs. 6.392 AE 1.508 ng/ml, P = .017).

Conclusion: This study showed that, similarly to plasma, there was an elevated change in salivary leptin levels in patients with metabolic syndrome compared to healthy individuals. However, for salivary adiponectin levels, the opposite result to plasma adiponectin levels was revealed. Replacing saliva to plasma for detecting altered leptin and adiponectin should be concerned in patients with metabolic syndrome. Objective: To examine dietary intake in family members with diabetes type 2 (DT2) to identify contributing factors to glycemic control and development DT2.

Design: Descriptive and prospective study involving 192 members of 40 families who provided food intake from 3 days, 2 weeks days and 1 weekend day. Inclusion criteria were proband member diagnosed with DM2 with ! 2 siblings and living parents.

Methods: Data were collected at the participants' homes or at the University Clinic. The biometric measures were glucose and hemoglobin glucose (HbA1c). Data was entered into Nutritional Data System to Research, the "gold standard" for nutritional analysis. Also, the data entry into SPSS v17 was done. : Of 192, (57% women, mean age 47.82 AE 17.49; , mean blood glucose 131.33 mg/dl AE 64.17; 57-347 and mean (HbA1c) 7. 43% AE 2.33; . Preliminary data indicate intake total fat was higher than the recommendations 94 % of participants, while carbohydrate intake was higher in 78%. Method: This was a retrospective, observational study of consecutive cardiac bypass patients that underwent surgery at Sultan Qaboos Univesity hospital in Muscat, Oman, between 2009 and 2012. Analyses were performed using descriptive statistics.

The study included a total of 101 cardiac bypass surgery patients with an overall mean age of 60 AE 10 years and 76% (76/101) were males. Mean body mass index was 27 kg/m 2 ranging from 17 to 38 kg/m 2 . Twenty-seven percent of the patients were either past or current smokers while 16% (16/101) had a family history of coronary artery disease. All but 2 of the patients (98%) were on statins pre-op. The most prominent co-morbidities were hypertension (93%), angina (90%), diabetes mellitus (72%), myocardial infarction (52%), and congestive heart failure (36%). The mean average pre-op total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, apolipoprotein A1 (apo A1), and apolipoprotein B (apo B) were 4.4 AE 1.2 mmol/l, 2.6 AE 1.0 mmol/l, 0.97 AE 0.27 mmol/l, 1.9 AE 1.4 mmol/l, 1.13 AE 0.18 g/l, and 0.91 AE 0.25 g/l, respectively. Eighty-one percent, 13%, and 6% of the patients had 3 or 2 or 1 diseased heart vessels, respectively. There was a total of 58%, 30%, and 10% of the patients that had on-pump, off-pump, and on-pump beating coronary artery bypass surgeries, respectively. Mortality was recorded in two patients (2%) in an approximately 4-year period.

Conclusions: Patients undergoing cardiac bypass surgery were observed with a high prevalence of cardio-metabolic risk factors. Aim: To evaluate the association between osteocalcin and phenotypic characteristics of metabolic syndrome.

Material and methods: Data of 276 children and adolescents participants of the project "Health Worker Cohort Study" was analyzed. To each participant we determined: insulin, glucose, triglycerides, HDL, waist circumference and blood pressure. Glucose and insulin were evaluated by glucose-oxidase method and HOMA. Total osteocalcin concentration was determined by chemiluminescence. Body mass index (BMI) was evaluated according to CDC chart′s for children and adolescents according to age and sex. Using multiple lineal regression and logistic regression we evaluated the association between osteocalcin values and components of metabolic syndrome.

Results: The proportion of male in the study population was 51.5%. The prevalence of overweigh and obesity was 33.4% and abdominal obesity was 26.4%. The proportion of elevated glucose, hypertriglyceridemia, low levels of HDL, hypertension and metabolic syndrome were 4.4%, 17.5%, 50.6%, 2.2% and 7.0% respectively. Difference of medians according to ages groups, was observed for glucose, insulin, HOMA and osteocalcin (P < 0.05). The study showed a negative correlation between BMI, fat percentage, waist circumference, glucose levels and CRP with ostelcalcin levels (P < 0.05).

Conclusions: Serum osteocalcin levels were associated with some phenotypic characteristics of metabolic syndrome and measures of adiposity. Background: Previous studies show that hyperuricemia precede the development of the metabolic syndrome and can be a risk factor to diabetes type 2, cardiovascular disease and heart failure, independently of obesity.

Aim: To identify the association between hyperuricemia and cardiovascular risk factors (CRF).

The study population included 746 adolescents, all of them participants from the "Cohort Study of Health workers". CRF were evaluated according to IDF pediatrics criteria. The cut-off points for hyperuricemia was levels of uric acid >7 mg/dl, for hyperinsulinemia >20 mU/l, insulin resistant (IR) have HOMA >3.16. A multivariate regression analyses was used to evaluate the association between hyperuricemia and CRF.

Resultados: The proportion of female in the study population was 52%. Mean age was 14 AE 3.7 years, prevalence of BMI >p85 was 30%, abdominal obesity (26.1%), hypertension (2.8%), hyperuricemia (10.7%), glucose ! 100 (3.9%), hypertrigliceridemia (19%), low levels of HDL (62%), hyperinsulinemia (18%), IR (26%), CRP (11.3%) and MS (8.85%). Proportion of hyperuricemia was six times higher in men, (19 vs. 3.1, P < 0.01). The study show association between hyperuricemia and age (OR:2.2;IC 95% 1.3-3.6), hypertrigliceridemia (OR:2.8;IC 95% 1.6-5.0) hyperglucemia (OR:3.4;IC 95% 1.2-9.4), hyperinsulinemia (OR:3.1;IC 95% 1.7-5.5), IR (OR:2.7;IC 95% 1.5-4.7), abdominal obesity (OR:6.0;IC 95% 3.5-10.2) and MS (OR:6.2;IC 95% 3.2-11.8).

Conclusions: Hyperuricemia is associated to CRF. Hyperuricemia is not considered for adolescent health diagnostic. However early diagnostic is important for avoid the presence of several CRF. Method: Pancreas of fetuses and offspring from diabetic and nondiabetic Sprague-Dawley rats were obtained and processed for histological and morphometric studies and for inmunohistochemical analysis of Pdx. 1, insulin and GLUT2.

Results: Fetuses of diabetic mothers, showed a significant delay in the morphogenesis of the islets, with a significant reduction of the diameter, area and beta cell mass and expression of Pdx1, Insulin and GLUT2. These fetal alterations had an impact on postnatal life and offspring of diabetic rats had significantly higher glucose levels. In offspring of 20 days, the alterations persisted and the expression of Insulin and GLUT2 was significantly lower. At 28 days the islets were mature but the size, beta cell mass and expression of Insulin, GLUT2 and Pdx.1 were still significantly lower. At 90 days the structure of the islets was normal, but the reduction in size, beta cell mass and expression of GLUT2 persisted, but with no significant reduction in the expression of Insulin and Pdx.1

Conclusions: In utero hyperglycemia induced a delay on the differentiation of beta cells and morphogenesis of islets, a reduction of the beta cell mass and in the expression of Insulin, GLUT2 and Pdx.1. These alterations persisted up to adulthood causing hyperglycemia to offspring.

G. Yoshino 1 , T. An 2 , S. Nakano 2 , K. Kuboki 2 1 Center for Diabetes, Shinsuma General Hospital, Kobe, 2 Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University, Tokyo, Japan Background and aim: It has been a matter of debate whether the intervention is necessary even for elderly metabolic syndrome subjects. Present study is therefore conducted to explore whether the elderly subjects with metabolic syndrome show increased CAD risk measuring plasma small, dense LDL-cholesterol, hs-CRP and plaque score of the carotid artery.

Methods: A total of 130 subjects including 88 male ranging from 30 to 85 years-old, were recruited for this study. They are divided into four groups according to their age (below 64 and above 65 years-old) and an association of metabolic syndrome. Blood sampling was done after overnight fast. Small, dense LDL-cholesterol was measured employing direct assay method.

Results: In the non-elderly subjects, plasma triglyceride, small, dense LDL-C, hs-CRP and plaque score of carotid artery were all increased in the metabolic syndrome group compared to that of non-metabolic group, while there was no significant difference in either hs-CRP or the plaque score between the two groups within elderly subjects. Within the elderly metabolic syndrome group, subgroup with type 2 diabetes had higher fasting blood glucose, hs-CRP, small, dense LDL-C and plaque score than the subgroup without type 2 diabetes.

Conclusion: Metabolic syndrome is an important factor for progression of subclinical atherosclerosis in the non-elderly subjects, but it cannot be a significant determinant of subclinical atherosclerosis if the subjects are limited within elderly group without type 2 diabetes. Thus, intervention for metabolic syndrome may not be obligatory for elderly metabolic syndrome subjects if they are not diabetic.

Methods: A retrospective cross-sectional study of randomly selected 101 patients on antihypertensive drugs at the outpatient clinic at Sultan Qaboos University Hospital, Muscat, Oman. The recorded variables included age, gender, history of diabetis mellitus, weight, fasting blood glucose, creatinine level, systolic blood pressures (SBP), diastolic blood pressure (DBP), and type of medication. All Parameters were collected of the last two visits from (January 2011 and December 2011) for each patient who had been labeled with persistent hypertension using the hospital information system (HIS). Analyses were conducted using descriptive statistics.

Results: Overall mean age of the cohort was 58 AE 11 years, 56% were male, 47% were diabetic, mean SBP 137 AE 20, DBP 76 AE 14, weight 77 AE 17, and FBG 7.4 AE 3. On visit 2, 88% were on B-blockers, 26% patients were on Calcium channel blocker, 26% on Angiotensinconverting enzyme inhibitor and 14% were on Diuretics either as a monotherapy or in combination. Target BP was attained in 23.40% patients with diabetes mellitus compared to 37.04% in non diabetics after the second visit. The mean body weight in patients with controlled hypertension was 73.6 kg compared to 78.8 kg in patients with uncontrolled hypertension.

The study showed that diabetes mellitus, increased body weight and high fasting blood glucose reduces the attainment of blood pressure goal in patient on antihypertensive therapy. 

Purpose: Comparable evaluation of lipid profile and inflammatory markers between patients with stable angina (SA) and patients with SA and diabetes mellitus of type 2 (DM).

Material and methods: A total of 66 patients with SA (mean age 57.4 AE 7.5 years) with coronary stenosis <70% were examined. Group I included 37 patients with SA and DM; Group II -29 patients with SA without DM. Lipid profile parameters; inflammatory markers (hs-CRP, TNF-alpha, homocysteine, interleukine 1 β, 6, 8; sCD40 L, MMP-9, TIMP-1); endothelial dysfunction markers (endothelin-1, nitrites) were measured initially and in 1 year.

Results: There were high levels of hs-CRP, TNF-alpha, lipoprotein (a), MMP-9, triglycerides, and endothelin-1 in both groups. The level of TIMP-1 reduced in both groups. Patients in Group 1 had significantly elevated levels of total cholesterol, LDL cholesterol, homocysteine, Apo-B, Apo-B/Apo A-1 ratio, IL-1 β. In Group 1 the following positive correlations were found: between glycohemoglobin and Apo-B, Apo-B/Apo A-1 ratio, homocysteine; IL-6 and hs-CRP; homocysteine and LDL cholesterol, MMP-9, duration of coronary artery disease; endothelin-1 and sCD40L, TNF-alpha. Reliable increasing homocysteine, TNF-alpha MMP-9, LDL cholesterol were revealed in both groups.

Conclusions: Prospective study showed that both groups had similar blood biochemical abnormalities. However in patients with DM there was an increase in the levels of atherogenic lipid fractions as well as homocysteine, TNF-alpha and MMP-9 which may indicate a higher risk of developing coronary events even in the absence of significant coronary stenosis. Objectives: IL-18 is a pleotropic cytokine and is reported to be involved in various inflammatory and immune-mediated disorders. Previous data in Apo E-/-mice demonstrated that IL-18 accelerates atherosclerosis via IFN-c and CXCL16 expression and the effect was independent of T-cells. We therefore investigated whether IL-18 is involved in cholesterol efflux and plaque stability.

Methods: Two groups of chow-diet-fed, male Apolipoprotein E-/mice, aged 12 weeks (n = 6/group) were fed a normal diet and injected intraperitoneally for 30 days with either recombinant IL-18 (30 ng/g/ day) or with phosphate buffer saline (PBS). mRNA expression of IL-18, scavenger receptor CD36, MMP-9 and LXR-a genes was determined by Real-Time PCR. Immunohistochemistry was also performed for expression of above genes.

Results: IL-18 administration led to a significant increase in serum cholesterol and lipoproteins except HDL-C which was decreased. In heart and aortic tissues, expression of IL-18, scavenger receptor CD36 and MMP-9 genes increased 3.5, 8 and 3 fold respectively, whereas expression of LXR-a gene was reduced by 0.6 fold. Atherosclerotic lesion size was quantified in the ascending aorta and the aortic arch. Exogenous IL-18 administration significantly increased frequency of atherosclerotic lesions and lesion area in IL-18 treated mice vs. control animals (1.15 AE 0.71% vs. 5.39 AE 1.70% (P < 0.01; PBS vs. IL-18 group).

The observed data strongly implicates IL-18 as a proatherogenic and proinflammatory molecule which not only enhances inflammation but augments CD36 and MMP-9 expression which may lead to enhanced foam cell formation and plaque instability and thereby aggravate atherosclerosis. Objective: The present study was attempted to found the association between TNF-a promoter gene G-308A polymorphism with Metabolic Syndrome and insulin resistance.

The G-308A TNF-a polymorphism has been studied in 305 subject with Metabolic Syndrome according to NCEP ATP III criteria (Age 31.91 AE 6.05; BMI 28.1 AE 5.09) and 310 healthy control without Metabolic Syndrome (Age 30.96 AE 7.01; BMI 22.98 AE 4.36). The G-308A variant was detected by PCR amplification and Nco-1 digestion. Furthermore Insulin Resistance, Serum Leptin and TNF-alpha levels were also measured in both the groups. polymorphism was significantly less frequently observed in the control population as compared to study group. Furthermore, on dividing the subjects into two groups according to the absence (homozygous for the wild type G allele) (TNF-1 allele) or presence of the mutant A (TNF-2) allele, significantly high levels of TNF-a (P = 0.001, OR = 1.80, 95% CI = 1.25-2.60) and Leptin (P = 0.003, OR = 2.19, 95%CI = 1.43-3.36) were observed in TNF-2 group as compared to TNF-1 group. Whereas, there was a non-significant tendency toward insulin resistance in the TNF-2 group.

Conclusions: Our results suggest that the G-308A mutation of the TNF-a gene is likely to play an important role in the development of metabolic syndrome and metabolic abnormalities.

METABOLIC SYNDROME IS ASSOCIATED WITH RESIDENTIAL-AREA CRIME RATES FOR MEN AND PERCEIVED CRIME FOR WOMEN: GENDER DIFFERENCES IN SOCIAL VULNERABILITY TO METABOLIC SYNDROME Introduction: Crime rates and perception of crime within neighbourhoods have been linked to residents' cardiometabolic outcomes. Men and women vary in their perception of crime but share exposures to residential-area crime. It is unclear whether gender differences exist in the nature of crime-related vulnerability to metabolic syndrome.

Aim: To assess gender-specific associations between perceived and reported crime, and metabolic syndrome (MetS)

Methods: Cross-sectional data from a biomedical cohort study of adults randomly selected from the north-west region of Adelaide, South Australia, were analysed (n = 1.444) (mean age = 54.5, standard deviation = 14.2). Clinically measured MetS was defined using International Diabetes Federation criteria. Perceived crime was expressed as a standardised factor score reflecting six items related to neighbourhood safety and crime. Reported crime rates were obtained from police data, aggregated at the Statistical Local Area level (n = 26) and standardised. Associations were evaluated using multilevel regression models accounting for area-level clustering and covariates including area-level income and participant sociodemographic factors.

Results: The prevalence of MetS was, for men (n = 680), 41.9% (95% CI = 38.2-45.7), and for women (n = 764), 29.1% (95%CI = 25.9-32.4). For men, MetS was associated with rates of violent crime (OR = 1.22, 95%CI = 1.01-1.47) and total crime (OR = 1.21, 95% CI = 1.01-1.46), but not perceived crime. For women, MetS was associated with perceived crime (OR = 1.26, 95%CI = 1.05-1.50), but not reported crime.

Conclusions: Crime is an adverse social exposure. MetS is associated with perceived crime in women and reported crime rates in men. These differentials suggest gender-specific causal pathways by which awareness and perception of adverse social exposures relate to MetS independent of socioeconomic factors. 

Background: Epidemiological studies suggest that the resting heart rate (RHR) is an independent predictor of cardiovascular and all cause mortality. However, the power of the RHR to predict cardiovascular events in patients with the metabolic syndrome (MetS) is not known.

Methods: We prospectively investigated the relationship between RHR and cardiovascular events in 756 consecutive patients undergoing coronary angiography for the evaluation of coronary artery disease (CAD) over a follow-up period of 7.1 AE 0.1 years. The MetS was defined according to NCEP-ATPIII criteria.

Results: In the total study population, both all cause and cardiovascular mortality were increased with an increasing RHR (standardised adjusted HRs 1.03[1.01-1.04]; P = 0.001 and 1.15 [1.03-1.47 ]; P = 0.001, respectively). From our patients, 357 (47.2%) had the MetS and 399 did not have the MetS. Among patients without the MetS, a higher baseline RHR indicated a significantly higher risk of total mortality (H = 1.14[111-1.16], P = 0.001) and cardiovascular mortality (HR = 1.13 [1.12-1.16 ], P = 0.001) after multivariate adjustment. However, the RHR did not significantly affect total mortality (P = 0.120) or cardiovascular mortality (P = 0.244) in patients with the MetS. Interaction terms RHRxMetS were significant for both total and cardiovascular mortality (P = 0.027 and P = 0.037, respectively), indicating that the respective risks conferred by a high RHR were significantly higher in patients without the MetS than in patients with MetS.

Conclusion: We conclude that among angiographically characterized coronary patients, the metabolic syndrome status significantly affects the association of the RHR with total and cardiovascular mortality: RHR is a strong predictor of both total and cardiovascular mortality among subjects without the MetS, but not among MetS patients. Aim: To estimate influence of diet therapy, physiotherapeutic treatment to body mass reduction and prevention of cardiovascular and metabolic risks.

Patients and methods: Were surveyed 62 patients with a metabolic syndrome aged of 24-52 years: 35 women (56 %) and 22 men (44 %): 8 (13 %) pts were overweight, 34 (55 %) pts had BMI 32.6 AE 0.39 kg/sq.m, 20 pts (32 %) -BMI 37.6 AE 0.38 kg/sq.m. 77 % pts had hypercholesterolemia, 48 % -glucose intolerance, 27 % -high arterial blood pressure. All patients were undergone by the assessment of nutrition status, biochemical researches. There was executed food allowance correction and added complex of physiotherapeutic treatment. Control examination was carried out in 4 weeks by body structure definition by bioimpedance analysis and biochemical blood tests.

Results: There were noted that level of cholesterol decreased from 6.4 AE 0.22 mmol/l to 5.0 AE 0.28 mmol/l (P 0.05), level of blood glucosefrom 6.27 AE 0.34 mmol/l to 5.6 AE 0.3 mmol/l. There was registered decreasing systolic arterial pressure of 92 % of patients to 135.3 AE 3.99 mmHg (P 0.05) and diastolic at 82 % pts -to 93.3 AE 1.19 mmHg (P 0.05). There were fined reduction of a fatty component on 3.1 AE 0.61 by kg, with preservation of active cellular weight -0.5 AE 0.28 in kg (P < 0.05) in patients.

Conclusions: Physical exercises, physiotherapeutic procedures jointly balanced food allowance promote more considerable decrease in weight of body and decrease in cardiovascular and metabolic risks. Results: After adjustment for sociodemographic and lifestyle factors, the relative risk (RR) of PD comparing subjects with metabolic syndrome to those without it was 0.41 and the 95% confidence interval (95% CI) 0.22-0.74. This association was especially due to high serum triglyceride levels ( ! 1.7 vs. <1.7 mmol/l, RR 0.43, 95% CI 0.23-0.81), and high plasma glucose levels ( ! 5.6 vs. <5.6 mmol/l, RR 0.52, 95% CI 0.28-0.98). The results remained after excluding the first 10 years of the follow-up. After this exclusion and further adjustment for other components of the metabolic syndrome, the suggestive association between PD and BMI was strengthened ( ! 25 kg/m 2 vs. <25 kg/m 2 , RR 1.75, 95% CI 1.00-3.07).

Conclusions: High serum triglycerides and plasma glucose levels predicted low PD incidence, even after excluding the presumable preclinical disease phase. Also, the suggestively increased PD risk in subjects with high BMI varied according to the follow-up time, proposing that an adequate time period should be considered to account for the preclinical disease phase in PD. Pancreatic Intrinsic Nervous System (PINS) maturation goes on postnatally and is involved in the control of pulsatility and amplitude of insulin secretion (IS), both altered in obese and diabetic patients. The aim of our study was to determine the impact of obesity in infancy on PINS maturation and control of IS.

C57BL/6J mice aged 4 weeks received a normal (ND) or a western diet (WD) for 12 weeks. 4 weeks old mice were used as initial controls (T0). After sacrifice, pancreases were placed in organ incubators for 1 h. The impact of PINS upon IS was studied by adding to the culture the nicotinic receptors agonist DMPP in presence or absence of L-NAME (inhibitor of NOS) or SNP (NO donor). Insulin was assayed in culture supernatants. PINS density and phenotype were determined by IHC.

PINS density was less in ND compared to T 0 mice, whereas there was no difference between WD and T 0 mice. Cholinergic innervation significantly increased with age in both WD and ND mice whereas nitrergic innervation increased in ND mice and decreased in WD. PINS stimulation by DMPP induced a time-dependent increase in IS, significantly larger in ND compared to WD mice. IS profile was identical in WD and T 0 mice. Addition of L-Name inhibited DMPPinduced IS in ND mice while SNP tended to reduce it. Neither L-Name nor SNP altered IS in WD mice.

Our study suggests that WD induces neuroplastic changes in the PINS that could be involved in pancreatic dysfunctions observed during obesity. Purpose: Inflammation drives the progression from central obesity to insulin resistance, metabolic syndrome and hypertension. Whether inflammation caused by allergic diseases such as allergic rhinitis can predispose to hypertension is controversial. Therefore, we studied the association between hay fever and hypertension in the United States National Health and Nutrition Examination Survey (NHANES).

We analyzed data on 1883 men and 2029 women in NHANES 2005 NHANES -2006 . We included participants aged 20 years or older who had valid data on hay fever and hypertension.

Results: 13.5% of the participants had a previous diagnosis of hay fever and 36.2% of them had hypertension. There were ethnic differences in the prevalence of previous hay fever diagnosis (P < 0.001) and hypertension (P < 0.001). Overall, there was no significant association between previous hay fever diagnosis and hypertension. In women aged 20-39, there was an association between previous hay fever diagnosis and hypertension (OR = 2.59, 95% CI = 1.26-5.30, P = 0.013). This association was not diminished after adjustment for age, race and body mass index (OR = 2.74, 95% CI = 1.48-5.06, P = 0.003). After further adjustment for physical activity, alcohol consumption, smoking, liver enzymes, C-reactive protein and IgE level, the association remained significant (OR = 2.72, 95%CI = 1.19-6.22, P = 0.021).

Conclusions: In this nationally representative population-based survey, previous hay fever diagnosis is not significantly associated with hypertension in adults, except for women aged 20-39. Further work is needed to confirm that this is a true association. The University of Hong Kong, Hong Kong, Hong Kong S.A.R.

Objective: Beta-2 microglobulin (B2M) is the light chain of the major histocompatibility complex Class 1 molecule. Glycation of B2M renders it toxic. Serum B2M level predicts mortality in chronic kidney disease and some malignancies such as multiple myeloma. We hypothesized that it also predicts mortality in people with diabetes.

Research design and methods: 897 participants of the Third National Health and Nutrition Examination Survey aged 20 or above who had diabetes or were on medication for diabetes were included in the analysis. Results: During a median follow-up of 11.8 years (range 0.1-18.2 years) and 9.222 person-years, 207 (16.8%) and 542 (42.4%) participants died from diabetes-related causes and all causes, respectively. Tertile 3 of B2M was significantly associated with allcause (hazard ratio (HR) = 3.28, 95% CI: 1.54-7.00) and diabetesrelated mortality (HR = 4.03, 95% CI: 1.20-13.59). The association was independent of cardiometabolic risk factors, cancer, microalbuminuria and impaired glomerular filtration rate.

Conclusions: Serum B2M level is a novel independent predictor of diabetes and all-cause mortality in people with diabetes. An elevated level is associated with a substantially increased risk of death. Metabolic syndrome (MS) refers to a constellation of factors that increase risk of cardiovascular diseases (CVD) and diabetes. Insulin resistance and associated abnormalities is considered to be a link between obesity and CVD. Our ongoing study investigates relationship of anthropometric, metabolic and cardiovascular parameters in young patients with incipient MS (young lean subjects with essential hypertension; HT) and obese otherwise healthy subjects (OB) in comparison to healthy lean controls (C) similar for age and sex.

Methods: All subjects underwent the oral glucose tolerance test. The insulin sensitivity index according Matsuda (ISIMAT) and IR HOMA were calculated. Fasting serum concentration of total cholesterol (Tchol), HDL cholesterol, triglycerides (TG), and uric acid as well as fasting and post load plasma glucose and insulin concentrations were measured.

Results: Young lean HT patients had comparable BMI but higher body fat percentage (P = 0.03), higher fasting plasma insulin (P = 0.03), slightly higher uric acid (P = 0.05), and higher T-chol (P = 0.01) than C. Despite NGT, HT patients had lower ISIMAT (P = 0.02) and higher IR HOMA (P = 0.03) than controls., but these parameters were comparable to the OB group. 2/3 of young lean HT patients similarly to OB otherwise healthy subjects exhibited three and or more features of MS.

Conclusions: Young lean patients with hypertension displayed signs of insulin resistance comparable to obese subjects and metabolic abnormalities typical for metabolic syndrome. Early life style interventions might prevent theto development of complete MS in these young HT and OB subjects.

increased prevalence of overweight in male patients, whereas women had increased prevalence of obesity (Grade II and III). Hypertensive diabetic subjects with other metabolic risk factors are more prone to microvascular and macrovascular complications. Methods: Eighty-six patients were divided into two groups. The group 1 included 46 subjects (mean age 47.20 AE 9.6 years) with AH and AO (mass body index (MBI) 34.5 AE 3.9 kg/m 2 ) and the group 2 -40 subjects (mean age 45.30 AE 10.2 years) without metabolic disorders. The parameters of 24-hour BP monitoring; microalbuminuria and MDRD; total cholesterol, low-density lipoprotein cholesterol, highdensity lipoprotein cholesterol, triglyceride, diene conjugates (DC), malonic dialdehyde (MD), catataze and inflammatory markershomocysteine, high-sensitivity C-reactive protein (hs-CRP) and fibrinogen were estimated.

Results: In group 1 there was registered increase in mean 24-h and daytime systolic BP, time and square indices, in night time systolic and diastolic BP variability. In renal function factors there was registered increase MDRD. In biochemical parameters there was detected increase in total cholesterol, triglyceride level, MD and DC level, fibrinogen and hs-CRP level; and decrease of catalase level; high density lipoprotein cholesterol compared to group 2. Besides in group 1 positive correlation between lipid and inflammatory markers against each other and with parameters of 24-h BP monitoring, microalbuminuria, MDRD and MBI was found.

Conclusion: We revealed relationship between blood pressure profile parameters, renal function parameters, atherogenic lipid profile parameters, inflammatory markers and MBI, that is indicative of development of cardiovascular and cardiorenal risk in patient with AH and AO. There is considerable interindividual variation in therapeutic response to metformin in women with PCOS and obesity. Genetic factors may play an important role in therapeutic response to metformin and TCF7L2 gene could be one of such factors. TCF7L2 marker is one of the strongest risk factors known for predicting increased likelihood of conversion from prediabetes to T2D. TCF7L2 belongs to a subfamily of TCF7-like HMG box-containing transcription factors. TCF7L2 is a component of the Wnt-signaling pathway and determine the glucoseinduced insulin secretion and regulates the maturation of β-cells of the pancreas from pluripotent stem cells. In addition, this gene plays an important role in adipogenesis and differentiation of adipose tissue.

The aim of our study was to evaluate the efficacy of using metformin in patients with PCOS and obesity in relation to their rs7903146 polymorphism of the TCF7L2 gene. 56 patients with PCOS and obesity receiving therapy with metformin were examined. Comparative analysis revealed a significant increase in the frequency of genotype C/T (v 2 = 14.93; P < 0.001; OR = 4.89; 95% CI = 1.19-20.13) and T/T (v 2 = 14.93; P < 0.001; OR = 4.61; 95% CI = 0.54-39.49) in the group of patients with positive dynamics of treatment with metformin compared with the group without positive dynamics of treatment.

Thus, patients with PCOS and obesity who possess the genotype C/T and T/T of the TCF7L2 gene are more likely to have positive therapeutic response to metformin. Objective: To investigate the relationship between resistin gene polymorphism with its circulating level, metabolic risk factor and insulin resistance in adult women.

Design: Total 615 healthy subjects were enrolled for the study, 305 (age 30.12 AE 6.70 years) were with metabolic syndrome and 310 were age matched control (age 29.07 AE 7.28 years) without metabolic syndrome. Circulatory resistin, insulin, plasma glucose and lipid profiles fasting level were estimated along with insulin resistance. Resistin-C420G promoter region polymorphism were done by RFLP method digested with BbsI restriction enzyme.

Results: Homozygous mutant genotype (CC) (CC v/s CG + GG) (P = <0.001: OR = 2.22: 95% CI = 1.60-3.10) of the 420C/G resistin gene polymorphism was significantly less frequently observed in the control population. On dividing the subjects further in to two groups according to the abscence (Resistin-1) and presence (Resistin-2) of the mutant G allele, significantly high levels of resistin (P = 0.006, OR = 1.90, 95% CI = 1.22-2.98), Triglyceride (TG) (P = 0.0001), plasma Glucose (P = 0.01), Systolic Blood Pressure (SBP) (P = 0.0003), Diastolic Blood Pressure (DBP) (P = 0.0003), WHR (P = <0.001) were observed in resistin-2 group .

Conclusion: Our results conclude that the 420 C/G mutation of the resistin gene is likely to play an important role in metabolic syndrome and metabolic abnormalities. Background: In both obesity and allergy, inflammation occurs. Therefore, we examined the association between body mass index (BMI), a measure of general obesity, and serum IgE level, a measure of allergy. excluded from this study. Using the complex sampling function of SPSS, the unstandardized regression coefficient, b, for the relationship between BMI and the natural logarithm of IgE level was calculated.

Results: There was a sex difference in IgE level (P < 0.001). Before adjustment, IgE was associated with BMI in women (b = 0.451, P = 0.006) and in the overall population (b = 0.338, P = 0.001). After adjusting for race/ethnicity, age and sex except in sex-specific analysis, the association in women (b = 0.382, P = 0.018) and the overall population (b = 0.309, P = 0.006) remained significant. After further adjustments for physical activity, alcohol consumption and smoking, the association was still significant in women (b = 0.373, P = 0.010) and the overall population (b = 0.323, P = 0.003). The association was attenuated but remained significant in women (b = 0.233, P = 0.036) and the overall population (b = 0.179, P = 0.042) after further adjustment for levels of liver enzymes and C-reactive protein.

Conclusions: In this nationally representative population-based survey, IgE level is associated with BMI. The attenuation in the association after controlling for liver enzymes and C-reactive protein suggests that hepatic inflammation accounts for some of the association. 

Background: Janus kinase (JAK) 3 is involved in cytokine receptormediated intracellular signal transduction. Inhibition of JAK3 protects beta-cells from cytokine toxicity and has been shown to delay the onset of diabetes in the mouse model. The influence of JAK3 single nucleotide polymorphisms (SNPs) on diabetes risk or on diabetesrelated metabolic traits is unknown.

Methods: We therefore investigated the association of JAK3 tagging SNP rs3212780 (C>T) with metabolic phenotypes and type 2 diabetes (T2DM) in a cohort of coronary patients including 1220 non-diabetic subjects and 375 patients with T2DM, totally comprising 1595 individuals.

Results: Among non-diabetic subjects SNP rs3212780 was significantly associated with HbA1c (CC: 5.8 AE 0.4, CT: 5.7 AE 0.4, TT: 5.6 AE 0.4%; P = 0.001), fasting glucose (CC: 5.4 AE 0.7, CT: 5.3 AE 0.7, TT: 5.5 AE 1.1 mmol/l; P = 0.010), and HDL-cholesterol (CC: 55 AE 17, CT: 55 AE 16, TT: 51 AE 16 mg/dl; P = 0.009), as well as with total cholesterol (CC: 212 AE 44, CT: 206 AE 46, TT: 196 AE 48 mg/dl; P = 0.002) and LDL-cholesterol (CC: 134 AE 37, CT: 131 AE 40, TT: 124 AE 42 mg/dl; P = 0.013). In patients with T2DM, the JAK3 variant was significantly associated with fasting glucose (CC: 8.3 AE 2.7, CT: 8.7 AE 2.8, TT: 7.4 AE 1.9 mmol/l; P = 0.036). The association between SNP rs3212780 and T2DM did not reach statistical significance (allelic odds ratio = 1.18 [0.98-1.40]; P = 0.076).

We conclude that JAK3 tagging SNP rs3212780 is significantly associated with phenotypes conferring an increased cardiometabolic risk, at least in non-diabetic coronary patients. The association between rs3212780 and the risk of T2DM warrants further investigation.

L. Garrido-S anchez 1 , X. Escoté 1 , L. Coín-Aragü ez 2 , J.C. Fren andez-García 3 , R. El Bekay 4 , J. Background: Munc18c is associated to glucose metabolism and could play a relevant role in the insulin resistance. However, little is known on the regulation of Munc18c expression. We analyze Munc18c gene expression in human visceral (VAT) and subcutaneous adipose tissue (SAT) and their relationship with obesity and insulin.

We evaluated 70 subjects distributed in 12 non-obese lean subjects, 23 overweight subjects, 12 obese subjects and 23 nondiabetic morbidly obese patients (11 with low insulin resistance and 12 with high insulin resistance).

Results: The lean, overweight and obese persons had a greater Munc18c expression in adipose tissue than the morbidly obese patients (P < 0.001). VAT and SAT Munc18c correlated negatively with weight (P = 0.022, P = 0.018) and BMI (P = 0.005, P = 0.016). VAT Munc18c correlated negatively with glucose (P = 0.027). SAT Munc18c correlated negatively with insulin (P = 0.032) and HOMA-IR (P = 0.037), and was the main determinant of the improvement in HOMA-IR index at 15 days after bariatric surgery (B = À2148.4, P = 0.038). SAT explants cultures show that insulin produced a significant down-regulation of Munc18c expression (P = 0.048). This decrease is also obtained when explants are incubated with a liver X receptors alpha (LXRa agonist, either without (P = 0.038) or with insulin (P = 0.050). However, Munc18c expression is not affected when explants are incubated with insulin plus a sterol regulatory element-binding proteins-1c (SREBP-1c) inhibitor (P = 0.504).

Conclusions: Munc18c gene expression in human adipose tissue is down-regulated in obesity and is inversely associated with insulin resistance. Insulin may have an effect on the Munc18c expression, probably through LXRa and SREBP-1c. Lab., Faculty of Medical Technology, 3 Endocrin, Tripoli-University of Medical Sciences, 4 Biochemstry, CDC, 5 Biotechnology, Research Centre, Tripoli, a protective factor for obesity, type-2 diabetes mellitus (T2DM), polycystic ovary (PCOs), and lacunars infarction.

Objectives: The objective of this study was to investigate the association between this polymorphism and T2DM, gestational diabetes (GDM), and obesity.

Methods: Genotyping was achieved by PCR-RELP in 227 individuals chosen randomly from the out patient's clinics of Al-Jala maternity hospital of Tripoli and Gharian hospital, including: 63 T2DM patients, 59 GDM patients, 57 obese, 47 healthy control individuals from Libyan pregnant women population (North-West Region).

The results revealed that this polymorphism has no association with T2DM, GDM, and obesity in comparison with the control sample.

Conclusion: T228A polymorphism of SORBS1 gene is not associated with the pathological conditions studied.

R. Parhimovich, N. Konovalova, R. Tishenina, N. Mylov Moscow Regional Research Clinical Institute named after M.F. Vladimirskiy, Moscow, Russia area (0.744) of BMI ! 23.00 kg/m 2 (BMI23) had significant larger areas than those of WCM9080 (0.658). WCI8075 and BMI23 had good sensitivity (72.73% and 76.36%). WCI9080 and WCI8075 had good specificity (89.73% and 77.12%) and classification (89.36% and 77.08%).

The proposed cutoff values were WCI8075. Further cohort study is needed to confirm these values. For national reference, we recommend measuring at umbilical due to its feasibility. Servicio de Endocrinologia y Nutricion, Hospital Regional Universitario Carlos Haya, 2 CIBERDEM, 3 Servicio de Cirugía, Hospital Regional Universitario Carlos Haya, M alaga, Spain Introduction: The Fndc5 gene encodes a membrane protein which is proteolytically cleaved, glycosylated and secreted into the blood as irisin. It has been described that causes a significant increase in total body energy expenditure, reduces body weight and improves dietinduced insulin resistance in mice. However, little is known in human. The aim of this study was to analyze the irisin levels in morbidly obese subjects undergoing bariatric surgery at baseline and 6 months after surgery.

Material and methods: We measured serum irisin levels in 33 morbidly obese subjects undergoing Roux-en-Y gastric bypass and in 10 healthy controls. We have analyzed anthropometric variables and the level of insulin resistance with the HOMA-IR index.

Results: Morbidly obese patients have a lower serum irisin levels that control subjects (450.9 AE 208.0 vs. 955.9 AE 861.9 ng/ml, P = 0.043). Serum irisin levels were similar before and after bariatric surgery in morbidly obese subjects (450.9 AE 208.0 vs. 449.1 AE 234.1 ng/ml; P = 0.786). There were no significant differences between morbidly obese subjects according to the HOMA-IR levels, neither before nor after surgery.

Irisin levels correlated negatively before surgery with glucose (P = 0.022), triglycerides (P = 0.045), cholesterol (P = 0.046), HOMA-IR (P = 0.045) and waist to hip ratio (P = 0.008).

In a multiple lineal regression model, irisin levels were associated with waist to hip ratio (P = 0.046) after adjusting for fasting glucose, cholesterol, triglycerides, HOMA-IR and age. No significant correlations were found at 6 months after surgery.

Conclusions: Irisin levels in decreased in morbidly obese subjects and is mainly related to waist to hip ratio.

Results: The level of uric acid increased with age in women and had a significant difference in women of 80-89 years (r = 0.18, P < 0.05). In men, the maximal level of uric acid was in the group 60-69 years. Incidence of hyperuricemia among women was 17%, in men -30%. We determined that the highest level of triglyceride, cholesterol, systolic and diastolic pressure was among women and men with hyperuricemia. The higher level of uric acid was found in patients with maximal body mass index (BMI >35). Incidence of hyperuricemia among women in the I group was 10.2%, in II -15.9%; in III -21.2%, in IV -34.2%.

Conclusions: It was determined that the level of uric acid was increasing with age and the highest level of some components of metabolic syndrome (triglyceride, cholesterol, systolic and diastolic pressure) was among patients with hyperuricemia. Introduction: Cushing's disease (CD) is the most common reason of endogenous hypercortisolaemia. The cortisol excess leads to serious metabolic and cardiovascular complications which significantly increase the morbidity and mortality in CD.

Objective: To assess the prevalence of preoperative glucose homeostasis alterations in CD and their influence on the effectiveness of surgical treatment.

Material and methods: A prospective study that included 36 patients (30 women; six men) with CD. The prevalence of prediabetes (impaired fasting glucose, impaired glucose tolerance) and overt diabetes was assessed. The relationship was evaluated between duration of CD symptoms and the presence of glucose homeostasis alterations as well as their impact on the efficacy of surgical treatment for CD.

The proportion in the study group of overt diabetes was 16.7%, whereas the prevalence of prediabetes was 33.3%. 36.1% of patients were obese (BMI ! 30) and additional 44.4% were overweight (BMI ! 25). There was confirmed the association between duration of CD symptoms and occurrence of diabetes (P < 0.01) and any type of glucose homeostasis alterations (P = 0.04). There was no relationship confirmed between the presence of glucose homeostasis alterations and efficacy of transsphenoidal surgery for Cushing's disease.

Conclusion: A longer duration of CD symptoms was associated with greater risk of metabolic complications such as: prediabetes and secondary diabetes. The efficacy of surgical treatment for corticotroph adenoma does not depend directly on the presence of preoperative glucose homeostasis alterations. Objective: The study objective was to identify factors associated with depressive symptoms in elderly with metabolic syndrome.

Material and methods: It was a case-control study to check sociodemographic and lifestyle influencing depressive symptoms in elderly patients with metabolic syndrome. The cases were attended in program Family Health Strategy, classified as having metabolic syndrome and depressive symptoms and the control group consisted of individuals with metabolic syndrome who didn′t have depressive symptoms. It was used as a measure of association, odds ratio (OR) with confidence interval of 95% and P-value, obtained by conditional logistic regression model. Conclusions: In the population studied showed that depression was associated with individuals at higher stress levels, those who had shown the mourning, elderly older than 80 years, those with cognitive deficits and negative perception of health. The results reinforce the need to train health professionals so that they can identify and intervene in this population, to improve the quality of life for seniors. Introduction: Vascular endothelial growth factor (VEGF) is said to play key role in pathogenesis of Diabetic nephropathy by upregulating the expression of Endothelial nitric oxide synthase (eNOs). Human VEGF gene, located on Chromosome 6 and is highly polymorphic. Insertion/deletion (I/D) polymorphism of the 18 bp fragment at 2549 position of the promoter region of VEGF gene has been implicated in many diseases of angiogenic origin.

Aim of the study: To investigate I/D polymorphism of VEGF gene in patients with type 2 diabetes mellitus and to assess their possible role in Diabetic nephropathy.

Materials and method: Fifty subjects with diabetic nephropathy, 50 subjects with diabetes mellitus without nephropathy and 50 normal controls were evaluated for I/D polymorphism of the 18 bp fragment at 2549 position of the promoter region of VEGF gene by polymerase chain reaction. The frequency of VEGF alleles and genotype distribution were compared in diabetic subjects, diabetic nephropathy subject and control groups.

Results: Distribution of VEGF genotype was found to be significantly (P < 0.05) different amongst Diabetic nephropathy subjects, diabetic subjects and controls by Fisher's exact test and Chi square test. Statistically significant association (P < 0.05) of D allele was also found with diabetic nephropathy.

Conclusion: Our study shows that I/D polymorphism of the 18 bp fragment at 2549 position of the promoter region of VEGF gene is associated with Diabetic nephropathy.

University of Delhi, New Delhi, India between BAI, BMI and percent body fat (PBF) in an endogamous population of India.

Design: Data was collected on 578 adults with respect to bodyweight, height, skinfolds, hip and waist circumference, and blood pressure. Pearson correlations was calculated for BAI and BMI with PBF. Differences in correlation for BAIvsBMI were examined using Fisher z-tests. Receiver operating characteristic (ROC) analysis was used to compare the predictive validity, and to determine optimal cut-off values. ORs were calculated to assess the risk of having hypertension using the proposed cut-off points.

Results: The correlation of PBF with BMI (men: r = 0.83; women: r = 0.71) were stronger than those with BAI (men; r = 0.66; women: r = 0.58). The regression model for BAI explained 66.4% of the variance in PBF in men and 57.7% in women whereas the corresponding regression model for BMI explained 82.8% variance in men and 70.7% in women. In men, the sensitivity and specificity of BAI to predict hypertension was higher than WC, WHR and WHtR but lower than BMI. In women, the sensitivity of BAI was higher than BMI and WC. In men, odds of hypertension on BAI were lower than other anthropometric markers while in women, it was higher for other anthropometric markers.

Conclusions: BAI can be used as an additional marker for screening population, however its validity needs to be demonstrated on other populations too. Obesity is a multifactorial syndrome characterized by a chronic state of positive energetic balance. The experimental model of treating neonatal rats with monosodium L-glutamate (MSG) was used. Amino acids, which also participate in the formation of proteins, are precursors of signaling molecules as local hormones and mediators; indeed, glycine can induce catecholamine secretion of adrenal medulla. Catecholamines of the adrenal medulla have an important role in the regulation of the metabolism, affecting the mobilization of fats. Therefore, abnormalities in catecholamines secretion can contribute for obesity development. Thus, the purpose of our work was verify if glycine administration has an inhibitory effect on hypothalamic obesity development. Animals were treated with tap water added to glycine (0.1 g/kg). Catecholamine content and secretion from adrenal medulla were measured using the trihydroxyindole fluorescence method. MSG treatment induced 65.5 % enhancement of perigonadal fat pad when compared to control animals (P < 0.001). However, glycine treatment caused a reduction of almost 8% on perigonadal pad in obese group (P < 0.05); control-glycine group presented a decrease of 14.4% in perigonadal fat pad related to control (P < 0.05). MSG treatment reduced 41.3% basal catecholamine secretion (P < 0.05). Obese animals that received glycine presented an increase in basal catecholamine secretion (62.3%, P < 0.001). In conclusion, we showed that glycine treatment did not inhibit obesity development, but the decrease in adiposity observed in obese and control rats treated with glycine may be consequence, at least in part, of the enhacement in basal catecholamine secretion due to stimulatory effect of the glycine. Background: Increased high sensitivity C-reactive protein (hsCRP) and c-glutamyl transferase (GGT) have been reported to be associated with metabolic syndrome (MetS) and its components. The aim of this study is to determine whether these two biomarkers independently predict new occurrences of MetS in Koreans.

Methods: On-going prospective cohort study, Korea Health Examinee Study (KoEX), has recruited 60.398 individuals since 2004. Among them, repeated survey was done in approximately 2 years for 6154 individuals. Only newly occurring MetS cases during follow-up was included in this study. Odds ratios (OR) and 95% confidence intervals (CI) for the risk of Mets were estimated using multivariate logistic regression analysis.

Results: Three hundred seventy-six newly occurring Mets cases were ascertained in the follow-up survey. Two years' cumulative incidence of Mets was 8.0% and was higher among men than women (16.4% vs. 5.4%). After adjustment for potential covariates, an increased risks for newly occurring MetS were observed among those with higher hsCRP measured at baseline examination in men (OR = 2.31, 95% CI 1.52-3.50; ! 0.1 (mg/L) vs. <0.05 (mg/L)) and in women (OR = 2.26, 95% CI 1.52-3.35; ! 0.1 (mg/L) vs. <0.05 (mg/L)). Also higher risk was observed in those with higher gGT in women (OR = 3.82, 95% CI 2.54-5.75; ! 25 (IU/l) vs. <15 (IU/l)) and in men (OR = 2.17, 95% CI 1.42-3.33; ! 50 (IU/l) vs. <30 (IU/l)).

Conclusions: Metabolic markers such as hsCRP and gGT are clearly predicted new occurrence of Mets. Clinical usefulness of these markers needs to be more investigated in the extended follow-up study. Objective: Thyroid dysfunctions are supposed to be implicated in metabolic risk. We assessed the effects of hyper-, hypo-and euthyroidism on patients′ lipid metabolism and oxidative stress from a 6 month follow-up clinical pilot study.

Methods: A study cohort of 96 probands was grouped into hyper-(n = 9), hypo-(n = 21) and euthyroid (n = 18) patients and healthy controls (n = 48). Patients received their individual medication and underwent a 6 month follow-up. Routine thyroid parameters, inflammatory status, lipid metabolism and oxidative stress were analyzed in patients before and after 6 months of medication and in healthy controls. Additionally, we measured the body weight, length, waist and hip circumference, BMI as well as blood pressure (BP).

Results: Analyses of routine thyroid parameters confirmed patient's status. Anthropometric baseline characteristics were comparable between groups. BP was significantly higher in all baseline patient groups compared to controls. Baseline vs. follow-up analyses revealed that euthyroid follow-ups had a significant increased BMI, waist circumference and waist-to-length ratio. Further, euthyroid and hypothyroid follow-ups had a significantly lower BP. Observations on lipid metabolism revealed that hypothyroid and euthyroid follow-ups showed declined HDL levels and significant higher HLD-LDL ratios compared to their pre-treated state. Cholesterin, LDL, TG, oxLDL levels and inflammatory markers were comparable in baseline and follow-ups. Concerning oxidative stress we found significantly declined asymmetric dimethylarginine (ADMA) levels in all three follow-up groups. Results: In the elderly group without metabolic syndrome, autonomy was associated with increasing age, sedentary behavior, and depressive symptomatology. In the presence of metabolic syndrome, in addition to these factors, the lowest level of education, being insufficiently active in physical activities, and have at least one chronic disease is not transmissible, also correlated with worse autonomy. The strong association between obesity and cardiovascular disease stresses the necessity of elucidation the underlying molecular mechanisms linking these pathologies. Adrenergic over-activation can promote cardiac hypertrophy and progression to heart failure. Our aim was to evaluate a novel sensor for cAMP namely Epac (exchange protein directly activated by cAMP) and downstream signalling pathways in the development of cardiac hypertrophy and susceptibility to ischaemia/reperfusion injury in a rat model of obesity-induced insulin resistance.

Methods: Wistar rats on a hyperphagia-inducing diet, HID (supplementing normal rat chow with sucrose and condensed milk) for 8 and 20 weeks were compared to age matched controls. Isolated working hearts were subjected to 20 min global ischaemia and functional recovery was measured after 30 min reperfusion. Hearts were also freeze-clamped at different time points during ischaemia and reperfusion. Epac activation was determined by Rap1 activation kit. NFAT, p38 MAPK, ERK 1/2, PKB and CREB were determined by Western Blotting using appropriate antibodies.

Results: The heart weight increased significantly after 20 weeks on HID along with an increase in the hypertrophic marker, nuclear NFAT. The 8 weeks HID hearts recovered significantly after ischaemia compared to controls, along with a significant increase in phospho-PKB after 10 min reperfusion, compared to 20 week HID hearts. However, results on Epac activation showed variable responses. Type 2 diabetes mellitus (T2DM) and Hypertension (HTN), both illnesses share pathogenic mechanisms that predispose to micro/ macrovascular complications. It is well known the role of hyperglycemia and insulin resistance of diabetes in vascular endothelial dysfunction. Several studies have shown the association of serum concentrations of Osteocalcin (OC) in the metabolism of glucose. OC a marker of bone formation by osteoblasts and produced hormone that regulates energy metabolism, was found recently in arteries with atherosclerosis, suggesting their direct association with vascular disease. We analyzed the relationship between serum OC concentrations and cardiovascular risk factors. A cross-sectional analytical study was carried out in 63 patients with T2DM plus HTN and 51 healthy subjects (HS). OC serum levels were measured and also statistically correlated with cardiovascular risk parameters. Total osteocalcin serum levels in T2DM + HTN subjects were significantly higher than those in HS (P < 0.001), whereas the uncarboxylated OC concentrations were lower in T2DM + HTN subjects than in HS (P < 0.05). Body mass index, waist circumference, fat percentage, fasting plasma glucose, high-density lipoprotein cholesterol, fasting serum insulin, homeostasis model assessment-insulin resistance and high sensitivity-C reactive protein were negatively correlated with uncarboxylated osteocalcin (P < 0.05). In addition, carboxylated OC was also positively correlated with systolic and diastolic blood pressure (P < 0.001) and homeostasis model assessment-insulin resistance (P < 0.05). OC serum concentrations are associated with cardiovascular risk factors in patients with T2DM + HTN. The OC forms (uncarboxylated/carboxylated) might play different roles in cardiovascular and endocrine physiology and hence be of different value as cardiovascular risk markers.

Aim: To evaluate the prevalence of MS in a group of medical students from Bucharest and their habits related to nutrition and physical activity.

Cross-sectional study: MS was defined according to International Diabetes Federation criteria. Medical students from Bucharest were included in the survey, based on their informed consent. They were examined clinically (weight, height, waist, blood pressure), provided a blood sample (glycaemia, lipids, triglycerides, cholesterol, high and low-density lipoproteins) and answered to Block Adult questionnaire for food and physical activity.

Results: 235 students enrolled, 70.2% females. 40.9% of subjects were free of signs of MS, 46.8%, 11.1% and 1.3% met one, two and three criteria for MS diagnosis. The highest prevalence of abnormality was found in waist (above the limit in 49.4% cases), followed by HDL (decreased in 13.2% cases). Significant differences among genders were found in waist. Food habits: boys were found to eat significantly more calories, fats, carbohydrates and proteins compared to girls. No differences for fibres, transfats, free sugar, fruits and vegetables. Physical activity: boys consumed significantly more energy through physical activity, recreational activities and vigorous physical activity compared to girls. Only in 10% of cases the energetic consume was higher than the ingestion (no difference by gender).

Conclusion: High prevalence of unhealthy habits related to nutrition and physical activity in a particular highly educated young group are concerning for the occurrence of MS in the future. Triphala an age old commonly used powered preparation of three medicinal dried plant fruits amla (Emblica officinalis), harad (Terminalia bellirica) and bahera (Terminalia chebula) in equal proportionsis used in Indian systems of medicine. Present work evaluated the anti-hyperglycemic, anti-hyperlipidemic, and antioxidant potentials of 'Triphala' formulation viz., (Emblica officinalis: Terminalia bellirica: Terminalia chebula:: 4:1:1) in subjects with IGT and TIIDM.

The therapeutic effect of 'Triphala' administration (5 gm BD) in 20 TIIDM, 10 IGT and 10 healthy individuals was assessed by monitoring blood glucose at 30 days intervals, HbA1c, lipid profile, oxidative stress markers, and Liver & kidney function markers at 90 days intervals. DNA damage was assessed by comet assay, flow cytometry and Hoechst nuclear stain. Molecular markers were determined in the beginning and at the end of therapy.

Results: 'Triphala' (4:1:1) administration for 1 year significantly brought down Blood glucose levels with a marked improvement in lipid profile in all the groups, this was further supported by increased protein expression of AMPK and adiponectin. Triphala provided resistance to oxidative stress generated not only by the increasing the antioxidant enzymes activity, but also by shortening comet tail length and number of cells in G 0 phase of cell cycle. Our results indicated that diabetes is strongly associated with elevated levels of AR, TNF-a, IL-6 and IL-10, but Triphala down regulated the same, proving its anti-inflammatory potential.

Conclusion: These observations raise the prospects of using Triphala formulation for treatment of diseases associated with oxidative stress and imbalanced cytokine production. 

Introduction: Glucoregulation disorders are a state of pre-diabetes increasingly diagnosed in the general population. Its association with hypertension, increases the risk of cardiovascular morbimortality

Objective: Identify the blood pressure profile in patients with disorders of carbohydrate.

Patients and methods: This monocentric study has permitted the prospective recruitment of 195 patients.

All had an oral glucose tolerance test (OGTT) with a mesure of plasma glucose level immediately before and 2 h after taking 75 g of glucose. Clinical examination with taking blood pressure to two arms and a cardiovascular evaluation were performed.

Results: The glucoregulation disorders were concerned with 90 patients (46%) with an average age of 58.6 years (38-86 years). sexratio: 1.04.

IFG was found in 39 patients. OGTT revealed 15 diabetes, 51 IGT.

Only 13 patients with glucoregulation disorders have normal blood pressure.

Seventy-two patients have been followed for high blood pressure and five patients are newly diagnosed. More than a half of these hypertensive patients has an IGT and a third is diabetic.

In the family, the high blood pressure is reported in 58%, the early cardiovascular events are dominated by myocardial infarction and stroke.

In high blood pressure group, 1 patient/4 is dyslipidemic and metabolic syndrom, as defined by IDF 2005, is concerned with 2 patients/3. As for as cardiovascular events, they are reported in 2 patients/5. (T2DM) is an ongoing concern and adequate treatment remains an important issue. Thiazolidinediones (TZDs) are a class of drugs that initially showed great promise as unique receptor-mediated oral therapy for T2DM. The TZDs, rosiglitazone (Rosi) and pioglitazone (Pio) were widely used as hypoglycemic drugs in patients with T2DM, but a host of serious side effects, primarily cardiovascular, have limited their use.

Aim: In the present study we have used a systems biology approach to assess specific gene expression profiles underlying the pathological processes in the heart of pre-diabetic mice treated with rosiglitazone or pioglitazone.

Results: Our data demonstrate that both Rosi and Pio efficiently decreased high fat diet-induced plasma glucose and insulin levels.

Analysis of the heart demonstrated that Rosi, but not Pio, led to an increase in atherosclerotic plaque formation and an increase in heart weight to body weight ratio. A combined transcriptomics and bioinformatics approach revealed specific regulatory pathways that may explain the adverse heart effects associated with rosiglitazone but not pioglitazone treatment.

Conclusion: Our data provide new insights into the mechanisms underlying rosiglitazone and pioglitazone action within the cardiovascular system, including drug efficacy and cardiotoxicity.

A. Vlassopoulos 1 , M. Lean 1 , E. Combet 1 1 Human Nutrition, School of Medicine, University of Glasgow, Glasgow, UK Introduction: The new HbA1c criteria for diagnosis of pre-diabetes have been criticised for overdiagnosis, because many more people are diagnosed than with the old OGTT criteria. It is possible that some elevation of HbA1c is not driven by hyperglycaemia.

Aims: This study assesses associations of HbA1c, commonly assumed to relate solely to glucose concentration, with, 1. smoking, a major source of reactive oxygen species (ROS) and

2. fruit & vegetables consumption associated with improved redox status.

Methods: One-way ANOVA, Chi-squared and multivariate linear regressions, adjusted for all known confounders were used to explore associations of HbA1c with self-reported smoking status and fruit & vegetables consumptions in the Scottish Health Surveys 2003-2010, among individuals without known diabetes and HbA1c <6Á5%.

Results: Compared to non-smokers (n = 2831), smokers (n = 1457) were younger, consumed less fruit & vegetables, had lower physical activity levels, lower BMI, higher HbA1c and CRP (P < 0Á05). HbA1c was higher in smokers (P < 0Á001) by two SDs (0Á08%), and 3.5 SDs higher (0Á14%) in heavy smokers (>20 cigarettes/day) than nonsmokers. Smokers were twice as likely to have HbA1c in the 'prediabetic' range (5.7-6.4%). Pre-diabetes and low grade inflammation did not affect the associations. For every extra 80 g vegetable portion consumed, HbA1c was 0.25 SDs (0.01%) lower (P = 0.02), but fruit consumption did not impact on HbA1c, within the low range of consumptions in this population.

Conclusion: This study adds evidence for a neglected link between oxidative stress and protein glycation, with implications for individuals exposed to ROS and for epidemiological interpretation of HbA1c.

V. Aursulesei, I.C. Roca, L. Mihalache

Objective: To assess the relation between the traits of metabolic syndrome (MS) and the parameters with independent prognostic significance for cardiovascular risk.

Material and methods: Hundred and forty-three patients were included according to the number of traits of MS (69.2% arterial hypertension, 29.7% abdominal obesity, 43.9% low HDL-cholesterol, 61.2% high tryglicerides, 55.6% abnormal oral glucose tolerance). The markers of cardiovascular damage were assessed: pulse wave velocity (PWV -Complior method), carotidian intima media thickness (IMT), left ventricular hypertrophy (index of mass -LVMI and geometric patterns), flow mediated vasodilation (FMD), microalbuminuria (absent/present), ankle-brachial index (ABI).

Results: In our study the cardiovascular damage is present in 66.8%. PWV values increase with number of traits of MS (t-test) after adjusting for confounders/other cardiovascular risk factors (ANCOVA). Decreased ABI is related with each of MS traits; the power of correlation depends on criteria association. PWV and ABI are both related with postprandial hyperglicaemia and systolic blood pressure (P < 0.05), while IMT is strongly related with HDLcholesterol (r = 0.43, P = 0.04). LVMI and concentric hypertrophy pattern are also related with systolic blood pressure (r = 0.29, P < 0.05), while eccentric pattern relates to waist circumference (r = 0.32, P < 0.05). We cannot establish a relation between traits of MS and FMD or microalbuminuria.

Conclusions: Hyperglicaemia and systolic blood pressure are best related with parameters of cardiovascular risk, but the clustering of MS components may interact to synergistically affect the extent of cardiovascular damage. PWV, ABI and left ventricular hypertrophy should be systematically used for defining cardiovascular risk in MS. Interleukin-6 (IL-6) is pleiotropic cytokine with a key impact on immunoregulation and nonimmune events. Sudies have investigated the role of action/lack of action of IL-6 in the pathogeneses obesity, insulin resistance, type 2 diabetes.

Aim of the study: To evaluate IL-6 activity in hypertensive patients depend on prediabetes presence.

Materials and methods: 73 hypertensive patients were examined. Common clinical investigations were provided. IL-6 plasma levels were detected using ELISA. Data is represented as Me (Q 25 -Q 75 ). Median test were used, P < 0.05.

Results: Prediabetes was observed in 36.2% of hypertensive patients in 71% insulin resistance in hypertensive patients with prediabetes vs. 54 % insulin resistance in hypertensive patients were detected. Hypertensive patients with prediabetes (5.90 (5.20-7.10) %) characterized by significantly higher glycated haemoglobin levels as compared hypertensive patients (5.40 (4.70-6.97) %, P < 0.05). Hypertensive patients were characterized by increased IL-6 activity (18.81 (13.14-26.69) pg/ml). In hypertensive patients with prediabetes decrease IL-6 activity (13.94 (11.00-16.94) pg/ml) were found.

Conclusion: Hypertensive patients were characterized by increased IL- Adipose tissue is now recognized as a complex organ with a crucial role in energy metabolism and in the development of obesity and metabolic syndrome. Modified response and metabolism of hormones has been observed in the visceral adiposity during obesity, specifically related to cortisone. The aim of this study was to assess the response to different concentrations of cortisone in adipocyte cell line 3T3L1. The expressions of 11β-HSD1, enzyme responsible for the reduction of cortisone to cortisol, and AQP7, involved in glycerol transport, were quantified after treating differentiated cells with cortisone at doses of 0, 0.1, 1, and 10 lmol/l during 0, 5, 10, 15, 20 min, and 48 h. Total RNA and cDNA were obtained from the samples to develop a real time PCR using MnSOD as housekeeping gene. Results suggest time and dose dependent response of 11β-HSD1 and AQP7; increases in the expression were observed during the first 15 min of treatment (3 and 4 fold, respectively), followed by expression decrease for both in a 5 min period (P < 0.0001). For the treatment with 1 lmol/l cortisone, both proteins expressions showed quadratic tendencies, 11β-HSD1 tendency is described by the equation y = 3.131 + 0.069x À 0.094x 2 while AQP7 tendency is described by y = 5.273 À 1.232x + 0.078x 2 . It can be concluded that long term effects of cortisone over adipocyte metabolism may be modulated by the induction or repression of proteins like AQP7 and should be explored in obese individuals. Objective: To present a series of cases of metabolic syndrome patients suffering Sleep disorders in which the most relevant metabolic marker is Serum Tryglicerides levels. It has been considered that the key meatbolic alteration underlying Metabolic Syndrome is a resitance to Insulin action. However, there could be other metabolic abnormalities that may lead to the devleopment of the clinical feautres of this diseasea.

Materials and methods: Patients undergoing a medical check up at Medica Sur Hospital were included. Each patient was assesed in order to determine both Matabolic Syndrome and a current Sleep disorder. Anthropometric measures were taken, body rates were calculated and blood samples were taken for laboratory tests (serum glucose, Tryglicerides and Cholesterol levels determination). Results were analysed with the SPSS 20 software.

Results: Fifteen patients meeting the World Health Organization Metabolic Syndrome were included, and who referred snoring, difficulties on getting asleep or frequent waking up while sleeping. Anthropic measures, and lab results were.

Discussion: Yet, the majority of these patients do not have serum glucose abnormalities, but mainly their weights correspond to Overweight and to a phenotype of central adipose tissue distribution. The most significant metabolic alteration, in this set of patients, was hypertigliceridemia. This results suggests that there may be other metabolic pathways leading to the development of this disease.

Introduction: Prediabetes, a condition leading to diabetes and cardiovascular diseases (CVD). In Cameroon, few studies have been done about this health indicator.

Aims: To determine the prevalence of prediabetes and diabetes in Cameroon cohort, and to compare metabolic risk factors between normoglyceamia and prediabetes individuals.

Patients and methods: A sample of 731 Cameroonian men and women (18-65 years) participated in a health survey. Statistical analysis of data compared risk factors between three subgroups: normoglyceamia (NG), prediabetes (PD) and diabetes (DT). Prediabetes was defined as a glyceamia of 100-126 mg/dl. Metabolic syndrome (MetS) was diagnosed using the National Cholesterol Education Program (NCEP) definition.

Results: The distribution of NG, PD and DT prevalence in the overall sample was 70.98%, 22.37% and 6.65% respectively. The prevalence of MetS in those with PD (37.4%) was significantly higher than in those with NG (13%). Many significant differences between NG and PD subjects were also noticed.

Conclusion: In this study, approximately 30% of the population who were found to be diabetic and prediabetic is at risk of cardiovascular diseases. Our findings also show that Prediabetes individuals are different from those with Normal glycaemia in a great number of metabolic abnormalities including a higher prevalence of MetS. Prevention and control measures should be set urgently. Research design and methods: Prospective study of the Thai Comprehensive CIRS was further evaluated by multiple logistic regressions. In determine the ability of the Thai Comprehensive CIRS scores in predicting each outcome, the adjusted odds ratio was calculated, and backward stepwise selection was used in the statistical modeling.

Results: There were also prospective correlations between the baseline Thai Comprehensive CIRS instrument and 3-month outcomes). Total score at baseline emerged as significant predictors of 3-month QOL (r = 0.26-0.33, P < 0.05). Every subscale of the Thai Comprehensive CIRS was significantly related to patient satisfaction (r = 0.14-0.33), with only the neighborhood subscale as a significant predictor for ADL (r = 0.18). The other outcomes (self management behavior, cost of care, and DBP) were not significant concurrent baseline predictors. Method: We collected laboratory results of body mass index (BMI), blood pressure, fasting glucose, lipid profiles (total cholesterol, triglycerides, LDL-and HDL-cholesterol level) and visceral fat amount of cancer survivors who visited Health Promotion Center at Seoul National University Hospital. An age and sex-matched control was selected randomly for each cancer survivor from visitors of this center. We compared blood pressure, fasting glucose, lipid profiles and visceral fat amount between cancer survivors and controls using multiple regression analysis after adjustment for BMI.

Results: One hundred fifty five cancer survivors and controls were included in statistical analyses. Cancer survivors tended to have lower BMI compared to controls (23.05 AE 3.17 kg/m 2 vs. 23.75 AE 3.14 kg/ m 2 , P = 0.051) After adjustment for BMI, cancer survivors showed lower fasting glucose level (89.06 AE 1.24 mg/dl vs. 93.40 AE 1.24 mg/ dl, P = 0.051). However there were no significant differences of blood pressure, lipid profiles or visceral fat amount. Background: Both insulin deficiency and resistance are reported in patients with β-thalassemia major (BTM). We assessed the OGTT and 72-h continuous glucose concentration by the continuous glucose monitoring system (CGMS) and calculated homeostatic model assessment (HOMA), and QUICKI in 16 adolescents with BTM on regular blood transfusions and iron-chelation therapy.

Results: In adolescents with BTM (age: 19.75 AE 3 years), OGTT, (25%) showed impaired fasting blood (plasma) glucose concentration (BG) (>5.6 mmol/l). Two-hour after the glucose load, one of them had BG = 16.2 mmol/l (diabetic) and two had IGT (BG >7.8 and <11.1 mmol/l). Monitoring the maximum (postprandial) BG using CGMS, 4 adolescents had diabetes (25%) (BG >11.1 mmol/l) and nine had IGT (56%). HOMA and QUICKI revealed levels <2.6 (1.6 AE 0.8) and >0.33 (0.36 AE 0.03), respectively, ruling out significant insulin resistance in these adolescents. Neither fasting serum insulin nor c-peptide concentrations were correlated with fasting BG or ferritin levels. The average and maximum blood glucose levels during CGM were significantly correlated with the fasting BG (r = 0.68 and 0.39, respectively, with P < 0.01) and with the BG at 2-h after oral glucose intake (r = 0.87 and 0.86 respectively, with P < 0.001).

Ferritin concentrations were correlated with the fasting BG and the 2h blood glucose levels in the OGTT (r = 0.52, and r = 0.43, respectively, P < 0.01) as well as with the average BG recorded by CGM (r = 0.75, P < 0.01).

Conclusion: CGM has proven to be superior to OGTT for the diagnosis of glycemic abnormalities in adolescents with BTM. Background: In obese children pancreatic beta-cells may not be able to cope with insulin resistance leading to hyperglycemia and type 2 diabetes (T2DM).

Objectives: To assess oral glucose tolerance, 72-h continuous blood glucose concentrations (CGM) and calculate homeostatic model assessment (HOMA), and the quantitative insulin sensitivity check index (QUICKI) in 13 children and adolescents with simple obesity (BMISDS = 4 AE 1.06).

Results: OGTT performed in 13 obese adolescents (13.47 AE 3 years) revealed three cases (23%) with IFG (>5.6 mmol/l), four cases (30%) with IGT (>7.8 <11.1 mmol/l), and none with diabetes. Using the CGMS, IFT was detected in four cases, the maximum BG (2 h or more after meal) was >7.8 and <11.1 mmol/l (IGT) in nine children (69%) and >11.1 mmol/l (diabetes) in one case (7.6%). Five cases had a minimum BG recorded of <2.7 mmol/l (hypoglycemia). No glycemic abnormality was detected using HbA1C (5.7 AE 0.3 %). 11/13 patients had HOMA values >2.6 and QUICKI values <0.35 denoting insulin resistance. Beta cell mass percent (B %) = 200 AE 94.8 % and insulin sensitivity (IS) = 50.4 AE 45.5% denoting insulin resistance with hyperinsulinaemia and preserved beta cell mass.

In obese children and adolescents; CGMS is superior to OGTT and HbA1C in detection of the glycemic abnormalities, which appears to be secondary to insulin resistance. Introduction: The aim of this study is to evaluate the effect of vitamin E supplementation on glycemic control, lipid profile, inflammation markers and Malondialdehyde level of type 2 diabetic patients.

Material and method: Thirty type 2 diabetic patients were participated in this randomized single blind placebo controlled clinical trial study. Fasting blood glucose, serum triglyceride, total cholesterol, LDL, and HDL-cholesterol concentration, Malondialdehyde (MDA), hs-CRP, IL-6, and insulin level were measured. Each subject then given a breakfast that was contained 80 g fat. Subjects' Post-prandial biochemical measurement was measured as well. Patients' then randomly divided in two groups. Treatment Group received vitamin E (400 IU/per day) and control group received placebo for 6 weeks. At the end of 6 weeks baseline procedure was repeated and fasting, and 2-h postprandial biochemical markers were measured.

Statistical analysis: Data analyzed using Mann-Whitney U test to compare the mean differences between both groups. Basic data expressed as mean AE standard deviation, fasting and postprandial biochemical parameters before and after intervention expressed as median.

Results: No significant differences were found in fasting and postprandial lipid profile, glucose, insulin and HOMA-IR after 6 weeks of intervention between two groups. Significant decreases in fasting and postprandial serum MDA levels in treatment group were recorded. No significant differences were shown in fasting and postprandial inflammatory markers except fasting IL-6.

The result of this study shows that short term supplementation of vitamin E is safe and effective in decrease oxidative stress in type 2 diabetic patients. Objective: There is evidence that patients with normal weight and central adiposity (elevated waist circumference and waist-hip index) present a higher cardiovascular and metabolic risk. It has been proven that central adiposity is a risk factor for elevated systolic and diastolic pressure amounts, low HDL cholesterol and altered glucose while fasting.

Materials and methods: Patients treated at the Integral Diagnosis and Treament Center of Medica Sur Hosptial were inclued. Anthropometric measurments were taken and metabolic (Glucose and profile of lipids with ultrasensitive reactive C protein) parameters were analyzed.

Results: Nine hundred and forty patients were included. Women with a normal body mass index but with a waist >80 cm, had metabolic alterations on serum lipids which have a statistical significance when compared with those women with a waist circumference lesser ran 80 cm. An elevated waist circumference diameter, regardless of the BMI, increases the metabolic risk. The measurement of the circumference of the waist and the hip must take place by routine in any medical evaluation. Aim of the study: To study the prevalence of prediabetes in elderly age group (60 years and above) and to study cardiovascular risk factors in prediabetic group.

Methodology: Study was conducted on 200 patients of age 60 years and above. They were screened for prediabetes as per ADA guidelines 2011. Such prediabetic study group (32 cases) was investigated for cardiovascular risk factors (obesity, hypertension, microalbuminuria, CRP, retinopathy, dyslipidemia) along with age matched controls. Standard statistical tests were applied for analyzing data.

hypertension and retinopathy with the prediabetic state. Risk factors are more associated with IGT as compared to IFG.

Conclusion: Prediabetes is widely prevalent in the elderly population. It has strong association with metabolic syndrome. Prevalence of IGT is higher as compared to IFG. Similarly, cardiovascular risk factors are widely prevalent in the prediabetic population. Dyslipidemia, obesity, microalbuminuria, hypertension and retinopathy share the significant association as risk factors. Early identification, of prediabetic state followed by primordial and primary prevention of cardiovascular disease should be the focus of intervention. Background: Despite commonly using body mass index (BMI) in diagnosing obesity, the accuracy of BMI in detecting adiposity is unknown in Korean. We assessed accuracy of BMI in detecting body fat percentage (BF%) defined obesity.

Methods: This study is a cross-sectional design of 6017 subjects (age 20-69.9 years, men 43.6%) who conducted 2009 Korean National Health and Nutrition Examination Survey (KNHANES IV-3) in Korea from January 2009 to December 2009. We assessed the diagnostic performance of BMI using the WHO reference standard for obesity of BF% ! 25% in men and ! 35% in women, which were measured by Dual Energy X-Ray Absorptiometry. We tested the correlation between BMI and BF% by sex and age groups. We defined the BMI cutoff for BF%-defined obesity using ROC analysis.

Results: BMI-defined obesity was present in 38.7% of men and 28.1% of women. According to age and sex, a sensitivity and a specificity of BMI ( ! 25 kg/m²) showed difference. The BMI cutoff value for BF %-defined obesity is 24.2 kg/m² (sensitivity 78%, specificity 71%). Difference between BMI cutoff value of Korean and that of American to detecting BF% is about À1.3 kg/m².

In Korean, BMI showed a limited accuracy to detecting adiposity by age and sex. The difference between BMI cutoff-value of Korean and that of American to detecting BF% obesity is smaller than the difference of BMI cutoff-value between the Asia-Pacific and WHO criteria. Background: The HealthKick intervention was developed as part of a study that aimed to address diabetes risk factors in primary schools within low-resource settings in the Western Cape, South Africa. The intervention focused on Grade 4-6 learners, their parents and the educators.

Aim: To ascertain the risk of developing diabetes and other noncommunicable diseases among educators.

Method: Educators (n = 297) from 16 urban and rural schools, participated in a health check in 2011. Measurements included random blood glucose and cholesterol testing, and height, weight, waist circumference and blood pressure (BP) measurements. Cut-off values for BP levels in adults 18 years and older of the NHLBI were used for categorising hypertension.

Results: Educators participating in this study were mainly females, with most of them (68%) falling in the age range between 35 and 54 years, and 17% being older than 55 years. Only 23% of educators had BPs in the normal range. Half of those on treatment for hypertension had levels above 140/90 mmHg, while 22% with BPs above these levels were not on medication. About 61% of those who said they had diabetes (n = 31) knew what treatment they were on. Cholesterol levels above 5 mmol/l were seen in 45%. Only 20% said they smoked cigarettes, whereas 21% were previous smokers. Preliminary results show that most participants had a body mass index >25 kg/m 2 .

Conclusions: Many of the educators who participated in the HealthKick study are possibly at risk for developing cardiovascular and other related non-communicable diseases, such as diabetes.

S.K. Kota 1 , S. Ugale 2 , N. Gupta 2 , K.D. Modi 1 1 Endocrinology, Medwin Hospital, 2 Laparoscopic Surgery, Kirolskar Hospital, Hyderabad, India

Objective: The objective of the present study was to prospectively evaluate the results of laparoscopic ileal interposition (II) with diverted sleeve gastrectomy (DSG) for control of type 2 diabetes mellitus (T2DM) and related metabolic abnormalities.

Methods: All patients underwent II +DSG. They had T2DM ! 5 years with poor glycemic control despite adequate dosage of oral hypoglycemic agents (OHAs) AE insulin. The primary outcome was remission of diabetes (HbA1C <6.5% without OHAs/insulin) and secondary outcomes were reduction in antidiabetic agent requirement and components of metabolic syndrome.

We report the preliminary postoperative follow-up data of 13.1 AE 5.3 months (range: 3-26 months). There were 32 patients (M: F = 21:11) with mean age of 48.7 AE 7.8 (range: 34-66 years), duration of diabetes of 13.1 AE 5.8 years (range: 5-30 years), and preoperative body mass index of 29.1 AE 6.9 kg/m 2 (range: 22.4-39.5 kg/m 2 ). Sixteen patients (50%) had hypertension, while dyslipidemia and microalbuminuria was present in 12 patients (39%) each. Twenty two patients (70.5%) had diabetes remission. Fifteen/sixteen (93%) patients had remission in hypertension. All participants had weight loss ranging between 15% and 25%. Postoperatively statistically significant decline was observed in the glycemic and lipid parameters, microalbuminuria at all intervals (P < 0.05). Patients with postoperative duration >6 months had better improvement in terms of reduction in glycemic, lipid parameters and microalbuminuria. Three patients had vitamin B12 deficiency 1 year after surgery.

Conclusion: Ileal interposition combined with DSG addresses both foregut and hindgut theories and brings about remissions in T2DM patients. Background and objective: The objective of this study was to evaluate the screening potential of various anthropometric indices, namely body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in the early detection of dysglycemia among the Omani adult population.

Methods: Our study included 1274 Omani adults (476 males and 798 females) who participated in a cross-sectional, community-based study. We defined glycemic status based on American Diabetes Association (ADA) thresholds: <5.6 mmol/l as normal, 5.6-6.9 mmol/l as impaired fasting glucose (IFG) and ! 7.0 mmol/l as diabetes mellitus (DM). The cut-off values for the anthropometric indices namely, BMI, WC, WHR and WHtR were based on the standard definitions.

The age adjusted analysis showed that out of the four anthropometric indices, among the males the WHtR at the cut-point of 0.5 gave relatively higher value of odds ratio with OR = 2.29 (95% CI: 1.95, 4.31) and among the females WHR at the cut-point of 0.85 showed maximum odds ratio with OR = 3.66 (95% CI: 2.56.5.25).

The areas under the ROC curves, at the cut-point of IFG ! 5.6 mmol/l, was more for WHtR in case of males and WHR in case of females.

Conclusion: This study shows that out of the four anthropometric indices, there are differences in the predictive values of dysglycemia among the Omani males and females. In case of males, the WHtR ! 0.5 appears to be a better indicator for detecting dysglycemia whereas among the females the WHR ( ! 0.85) is a better indicator. Introduction: Increased serum ferritin and iron stores are involved in the pathogenesis of insulin-resistance. Polycystic ovary syndrome (PCOS) is diagnosed by oligomenorrhea and hyperandrogenism. PCOS and obesity were associated with elevated serum ferritin levels.

The link between obesity and altered iron metabolism was proposed.

Object: To evaluate the association between serum ferritin levels and insulin resistance and metabolic syndrome in obese and non-obese women.

Methods: Retrospective study. Five hundred thirty-nine women, 286 of whom had PCOS and 253 of whom did not have PCOS, were included in the study.

Results: Serum ferritin correlated with menstrual cycle length, sex hormone-binding globulin, total testosterone, androstenedione, triglyceride, and total cholesterol both in obese and non-obese women. Obese women (BMI >25) with high ferritin (ferritin ! 45.5 ng/ml, n = 270) levels had higher insulin resistance, impaired glucose tolerance, and liver enzymes than obese women with low ferritin levels (ferritin <45.5 ng/ml, n = 269). However, among non-obese women, insulin resistance and metabolic disturbances were not significantly different between high and low ferritin groups. Women with high ferritin levels had a greater risk of PCOS and hyperandrogenism than women with low ferritin levels. Independent of obesity, hypertriglyceridemia was the major metabolic disturbance in women with elevated serum ferritin levels.

Conclusions: The pathogenesis of increased iron stores correlated with insulin resistance and metabolic syndrome among obese and nonobese premenopausal women was different. The hypertriglyceridemia in women with PCOS might be associated with iron metabolism. Nutrition Rehabilitation, Unite de Dietetique, Pegomas, France and yogic counseling for stress management. All subjects underwent a residential program for 6 weeks followed by therapy at home for 12 weeks. Results were analyzed using paired 't' test. Conclusion: In remote areas organization of screening on base of diabetes bus helps to detect T2D and early glucose metabolism disorders in more than 50% of people with increased risk. FINDRISK scale is useful screening tool to detect these people. However, in older age groups, percentage of screen-detected T2D decreases, which may indicate lower efficiency of FINDRISK questionnaire at age ! 65. Background and aims: Changes in the cellular oxidative status are involved in the pathogenesis of obesity-associated hepatic steatosis. The possibility of gender difference in this process was examined in an experimental model of obesity induced by a western high-fat and highcarbohydrate cafeteria diet.

Methods: Four Groups of six Swiss CD1 mice (21 day old) received either cafeteria diet (male and female) or balanced diet (male and female) for 14 weeks. Hepatic hydrogen peroxide (H 2 O 2 ), thiobarbituric acid reactive substances (TBARS), reduced glutathione (GSH) and the activity and/or gene expression of catalase (CAT), glutathione peroxidase (GPx), superoxide dismutase (SOD), hypoxia inducible factor (HIF-1-alfa) and nuclear factor (erythroid-derived 2)like 2 (Nrf2) were measured.

Results: Higher levels of TBARS and mitochondrial H 2 O 2 were found in livers from cafeteria-fed animals of both genders, with higher levels in females. The level of GSH was lower in cafeteria-fed mice of both gender; females showed higher levels than males (cafeteria or balanced diet). CAT and GPx activities were reduced in cafeteria-fed mice of both sexes; the activities in females being lower than those of males. SOD activity and the gene expression of CAT, GPx and SOD were not significantly altered when compared by gender or dietary treatment, but the expression of HIF-1-alfa and Nrf2 was increased in female cafeteria-fed mice.

The female animals exhibited a higher susceptibility to cellular oxidative stress in cafeteria diet-induced obesity in comparison to males. The molecular mechanisms seem to be, in part at least, posttranscriptional.

Acknowledgements: CAPES, CNPq, Fundac ßa˜o Arauc aria. Objectives: To investigate the relationship between body fat percentage and body mass index (BMI) among young adults aged 20-25 years.

Methods: Young adults aged 20-25 years were recruited for study when they took health examination in September 2011 in Taiwan. All subjects underwent bioelectrical impedance analysis (Tanita BC-418) to estimate their body fat percentage. Basic demographic data, height, and weight were collected, and BMI was calculated from height and weight. Overweight and obesity were identified according to BMI. The correlation between body fat percentage and BMI was analyzed using SAS software 9.2.

Results: A total of 447 male and 447 female participants were enrolled. The mean age was 22.8 AE 0.8 years old. The mean body mass index was 22.2 AE 3.5 for men and 20.1 AE 2.6 for women. The mean body fat percentage was 18.5 AE 6.2 for men and 28.4 AE 5.3 for women. Categorized by BMI, the mean body fat percentage was 10.3 AE 2.1 for men and 23.5 AE 3.2 for women in BMI <18.5 group, 16.9 AE 3.6 for men and 29.3 AE 3.7 for women in BMI 18.5-24 group, and 23.0 AE 2.7 for men and 37.0 AE 2.1 for women in BMI 24-27 group and 31.6 AE 6.4 for men and 41.3 AE 2.0 for women in BMI >27 group (P < 0.05). The prevalence of too high or obese body fat percentage among young adults aged 20-25 years in Taiwan was 41.6% in male and 18.1% in female according to the WHO and NIH recommendations.

The cutoff values of healthy body fat percentage for young adults in Chinese population ought to be modified. It is estimated that 6-7% of women of reproductive age have polycystic ovarian syndrome (PCOS). This article summarizes the recent development and findings in the cardiometabolic abnormalities in patients with PCOS. Patients with PCOS have the clinical features of oligomenorrhoea, hirsutism and infertility; however, they also exhibit hyperinsulinemia, obesity, hypertension, dyslipidemia, and an increased pro-thrombotic state. They have an increased risk of type 2 diabetes and impaired glucose tolerance, and sleep apnea is also found more commonly in this population. However, despite the presence of cardiovascular risk factors and increased surrogate markers of cardiovascular disease it is unclear if they have accelerated atherosclerosis. End point studies are currently lacking and the available evidence are conflicting. This article will address the current evidence for the adverse cardiovascular risk in PCOS and the other factors that may be implicated. Finally the therapeutic options for treatment will be discussed.

Conclusion: Results suggest that in the fasted condition, when fatty acids levels are elevated, the gluconeogenic flux is higher in cafeteriafed rats, a finding consistent with the higher glycogen levels. The lower production of 14 CO 2 indicates a deviation of the citric acid cycle intermediates into the cytosol, a change which may favour the synthesis of fatty acids and triacylglycerols. These liver metabolic disturbances probably contribute to fatty liver diseases, hyperglycemia and dyslipidemia in cafeteria diet-induced obesity.

certain cancers. This study aims to evaluate the association between obesity and colorectal cancer risk and also if the association varies with the blood type, age of obesity or cancer subsites.

The study was carried out on 65 hospital patients, different ages, diagnosed with colorectal cancer. We determined the blood type, cancer subsites and age of symptoms. We evaluated their family history and their lifestyle in terms of physical activity, smoking and alcohol consumption.

Results: Out of the 65 patients, 94% had the BMI ! 30 kg/m 2 and all of them showed abdominal obesity. The age of obesity was up to 5 years to 58% of the subjects and over 10 years for 24% of them. Symptoms were detected over 6 months before diagnosis for 34% of the individuals and between 4 and 6 months for 32% of them. In what respects the cancer subsites, 72% of the cases were located on the descending colon, rectum and sigma. 28% of the patients had a family history of different types of cancer (colorectal, pulmonary, gastric or breast neoplasia). Sixty-five percent of them were smokers, 68% were alcohol consumers and 60% carry light or no physical activity. Forty-nine percent were blood group A individuals.

The study shows that obesity is a statistically significant risk factor for colorectal cancer and the association is stronger for the patients with a higher age of obesity, descending colon and rectum localisation of the neoplasia and blood group A individuals. Technical University Munich, Munich, 2 IKFe Institute, Mainz, Germany Purpose: The angiotensin II receptor antagonist telmisartan (T) has demonstrated bifunctional effects on the hemodynamic, vascular and metabolic features of patients with metabolic syndrome (MS). Accordingly, we tested the hypothesis, that antihypertensive therapy with T vs. amlodipine (A) improves diastolic myocardial function, vascular function and metabolic characteristics in MS.

Methods: This randomised cross-over study investigated 19 MS patients (BMI 36 AE 6 kg/m 2 ) with mild-moderate hypertension before and after 3 months therapy with T vs. A. Laboratory and ultrasound data were taken in the fasting state and 2 h after a test meal (48 g carbohydrates). Cardiac function was assessed by tissue Doppler as systolic (S') and diastolic myocardial velocity (E') and vascular function at the common carotid artery as elasticity modulus and pulse wave velocity.

Results: After 3 months with T, fasting systolic blood pressure was reduced by 10 AE 12 mmHg (P < 0.002) and postmeal by 12 AE 16 mmHg (P < 0.003) vs. A (5 AE 10 mmHg (P < 0.04) fasting and insignificant 3 AE 10 mmHg (P < 0.05 vs. T) postmeal). With T but not with A, diastolic pressure dropped by 9 AE 11 (P < 0.003) fasting and postmeal (P < 0.006). With T but not A, E' increased fasting and postprandially by 0.6 AE 1.2 (P = 0.04) and 0.8 AE 1.2 cm/s (P = 0.01) and so did S' (P < 0.001 and 0.03), whereas vascular function improved postprandially alone (P < 0.002 and P < 0.001).

Conclusion: In MS patients, mild to moderate hypertension and without cardiac disease, monotherapy with telmisartan improved diastolic and systolic cardiac function in particular postprandially whereas amlodipine did not. 

Introduction: The metabolic disorders at the Tunisian military pilots are more and more frequent affecting more and more young subjects.

The expert doctor is in front of a big problem to know the evaluation as well as the control of the evolutionary genius of these disorders to be able to minimize their complications Materials and methods: It is about a retrospective study which was interested in the files of the Tunisian military pilots followed regularly in the center of Expertise of Aeronautical Medicine since 1989.

On these files, we found the various types of metabolic anomalies by referring to the age and the anthropometric characters during their appearance, as well as the evolutionary follow-up of these anomalies with or without treatment Results: The metabolic disorders were found at 50 % of the military pilots. These disorders are represented in the order by dyslipide´mies, then disorders of the hepatic metabolism, the hyper urice´mie and finally the not insulin-dependent diabetes.

The therapeutic care ways begins with the hygie´no-dietary rules before the passage in the medicinal treatment.

The metabolic disorders make the bed of the cardiovascular diseases; their complications particularly at the military navigators are very grave. The correction of these anomalies is imperative to avoid the vascular accidents which can be responsible for a sudden incapacity during flight. comparison to WT controls, and the epididymal fat weighs significantly less in the KO (P = 0.008; normalized to body weight). The Irx5 KO mice showed increased feed and water intake relative to their body weight compared to WT littermates. Moreover, qPCR and Western blot analysis indicates differential expression of Irx5 during adipogenesis in 3T3-L1 cells. Our data suggest that IRX5 plays a role in the development of adipose tissue. Method: Forty-six obese participants (both sexes, age range from 20 to 55 years) group mean AE SD, 37.0 AE 11.6 years were selected for the study based on a BMI ! 23 kg/m 2 *. The participants were randomized as two groups. All participants were assessed for BMI and lipid profile at the beginning and end of 15 days of the intervention. Twenty six participants (13 from each group) were assessed for leptin and adiponectin. The yoga group practiced yoga for 45 min two times in a day for 15 days. At the same time of the day the walking group practiced 45 min of walking for two times in day. Each day participants were given non calorie restricted diet regulated as 1800 kcal/day. Data recorded at the beginning and at the end of the intervention were compared by Repeated Measures Analysis of Variance using SPSS Version 18.0, followed by post-hoc analysis.

Results: Both groups showed a significant decrease in BMI (P < 0.001) and in total cholesterol (P < 0.05). Only yoga group showed significant reduction in LDL cholesterol (P < 0.05) and significant increase in leptin (P < 0.01). The walking group alone showed a significant reduction in triglycerides (P < 0.05) and in adiponectin (P < 0.05). 

Objective: Human urotensin II is the most potent vasoconstrictor identified to data. However, association between urotensin II and hypertension and whether the association is independent of endothelial function has been controversial. Here, we studied the association under adjustment for serum nitric oxide in a case-control study.

Methods: Hundred and ninety-seven hypertensives and 197 age-and sex-matched normotensive controls were studied. Plasma urotensin II, serum nitric oxide and other traditional biomarkers were examined. Association between urotensin II and hypertension was evaluated by multivariate conditional logistic regression analysis.

Results: Hypertensives had higher levels of urotensin II [median (interquartile rang): 9.32 (7.86-11.52) ng/ml vs. 8.52 (7.07-10.41) ng/ ml] and lower nitric oxide [19.19 (2.55-38.48) lmol/l vs. 23.83 (11.97-43.40 ) lmol/l] than normotensive controls.

Urotensin II positively correlated with SBP (r = 0.169, P < 0.001), DBP (r = 0.113, P = 0.024) but negatively correlated with nitric oxide (r = À0.112, P = 0.027). In multivariate regression analysis, subjects in the highest 25th percentile of urotensin II concentration ( ! 10.91 ng/ ml) had 2.33 times the risk of hypertension than did individuals in the lowest quartile (<7.30 ng/ml) (P = 0.027). Both univariate and multivariate analysis in 106 pairs of serum nitric oxide level-matched cases and controls showed that risk of hypertension significantly and positively increased with levels of urotensin II (all P < 0.05).

Conclusions: Urotensin II was markedly associated with hypertension and the association was independent of endothelial function. This study suggested that urotensin II may have an etiological role in hypertension. Objective: Dilated cardiomyopathy (DCM) is the third most common cause of HF. The implication of transcription factors (TFs) in molecular pathways that guide heart development and cardio-specific gene expression has recently been established. However, the role of cardiac specific TFs; Myocardin and TBX20 in the failing heart is unknown. The present study was designed with the aim to determine the expression profile and regulation of these TFs in failing hearts.

Methods: Myocardin and TBX20 mRNA levels were estimated by quantitative RT-PCR (qRT-PCR) in human ventricular biopsies and PBMCs of DCM patients (n = 25) and controls (subjects with ventricular septal defect) (n = 12). Copy number variations in Myocardin and TBX20 were determined by qRT-PCR in DCM patients (n = 150) and control (n = 100). Myocardin and TBX20 promoter methylation patterns were studied in PBMCs of DCM patients (n = 80) and controls (n = 60) by methylation specific PCR (MSP).

Results: Myocardin and TBX20 mRNA levels were found to be significantly six fold (P 0.004) and seven fold (P 0.00017) increased in the failing human myocardium as compared to control samples respectively. Promoter hypermethylation of Myocardin was observed only in patients and none of controls were found to carry methylated alleles for Myocardin. We did not observe any significant difference in promoter methylation status of TBX20. There was no significant difference observed in the copy number of both the transcription factors; Myocardin and TBX20 between patients and controls.

Conclusion: Our results suggest that epigenetically regulated expression of cardiac specific TFs; Myocardin and TBX20 may contribute to pathophysiology of DCM. 

Introduction: miR-21is among the most abundantly expressed and consistently dysregulated miRNAs in heart failure and has been implicated in cardiac fibrosis. However, its role in diabetic cardiomyopathy is not known.

Abstracts of the 5th International Congress on Prediabetes and Metabolic Syndrome normalisation of the majority of indicators of lipid and carbohydrate metabolism.

A.G. Kistauri 1 , G. Devidze 2 , M. Jibladze 1 , A.A. Kistauri 3 1 Internal Medicine, Tbilisi State Medical University, Tbilisi, 2 Surgery, Kutaisi Ortodox Christian Hospital, Kutaisi, Georgia, 3 Lund University, Lund, Sweden Aims: Diabetic foot syndrome is a complex of purulent-necrotic and/ or ostheoarthropatic changes of the foot. In case of purulent-necrotic complications, lethality reaches 6-22%.

Objectives: Optimisation of infected diabetic foot treatment.

Methods: Eight-four patients, suffering from infected diabetic foot. Following was used as a material for antibioticogram: soft tissue scraping from the bottom of the injury, purulent discharge, bone biopsy.

Results: Degree of bacterial contamination was high: between 10 5 and 10 10 -10 12 : anaerobic flora -77.3%, aerobic flora À17.7%. Bacterial flora in purulent zone (decreased-38.1% to 4.7%): Staphylococcus aureus, Saprophyticus, Epidermidis, Ps. aeruginosa, Enterococcus, E. coli. The highest sensibility was shown to the following drugs (decreased-98.9 % to 40.1%): Tienam, Meronem, Amoxiklav, Vankomicin, Cefepim, Ceftriaxon, Ciprofloxacin, Likacin, Klindamicin. Less sensitivity was detected to the following drugs (4.7-2.3%): Ampicilin, Doxaciclin, Cefazolin, Erythromycin. Based on the above, the most appropriate combinations are: ftorchinolines + I-III generation aminoglycozides (Combination I) and/or III generation cefalosporines + lincosynamides (Combination II). Using the first drug combination, infection was stopped in 42.3% and in 48.1% of cases using the second. High amputations were performed in two cases, six more than half of foot. In 59 cases process was stopped and amputation was avoided.

Conclusions: Cause of tissue necrosis during neuropathic form of diabetic foot is infection, during neuroischemiccritical ischemy and infection. Neuroischemic infected injury is characterised with much faster course than infected neuropathic ulcer. The most appropriate treatment combination of diabetic foot is fluorcholines + I-III generation aminoglycozyed and III generation cefalosporines + lincosomydes. Background: Continuous glucose-monitoring system (CGMS) is a tool for assessment of glycemic excursions. Glucose variability is a risk factor independent of glycosylated hemoglobin (HbA1c) for diabetic complications.

Aim: To evaluate the prevalence and extent of glycemic excursions & unrecognized hypoglycemia in Type 2 diabetic patients.

Setting and design: The study was carried out in 50 Type 2 diabetes patients on oral agents.

Material and methods: Patients underwent continuous glucosemonitoring by CGMS for 3 days. Number and duration of glycemic excursions, unrecognized hypoglycemia, correlation coefficient (%) between CGMS and self-monitoring blood glucose (SMBG), mean absolute difference (%MAD were analyzed.

Results: The mean age of patients was 45.6 AE 14.3 years. The mean HbA1c was 9.5 AE 2.3%. The mean number of glycemic readings was 766.0 AE 186.9 times. The correlation coefficient was 0.65 and the MAD was 12.3 AE 8.0%, which were considerable. Twenty three (46%) patients experienced 134 hypoglycemic events. Twenty seven (54%) patients had hyperglycemic events. The hypoglycemic events were found to have significant correlation with the duration of diabetes and inverse correlation with HbA1c, whereas Age was significantly correlated with females diabetics (P < 0.05).

Conclusion: This study demonstrated that type 2 diabetic patients have a considerable number of hypoglycemic and hyperglycemia events that may be missed by SMBG. Internal Medicine Department, Zagazig University, Faculty of Medicine, University Hospital, 2 Medical Biochemistry, Zagazig University, Faculty of Medicine, Zagazig, Egypt Impaired fibrinolysis increase the risk of CVD in diabetics, it has been found also in IGT associating metabolic syndrome but there is no data concerning fibrinolysis in subjects with normal GT that may convert to diabetes. Therefore, the aim of work was to study the fibrinolytic activity, as measured by tPA activity and t-PAI-1 antigen as markers of endothelial dysfunction in normal and IGT offspring of type 2 diabetes compared to subjects without family history of diabetes.

We measured fibrinolytic activity (tPA activity and tPAI-1 antigen) in 150 subjects, 50 healthy volunteers and 100 offspring of type 2 (50 normal GT and 50 IGT), we measured fasting plasma insulin, lipid profile and insulin resistance. We found that tPA activity was significantly reduced and tPAI-1 was significantly raised in IGT group as compared to normal GT. Surprisingly tPA activity was also significantly reduced and tPAI-1 was significantly raised in normal GT. Also, we found that IGT increases the (tPAI-1 antigen and decrease tPA activity in IGT by 6.9 fold and 8.6 respectively than normal GT offspring. We can concluded hypofibrinolysis may aggravate insulin resistance and promote progression of atherosclerosis in those offspring in the future. This may explain the increased prevalence of cardiovascular diseases in early discovered diabetics. Moreover, changes of these parameters can be used as a predictor for early detection of prediabetic state even before occurrence of glucose intolerance and the proper correction of this hypofibrinolysis may delay the development of atherosclerosis in diabetic stage. 

Introduction: Type 1 diabetes in children is the most common juvenile endocrinopathy. Decreased bone mass has been shown to be a common complication of type 1 diabetes. The aim of our study was to evaluate the characteristics of bone mineral density (BMD) in diabetic children and their relationship with the age of diabetes, glycemic control and the biological markers of bone remodeling.

with an assay of biological markers of bone turnover were performed for each child.

Results: Sex ratio was 0.53 in the diabetic group and 1.1 in the control group. The average age of diabetics was 10.4 years and that of controls was 9.9 years. The two groups were comparable concerning the age, sex, anthropometric parameters and pubertal stage. The only difference found between the two groups concerning calcium intake that was lower in the controls. Bone mineral density did not differ significantly between the two study groups. A significant difference was found comparing averages of bone markers (osteocalcin and CTx). The seniority of diabetes was correlated to the bone mineral density only in the diabetic daughter. The glycemic control represented by HbA1c was inversely correlated to the bone mineral density.

Conclusion: The prevention of bone damage in the diabetic child must go through adequate calcium intake, a proper sports activity and especially a good control of the disease. Background and aims: The aim of the present study was to investigate all-cause mortality in relation to physical inactivity and diabetic status among patients surviving an acute myocardial infarction (AMI). We hypothesised that physically inactive patients had a higher mortality risk compared to those who were physically active, regardless of diabetic status.

Methods: We enrolled n = 1008 patients with AMI admitted to the coronary care unit of the Central Hospital in Va¨stera˚s, Sweden between November 2005 and May 2011. All-cause mortality was followed-up until May 2012. The relation between self-reported leisure time physical inactivity during the last year, diabetic status and allcause mortality was analysed univariately using Kaplan-Meier curves and multivariately using Cox regression adjusted for the confounders BMI, prior angina pectoris, prior stroke, smoking, age, sex, education level and immigration status. P-values<0.05 were considered statistically significant.

Results: A total of n = 972 (96.4%) of the AMI patients had valid values for diabetics status and leisure time physical inactivity. Of these, n = 219 (22.5%) died during follow-up. The mortality was significantly different (log-rank test P < 0.001) between physically active and inactive patients with or without known diabetes (see Figure) . Notably, physically inactive patients had a higher mortality regardless of diabetic status. After adjusting for confounders, the hazard rate was 1.64 (P = 0.002) for having diabetes and 2.56 (P < 0.001) for being physically inactive.

Conclusions: Physically inactive patients had a higher mortality risk compared to those who were physically active, regardless of diabetic status. Medical Pharmacology, Akdeniz University, Antalya, Turkey

Aims: We investigated functional effects of GLP-1(7-36), GLP-1(9-36), exendin-4(1-39), exendin (9-39) and role (s) of reactive oxygen species (ROS) and endothelium-derived hyperpolarizing factor (EDHF) in the effects of these agents in small resistance arteries from control and diabetic rats.

Methods: Mesenteric arterial rings were suspended in wire myograph and responses to GLP-1(7-36) and its analogues were recorded in the absence and presence of ROS scavengers; superoxide dismutase (SOD, 100 U/ml) and catalase (CAT, 1000 U/ml). Role of EDHF in GLP-1 induced responses was investigated in KCl (30 mmol/l)-contracted rings following incubation with NO synthase inhibitor L-NAME (10 À4 mol/l) and cyclooxygenase inhibitor indomethacin (10 À5 mol/l).

Results: GLP-1(7-36) and GLP-1(9-36), but not exendin-4(1-39) or exendin (9-39) produced concentration-dependent relaxations in mesenteric arteries from control and diabetic rats that were significantly higher in control compared to diabetic rats and in endothelium-intact compared to denuded preparations. Incubation of control and diabetic rat mesenteric arteries with CAT did not affect responses to GLP-1(7-36) and GLP-1(9-36) while, SOD caused a significant increase in relaxant responses only in diabetic rats. GLP-1 (7-36) and GLP-1(9-36) induced relaxations were significantly and similarly blunted by L-NAME plus indomethacin in control and diabetic rats.

We provided evidence about relaxant effect of GLP-1(7-36) and GLP-1(9-36) in rat resistance arteries and about the reduced vasorelaxant effect of GLP-1 in diabetic rats. Our findings suggested that EDHF played a role in GLP-1-induced relaxations and that increment in certain ROS and/or reduction in SOD function might play a role in reduced vazorelaxant responses to GLP-1 in diabetic rats.

Results: Significant differences for systolic blood pressure, lipids levels and kidney function between the groups are depicted in Table 1 . HOMA-IR was elevated in both groups, but significantly higher in the diabetic group (11.8 AE 9.7 vs. 5.1 AE 3.5; P < 0.001). Diastolic Blood Pressure, CRP and total cholesterol were not significantly different between the two groups. In the longitudinal group HbA1c levels decreased dramatically in the diabetes group (7.5 AE 1.4% vs. 5.8 AE 0.7%; P < 0.008), but less in the normal glucose tolerance test group (5.6 AE 0.4% vs. 5.3 AE 0.4%; P < 0.001).

Conclusion: Diabetic patients with morbid obesity have a much higher CV risk profile compared with nondiabetic subjects despite presenting with the same BMI and should therefore be the preferred candidates for metabolic surgery since capacities are very limited. Objective: Morbid obesity (MO) has been shown to be associated with hypothyroid disorders in some patients. We therefore investigated the relationship between thyroid function parameters, BMI and insulin resistance in patients with morbid obesity before and after bariatric surgery.

In 286 patients (82.9% women) with MO (41 AE 10 years; BMI 44.8 AE 9.4 kg/m 2 ), parameters of thyroid function (TSH, fT4, fT3) and HOMA-IR were determined before and 2 years after bariatric surgery (weight loss À40.3 AE 19.3 kg; P < 0.001). Due to the lack of normal distribution, thyroid function parameters were logarithmized for statistical evaluation.

Results: Of the 286 patients, 47 presented with hypothyroidism (TSHrange: 3.70-21.06 lU/ml) before surgery, six of them with overt hypotheroidism (fT4-range: 0.78-0.87 ng/dl). In the euthyroid patients, TSH decreased from 2.1 AE 0.8 to 1.9 AE 1.0 lU/ml (logTSH 0.28 AE 0.19 vs. 0.21 AE 0.24; P < 0.001). In the hypothyroid patients, TSH declined from 6.5 AE 3.9 to 3.4 AE 2.4 lIU/ml (logTSH 0.76 AE 0.19 vs. 0.40 AE 0.49; P < 0.001). In the latter, the decline in TSH was more pronounced than in euthyroid patients (P < 0.001). Concordantly, fT4 concentrations increased by 9.1% (P = 0.001) and by 3.3% (P < 0.001) in euthyroid and hypothyroid patients. HOMA-IR declined from 5.7 AE 4.2 to 1.9 AE 1.4 (P < 0.001) in euthyroid patients and from 6.5 AE 4.9 to 1.7 AE 1.3 in hypothyroid patients (P < 0.001), but did not correlate with the decline in TSH.

The improvement of thyroid function after bariatric surgery is not associated with the reduction in Insulin Resistance. Therefore the improvement of thyroid function could independently contribute to the positive long-term effects of this intervention. Introduction: Some years ago chronic diseases were considered to be a problem of the rich and elderly population. Today we know that within high-income countries, poor as well as young and middle-aged people are affected by chronic conditions. For chronic disease, there are a small number of risk factors common to many diseases. The major biological risk factors identified in the World Health Report 2002 are: overweight and obesity, raised blood pressure, raised blood glucose and abnormal blood lipids and its subset raised total cholesterol.

Objective: Was to carry out an epidemiological survey on prevalence of raised fasting blood glucose in Kosova.

Material and methods: According to the WHO STEPS methodology the fasting blood glucose in blood sample from finger was measure with Accutrend plus on sample of 1000 randomly selected participants aged 15-64 years.

Results: According WHO criteria raised fasting blood glucose is if capillary glucose is more than 6.0 mmol/l or more than 110 mg/dl. In Kosova, females are in higher risk for diabetes than males (Females 15.5% vs. Males 11.9%), Total 13.7%. Prevalence of raised fasting glucose was increased with age. At the age 15-24 year the prevalence of raised fasting blood glucose was 0.6%, at age 25-34 year 3.6%, at age group 35-44 year 10%, at age group 45-54 year was 21.2% and at the age group 55-64 year was 34.5%.

Conclusion: Effective preventive interventions are needed, and health systems should prepare to detect and manage diabetes and its sequel. Objectives: Hypertension and hyperglycemia are features of the metabolic syndrome and diabetes. Methylglyoxal (MG), a reactive glucose metabolite, is elevated in diabetic patients. We investigated whether MG induces hypertension and its molecular mechanisms.

Methods: Male 12 week old Sprague-Dawley rats were treated with MG (24 mg/day by continuous infusion with a minipump) for 4 weeks. Aortic rings were used for vascular contractility, and other tissues alongwith cultured vascular smooth muscle cells (VSMCs) for molecular studies. HPLC, Western blotting and Q-PCR were used to measure MG, proteins and mRNA, respectively. siRNA for angiotensinogen and the receptor for advanced glycation endproducts (RAGE) were used to study mechanisms.

Results: MG treated rats developed a significant increase in blood pressure, plasma aldosterone, renin, angiotensin (includes precursor and products), norepinephrine, epinephrine and dopamine levels. The aorta showed increased contractility to the a1 agonist phenylephrine. MG level and protein and mRNA for angiotensin, AT1 receptor, a1D receptor and renin were significantly increased in the aorta and/or kidney of MG treated rats. Treatment of cultured VSMCs with MG or high glucose (25 mmol/l) significantly increased cellular MG, and protein and mRNA for NF-jB, angiotensin, AT1 and a1D receptors, which were prevented by inhibition of NF-jB. Silencing of mRNA for RAGE prevented the increase in NF-kB induced by MG. Silencing of mRNA for angiotensinogen prevented the increase in protein for NF-jB, angiotensin, AT1 and a1D receptors.

Conclusions: MG activates NF-jB through RAGE and thereby increases activity of the renin angiotensin aldosterone system to cause increased vascular contractility and hypertension. Background: Guidelines state obesity as an indication for diabetes screening. Abdominal obesity is valuable to manifest metabolic risk as much as and may be even more than body mass index (BMI). In this study the answer to "Which is a better indicator for diabetes screening; BMI or waist circumference?" has been questioned.

Method: Three hundred people attended to the invitation of diabetes screening in Istanbul Medeniyet University Goztepe Research and Training Hospital outpatient clinics. Their demographic characteristics, BMI, waist circumference, fasting blood glucose (FBG), diabetes history and if diagnosed drug regimen were recorded.

Results: A total of 300 individuals (209 women, 91 men) were enrolled. One hundred forty three of 300 (48%) individuals had a BMI ! 30. Among those people 44 (31%) had FBG ! 100 and <126 mg/dl and 29 (%20) had FBG ! mg/dl (Table 1) . Abdominal obesity was observed in 225 individuals (173 women, 52 men). Thirty 2% had known diabetes mellitus (DM). Among patients with abdominal obesity and without DM diagnosis, 39% had dysglycemia (Table 2) . Among 143 obese individuals, 37% had a history of DM. Dysglycemia rate among obese persons without a history of DM, was 25% (Table 3) Conclusion: Abdominal obesity is a strong predictor of diabetes as obesity and its presence should be considered as an indication for screening diabetes. Internal Medicine and Cardiology, Expertise Centre of Aviation Medicine of Tunis, Mhiri, Tunisia Type 2 diabetes is a rare disease compatible with aviation activity with restrictions and constraints of regular medical checks. This retrospective study was interested in drivers with type 2 diabetes CEMEDA monitored since 1991 until 2010. The aim of this work is to investigate the incidence of diabetes in the Tunisian population of seafarers and show the difficulties of management of diabetic driver.59 sailors have diabetes type 2 (or # 5%) and three student pilots (two civilians and military) had type 1 diabetes resulting inability final flight. Average blood glucose of diabetic patients was 1.50 g/l with a range of 1.26 and 2.7 g/l; glycosylated hemoglobin A1C is an average of 7.3% [range: 6.3-11.8 %]. The average age of diabetes is 51 years and mean BMI of 30 kg/m². A mild to moderate hypertension was found in 44% of diabetics; dyslipidemia was found in two-thirds of diabetics. The treatment of diabetic subjects: Rules dietary guidelines were prescribed in only about 44% of cases. Moreover, these measures were associated with treatment with oral antidiabetic (Biguanide alone in 27% of cases; Biguanide + pioglitazone in 5% of cases associated Biguanide a sulphonylurea in approximately 17% of cases.

Conclusion: : The prevalence of NIDDM is significantly lower among sailors in the general population. The balance diabetic seafarers is the only guarantor of declining maturity of micro and macrovascular disease and strengthen the doctor′s attitude towards PN medical ethics and flight safety. Methods: Is a retrospective cohort study that included patients who attended a preventive evaluation unit between 2001 and 2011, with at least three visits in that period.

Results: A total of 105 patients were included, of whom 18 (17%) had NAFLD at their first visit. The basal variables were similar between groups, with male predominance in the NAFLD group. High blood pressure and dyslipidemia predominate in the NAFLD group until visits 4 and 3 respectively. The other cardiovascular risk factors were similar until visit 6. The study showed a tendency to present high blood pressure, dyslipidemia and gallstones in the NAFLD group in a shorter period of time than the control group. Levels of aspartate aminotransferase raised in a period of 6.9 vs. 8.7 years in the control group (P = 0.08).

The study was not able to demonstrate a clear difference in the presentation of cardiovascular risk factors and liver function tests in patients with NAFLD and although there was a higher presentation of gallstones, it requires a larger sample and a longer follow up period to have significant results. Objective: To determine the relationship between Metabolic Syndrome (MS) and exaggerated blood pressure response to exercise (EBP) in adolescents.

Methods: This cross sectional study was conducted in 553 adolescents (287 males, 266 females), randomly selected of high schools, in Maracaibo, Venezuela. They underwent an exercise treadmill testing. The MS was defined according to the definition of the National Cholesterol Education Program, Adult Treatment Panel III modified for adolescents. The BP was measured at rest and during the treadmill test (Bruce Protocol), and it was registered the Systolic BP (SBP) in maximal exercise to define adolescents with EBP ( ! 200 mmHg). Statistical analysis: Chi square test was used to establish associations between MS and EBP.

Results: The MS prevalence was 4.2% (n = 23) in all subjects, 6.3% (n = 18) in males and 1.9% (n = 5) in females (P: 0.01). The SBP in maximal exercise values were: 185.9 AE 25 in adolescents with MS and 160.3 AE 26 in adolescents without MS (P: 0.0001). The prevalence of the EBP was 8.1 % (n = 45) in all, 17.8% (n = 8) and 3% (n = 15) in subjects with MS and without MS, respectively (P: 0.0001).

The MS is closely linked to the SBP response to exercise in adolescents. Those adolescents with MS are more likely to have exaggerated SBP during exercise, indicating an important information about their cardiovascular risk. 

Background: Metabolic syndrome (MetS) is a cluster of risk factors that carries a great risk for atherothrombotic events leading to significant morbidity and mortality. Few studies evaluated the association between MetS and acute stroke. The aim of this work was to study the prevalence of MetS and its effect on ICU mortality in acute non embolic ischemic stroke patients.

Patients and methods: We studied 260 patients presented with acute ischemic stroke diagnosed by CT brain in the medical ICU, Zagazig University hospital for the presence of MetS and its relation to age and sex as well as the number of components of MetS. We studied also the relative risk of MetS with its different components as well as age, sex, Glasgow coma scale (GCS) and APACHE II score on the mortality in those patients.

Results: MetS was found in 53.8% of patients. It was more prevalent in males (55.7%). this prevalence increase progressively in males aged 40-60 years then decrease progressively while in females, prevalence increase progressively with age. 55.7% of patients have three components of MetS compared to 44.3% with more than three components. The relative risk of mortality was found to be increased with increasing age, male gender, obesity, hyperglycemia, low HDL-C, increased serum triglycerides, lower GCS, increased MAP, MetS Per se and higher APACHE II score. MetS and APACHE II score were good predictors of mortality.

Contrary to the usual approach, we could leave the future open to a bi-therapy associating GLP-1 mimetics and DPP-4 inhibitors (before the supplementation in metformin and sulfamids or glitazones).

Case report: Diabetes type 2 in balance for 20 years after being treated first with metformin only then added glitazone, to end by GLP-1 mimetics at maximum doses and metformin but still not under control.

It was decided to associate GLP-1 mimetics and DPP4 inhibitor, ending up to a glycemia 82 and insulin 5.8 and HBA1C:5.2.

After stopping the treatment for 10 days we observe: fast glucose 159, postprandial 111 (on a diabetic diet), relative hypoglycemia generating a multi metabolic syndrome spiral.

The increase of the fast glucose being explainable by the non-control of the glucagon produced during the night.

Pattern proposed: Glucagon would not work on demand but time continuously.

It has to be inhibited thanks to the GLP1 as soon as the glycemia increases and this would be irrespective of food intake.

Therefore, there is no reason to use the DPP4 inhibitors only in case of resistance to endogen GLP1 and let the GLP1-mimetics being destroyed by the DPP4.

This would lead to a therapeutic failure or usage of very high doses.

We could treat upstream the sequence of energetic metabolism.

First of all: GLP1-mimetics or DPP4 inhibitors.

Secondly: GLP1-mimetics and DPP4 inhibitors.

Those 2 steps could be part of tomorrow′s decisional algorithm of type 2 diabetes.

Abstracts of the 5th International Congress on Prediabetes and Metabolic Syndrome

Aim: To evaluate the prevalence tipe 2 diabetes mellitus (DM2) and ischemic heart disease (IHD), and diabetogenic/atherogenic factors in patients with newly diagnosed long-term gout

Material: Seventy males 33-77-years (mean 53) with untreated tophaceous primary gout 5-36 years (mean-9) duration (without renal insufficiency) were studied. Uric acid level was

Fasting serum glucose, insulin (control-19-123, mean 99 pmol/l), total and HDL cholesterol, triglyceride, BP and ECG monitoring

3 mmol/l, insulin 134 and 192 pmol/l. One more patient, 55 years, with IHD and triglyceride 11.6, cholesterol 6.2 mmol/l, insulin 192 pmol/l levels. Thus, diabetes was in one and IHD in three patients

Two patients (60-70 years) with 19 and 36 years of gout and hyperinsulinemia

Thus, long-term gout (hyperuricemia) even with concomitant high BMI, insulin, cholesterol and triglyceride levels is not an evident risk factor for diabetes and IHD development. Probably, antioxidative effects of uric acid play a role

Montes Claros, Brazil Background: The leptin receptor is an important regulator of leptin activity and a potential mechanism for the obesity. The polymorphism LEPRGln223Arg could be associated with high body fat percentage (BF%) and body mass index (BMI)

Objective: To investigate the association LEPRGln223Arg with obesity indexes

We obtained oral swab and anthropometric measures including waist circumference (WC), BMI and BF% for subjects aged ! 18 years. The genotypes were determined by PCR-RFLP method. The statistic analyze were carriedout in STATA software. Results: There were no differences of age average between sex (Female 44.7 AE 17.9; Male 44.7 AE 17.1). The prevalence of the overweight (BMI >25 kg/m 2 ) was 35.8%(38), normal, 38.7% (82) and obesity (BMI >30 kg/m 2 ) 22.6% (48). The prevalence of high WC (>80 cm for women or >94 cm for men) was 58.6% (78) and 41.8% (33) in women and men, respectively (P = 0.01) and of the high BF% (>30% for women and >25% for men) was 54

Adiposity was not associated with genotypes. The frequencies of overweight were 52.5%, 33.33% and 14.17% and of the obesity were 52.08%, 31.25% and 16.67% in the genotypes AA, AG and GG, respectively. There was not also association for high WC

Conclusions: These findings suggest that the LEPRGln223Arg is not associated with high BF%, BMI or WC in this population

Hydrogen Breath Test (BTH 2 ), based on lack of source for hydrogen gas in humans other than bacterial metabolism of carbohydrates, is use to detect carbohydrates malabsorption

Aims: To evaluate the utility of BTH 2 in detect carbohydrates malabsorption in overweight-obese subjects. Patients and methods: Hundred and six consecutive subjects (38 overweight, 68 obese; 16 males/90 females

leptin injection did not suppress EI. Importantly, TS treatment reinstalled leptin sensitivity as seeing a significant decrease in EI for 24 h (À39%, P = 0.023) and increase of pSTAT3 level (À94%, P < 0.001) in the hypothalamus after i

Acknowledgements: This work was supported by a grant of the Romanian National Authority for Scientific Research, CNCS-UEFISCDI, project number PN-II-ID-PCE-2011-3-0429". Dr. Lixandru, was supported by the postdoctoral program POSDRU/89/ 1.5/S/60746, from European Social Fund. 

This cluster-randomized controlled trial study aimed to assess the effectiveness of the interactive multi-modality technology (IMM) as an intervention to increase self-management among type 2 diabetic patients in a 3-month period. The IMM intervention contained email, short message system (SMS), and website with four main functions (i.e., selfregulation, self-monitoring and assessment, social support, and reminder system -linked to email and SMS). In this trial, four public offices in Bangkok Metropolis were recruited and randomly assigned into either the intervention or the control group. One hundred and twenty four Thai patients who had met inclusion criteria (Hemoglobin A1c or A1c >7.0%, no serious illness, and internet and mobile phone accessibility) were subsequently assigned to the intervention (n = 74) and the control (n = 48) group. Patients in the intervention group received the IMM intervention. Those in the control group received selfmanagement knowledge via email only. Outcome measures, A1c and behavioral questionnaires (Diabetes Quality of Life, Self-Efficacy, and

Division of Endocrinology and Metabolism, National Institute of Nutrition, Secundrabad, India Introduction: We showed earlier that increased visceral adiposity in the offspring of Magnesium deficient rats was associated with altered gene expression and increased stress.Aim: To assess whether maternal Magnesium deficiency modulates the gene expression of adipogenesis and insulin sensitivity in utero due to increased stress.Methodology: Female weanling WNIN rats received for 12 weeks, an AIN 93G diet (control: MgC) or the same with 61% restriction of Magnesium (MgR) and mated with control males. Half the pregnant MgR dams were rehabilitated from conception (MgRC) while others continued on Magnesium restriction. Total RNA was isolated from the MgC, MgR and MgRC embryos collected on day 10 of gestation and expression of 11βHSD1, PPARc2 and adiponectin was quantified by Real Time PCR. Body composition was determined in 6 month old offspring by Total Body Electrical Conductivity (TOBEC).Results: Plasma Magnesium levels in MgC and MgR dams before pregnancy; and 6 month old MgC, MgR and MgRC offspring were on expected lines. MgR embryos had significantly higher expression of PPARc2 and 11βHSD1 than MgC, whereas adiponectin expression was lower. On the other hand in MgRC10th day embryos 11βHSD1 and PPARc2 expression was restored to MgC, adiponectin expression

Introduction: Khaya senegalensis is presently used for the treatment of diabetes in some west African countries.Objectives: This study was conducted to investigate the anti-diabetic effects of the plant using in vitro and in vivo models.Results: Ethanolic extract of the root sample of the plant was subjected to solvent solvent fractionation which yielded a butanol fraction that possessed significantly higher (P < 0.05) anti-oxidative activity as well as a-glucosidase and a-amylase inhibitory activities than other (aqueous, ethyl acetate and dichloromethane) fractions. Enzyme kinetic studies indicated that the butanol fraction is a non-competitive inhibitor for a-glucosidase with an inhibition binding constant (Ki) of 1.30 lg/ml and a competitive inhibitor of a-amylase with a Ki of 7.50 lg/ml. Subsequently, the butanol fraction was subjected to in vivo studies in a type 2 diabetes model of rats. After 5 weeks of intervention, the fraction, at 300 mg/kg bw, was found to improve the feed and fluid intake, body weight gain, blood glucose, glucose tolerance ability, serum insulin concentration and β cell function of diabetic animals. Phytochemical analysis of the fraction through repeated column chromatography led to the isolation of bicyclo [2.2.0] hexane-2,3,5-triol. The structure of the compound was established through detailed spectroscopic methods including 1 H NMR, 13 C NMR and 2D NMR (COSY, HSQC and HMBC) experiments.Conclusion: Data from the study suggests that the butanol fraction of K. senegalensis contains bioactive agents that could be exploited in the management of type 2 diabetes. Objective: To determine the progression rate to impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes (DM2) in normal glucose tolerant (NGT) people during 8 years follow up study using WHO 1999 and new criteria of IFG (IFG 5,6 -fasting glucose 5.6-6.9 mmol/l).Research design and methods: This is an 8 year prospective study in a randomly selected urban population aged ! 40 years living in Krakow, Poland. 1752 persons had NGT. Based on WHO 1999 criteria, 564 (32.2% of invited, 209 men and 355 women, aged mean 60.7 SD = 9.2) attended the follow-up assessment.. Subjects underwent a physical and biochemical examination and questionnaire examination.Results: The prevalence of DM2, IFG and IGT according to WHO 1999 criteria in examined population with baseline NGT was 4.43%, 3.37% and 9.93% respectively. The prevalence of IFG 5,6 using new criteria, was 13.48%, lowering cutoff point for IFG caused 10.11% increase in the prevalence of IFG.Among people with diagnosed diabetes 56% had newly diagnosed diabetes during the control study. The prevalence of DM2 and IGT/ IFG was increasing with increasing age and BMI categories (P < 0.05). The lowest obesity prevalence both baseline and after follow up was found in those who remained NGT.Conclusion: In the baseline NGT population high follow-up progression rate to impaired glucose metabolism was found. The implementation of new IFG diagnostic criteria increased the prevalence of IFG by 10.1%. According to our results prevention of diabetes initiatives should focus on normal body weight preservation. Results: SBP was found to be elevated in 68.29% subjects whereas DBP was elevated among 23.34% subjects. Out of all the subjects, 52.83% were overweight and 35.39% obese. Obese subjects were found to be more hypertensive than non-obese subjects (r = 0.38). SBP had strong correlation with age (r = 0.12), BMI (r = 0.15), WHR (r = 0.10), FBS (r = 0.10), CHOL (r = 0.11) and LDL (r = 0.13) whereas DBP was found to be strongly correlated with same parameters and Triglycerides (r = 0.08) also. No significant correlation was found with HbA1c levels and HDL-cholesterol.

Conclusion: Hypertension was found to be more prevalent in males as compared to females in this diabetic population. There was an 

Background: The Medicine Faculty, Chiang Mai University provided health screening to detect health problem and risk group for high school students who past entrance examination in this academic year 2012. There is no official cutoff value of waist circumference (WC) measured at superior iliac crest level (WCI) for overweight and obesity in Thai young adolescence. We aimed to determine correlation between WCI and to those measured at midpoint between lower costal margin and superior iliac crest (WCM) and to define appropriated WCI and body mass index (BMI) cutoff levels for admission students in Northern Thailand.Methods: The admission students had weight (kg), height (cm), WC, and blood pressure measurements.Results: There were 6344 admission students. 59.30% of them were female. The correlation between WCI and WCM was 0.86. For receiver operating characteristics analysis of having high BP (systolic ! 140 mmHg or diastolic ! 90 mmHg.) using WCM of 90 cm in male and 80 cm in female as standard (WCM9080), area under curve (0.735) of WCI of 80 cm in male and 75 cm in female (WCI8075) andAbstracts of the 5th International Congress on Prediabetes and Metabolic Syndrome All patients were asked to follow a dietary plan for 2 weeks before BTH 2 , 1 day before the test, subjects were instructed to take a low fibre diet. BTH 2 was carried out both after overnight fasting (T 0 ) and during Oral Glucose Tolerance Test (OGTT). Hydrogen gas is detected in exhalate, cut-off value was settled at 12 ppm.Results: At T 0 BTH 2 was positive in 5% of overweight and 37% of obese subjects.Particularly, BTH 2 was positive in 46% of subjects with MS and in 30% of those without MS.During OGTT, 50% of BTH 2 results, negative at T0, became positive.Conclusions: Obese subjects with MS had an BTH 2 altered value at T 0 suggesting a intestinal dysbiosis.On the basis of our preliminary data, BTH 2 at T 0 can be helpful to diagnose gastrointestinal disorders driving the idea of intestinal dysbiosis as a possible cause in pathogenesis of obesity, thus a probiotic supplementation is to be considered as baseline therapy in overweight-obesity.

Department of Clinical Physiology and Pathology of Locomotor Apparatus, Institute of Gerontology AMS Ukraine, Kyiv, Ukraine Aim of research: To determine uric acid level in blood serum and incidents of hyperuricemia among women and men of different age and their relation with some components of metabolic syndrome.Object of research: Age of examined patients was from 20 to 89 years old: women (n = 450) and men (n = 120). They were divided in following groups: I group (BMI = 18.5-24.9), II -(BMI = 25.0-29.9), III -(BMI = 30.0-34.9), IV -(BMI >35). Average age of examined patients was 60.4 AE 0.7 years.Methods: Uric acid level in blood plasma was determined by uricaseperoxidase method. Aim: We studied the prevalence and prognostic impact of the metabolic syndrome (MS) in acute myocardial infarction (AMI) patients (pts) with normal (NGT) or abnormal glucose tolerance (AGT).Material and methods: A total of 295 consecutive nondiabetic AMI pts performed an oral glucose tolerance test at hospital discharge being categorized using IDF/NHLBI/AHA 2009 MS criteria into four groups (gr): Gr. I -NGT no MS (n = 137), gr. II -NGT with MS (n = 63), gr. III -AGT no MS (n = 54), gr. IV -AGT with MS (n = 41). Clinical characteristics and CV events during 2.5 years follow-up were studied.Results: MS was diagnosed in 35% pts, with a higher prevalence in AGT vs. NGT subjects (P < 0.005). NGTMS and AGTMS subjects were more likely to be older (P < 0.05), women (P < 0.001), hypertensive (P < 0.001), have stroke history (P < 0.05) and hypertriglyceridemia (P < 0.05) compared to pts without MS. In hospital heart failure rates were higher in gr. II, IV vs. gr. I, III (P < 0.05). AGTMS subjects showed more often atrial fibrillation and a lower LVEF% compared to NGTMS (P < 0.05). CV events incidence during follow-up was similar among groups excepting significantly higher mortality in pts with MS, especially in AGTMS subjects (RR = 1.63 (95% CI 1.0-2.6) for NGTMS; RR = 2.1 (95% CI 1.17-3.77) for AGTMS).Conclusions: MS was present in 35% of nondiabetic AMI patients and was associated with high long-term mortality; its incidence and the risk of death increased in the presence of AGT. Methods: A cross-sectional study was realized in government workers during his medical review, from April to September 2011. The screening included height, weight, waist circumference, blood pressure measurements, plus a blood draw sample to determine glucose, triglycerides, and total cholesterol. Body Mass Index (BMI) was used to diagnose overweight and obesity according to cut-offs proposed by the World Health Organization (2007). The MetS was defined according with AHA/NHLBI criteria (2005) . Waist circumference (WC) and waist-to-height ratio (WHR) were used as fat distribution indexes. All statistical analyses were performed using the SPSS v19.Results: In total, 84 workers aged 20-62 years, of both sexes (45% males and 55% females), were included. The overall prevalence of MetS was extremely high with 54% (61% in male, and 48% in female). Abdominal obesity was present in 86.7%, high triglycerides in 95.61%, high-density lipoprotein cholesterol levels in 88.9%, fasting hyperglycemia in 84.4%, and hypertension in 28.9% of the sample. 85% of the overweight or obese were diagnosed with metabolic syndrome. The prevalence of overweight and obese was extremely high too, according with gender: 82% in male, and 80% in female. MetS was associated with cigarette smoking, absence of physical activity, a higher BMI and a greater proportion of obesity.

The MetS prevalence in this sector of Mexican government workers is a very serious health problem. It is urgent to develop innovative programs that improve health situation.

Our rehabilitation department targets obesity and take care of 1000 patients a year, either in a outpatient (op, day hospital) or in patient (ip) programme.We focus on therapeutic education, and our approach is medical, nutritional, physical, psychological and social.The aim of our study is to compare the efficiency of the day hospital vs. in patient in the rehabilitation of obesity.Two samples of 40 patients who exited our unit 6 months ago were compared.Investigated criteria were: loss of weight during the programme, way of life after the programme (physical activities, diet), medical and psychological follow up.The results showed:1. a weight loss between the patient admission and the trial date of 7.2 kg for in patients vs. 7.4 kg for day hospital patients.2. the diet prescription is followed by 57.5 % of ip patients and by 85.5 % of op patients.3. the prescription of physical activity was followed by 50 % of ip patients and 67.5 % of op patients.4. a psychological follow up is done by 25 % of ip patients and 22 % of op patients.The efficiency of the therapeutical education programme is proven in either ip or op patients.The day hospital allows a smooth return to normal life after a nutrition inpatient rehabilitation. Research design and methods: A total of 100 asymptomatic T2DM subjects (51 men and 49 women; mean age: 56.4 AE 7.6 years) were enrolled. Clinical and laboratory parameters, including HbA1c, glycoalbumin, lipid profile were evaluated and cardiovascular magnetic resonance (CMR) was performed. Abnormal findings of CMR were defined as any one of the followings:

1. Silent myocardial infarction.2. Inducible ischemia.3. Suspected CAD.Within 90 days after taking CMR, invasive coronary angiography (ICA) was performed in selective patients.Results: Among 100 patients, a total of 51 patients (silent myocardial infarction (n = 3), inducible ischemia (n = 11), suspected CAD (n = 37)) had at least one abnormal finding on CMR and ICA was recommended. Finally, 20 patients underwent ICA, and 13 subjects had significant CAD (A total of 60 coronary territories assess) Overall, in asymptomatic T2DM patients, the positive predictive value (PPV) of SP-CMR, CMR-A, c-CMR are 100%. However, the PPV of each MRI to detect signinficant stenosis are 73%, 57% and 54%, respectively.

In asymptomatic T2DM patients, stress perfusion CMR showed higher PPV than CMR-A.

Introduction: Observational data suggests that low 25-hyroxyvitamin D is associated with metabolic syndrome in diabetic and non diabetic patients. We examined the difference between components of metabolic syndrome before and after treatment with calcitriol in type 2 diabetic patients with vitamin D deficiency.Method and material: A total 119 type 2 diabetic patients were selected. 43 patients had vitamin D deficiency that underwent calcitriol treatment with 0.5 lg per day for 8 weeks. In all cases, clinical parameters including weight, systolic and diastolic blood pressure and laboratory parameters including levels of fasting blood glucose, insulin, lipid profile, calcium, phosphorous, HbA1C and insulin resistance were measured, before and after the treatment period. The two sets of results were then compared with one another.Results: Following treatment with calcitriol HbA1C, total cholesterol, LDL, HDL and diastolic blood pressure decreased significantly. (P = 0.01, 0.01, 0.04, 0.001 and 0.04 respectively). But the changes in other parameters were not significant. 

Subjects and methods: The five components of MetS following the criteria of the International Diabetes Federation (IDF) were measured in 613 men (mean age 44.8 AE 10 year) and 788 women (mean age 43.8 AE 9.3 year) participating in the PEP Family Heart Study. We determined percentage body fat using skinfold thickness. We defined high %BF >34% for females and >22% for males and elevated BMI as ! 25 kg/m². SPSS version 19 was used for the statistical analyses; multiple linear regression models were used. Two-tailed P < 0.05 was considered significant.Results: Mean values of WC, blood pressure (BP), fasting plasma glucose (FPG), triglycerides (TG), HDL-Cholesterol and BMI were significantly higher in men than in women who had higher %BF (28% vs. 21%). Using multiple linear regression models, we found significant associations with WC, %BF and BMI. BMI had the strongest associations with TG (beta 5.4; CI 95% 4.6-6.2), HDL-C (À1.07; À1.22 to À0.01), SBP (1. 

Objective: Patients with ESRD have an increased risk for cardiovascular morbidity and mortality. Metabolic syndrome (MetSy) has been implicated in the progression of cardiovascular disease (CVD). This cross sectional study investigated the prevalence of MetSy in 210 maintenance hemodialysis (HD) patients using a joint definition for MetSy.Patients and methods: Subjects had to meet at least three of the following five criteria for MetSy: elevated waist circumference, elevated triglyceride levels, low HDL cholesterol, elevated blood pressure and elevated fasting serum glucose. Demographics, medical history, anthropometric and laboratory data were collected from the medical records. Serum chemistries were obtained mid-week and waist circumference was measured twice after a HD session and the mean value was calculated.

The study cohort consisted of 65% male patients with the mean age of 62.4 AE 14.1 years. Hypertension was the leading cause of ESRD (38%) followed by diabetic nephropathy (26%). MetSy was identified in 69% of the cohort, with 38%, 27% and 22% having 3, 4 and 5 risk factors, respectively. The prevalence of MetSy was highest amongst patients on HD for >3 years (35%). For those patients on HD <6 months, 6-12 months and >1 to <3 years, MetSy was identified in 15%, 19% and 28%, respectively. Metabolic syndrome was not associated with gender and age.Conclusion: MetSy is highly prevalent in hemodialysis patients, which suggests an additional risk for CVD. Early screening for MetSy may have protective role on CVD morbidity and mortality.

Department of Family Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea Introduction: It was reported decreased relative muscle mass was related with insulin resistance and prediabetes in US. The aim of this study is to investigate the association of relative muscle mass with cardiovascular disease risk factor using the nationally representative sample of Korean adults.Methods: This is a cross-sectional study using the data of the 13 003 subjects who participated in the Korean National Health And Nutrition Examination Survey (KNHANES) in 2008-2010. Multiple linear regression analysis for survey design was used to explore the association between relative muscle mass and the factors of metabolic syndrome and HOMA-IR with adjustment for confounding factors.We also conducted multiple logistic regression analysis for survey design to investigate the relationship of relative muscle mass with metabolic syndrome.Results: In comparison with subjects in the first quintile of relative muscle mass, the odds ratio (95% confidence interval) for metabolic syndrome for subjects in the fifth quintile was 0.292 (0.183, 0.467) in the age <60 group and 0.155 (0.088, 0.272) in the age ! 60 group respectively after adjusting for confounding variables. Relative muscle mass was inversely associated with SBP, DBP, serum TGs, FBS and HOMA-IR in both age <60 and age ! 60 group, showing significant liner trend.Conclusions: Decreased relative muscle mass was inversely associated with the prevalence of metabolic syndrome, and the factors of metabolic syndrome except HDL-C. The causal relationship is not exactly known and would be elucidated through further longitudinal study. Endocrinology, Moscow Regional Research Clinical Institute, Moscow, Russia

Background: There has been growth in registered prevalence of type 2 diabetes (T2D) in Russia. Real prevalence of T2D is much more higher. New approaches for early detection of glucose metabolism disorders are important.Aim: Assess effectiveness of new approach to screening of glucose metabolism disorders based on using diabetes bus in remote areas of Moscow County. 

Objective: To study the frequency of metabolic syndrome according to the ATPIII criteria among elderly people attending the family practice clinic at the Jordan University Hospital, and to investigate the pattern of antihypertensive medications used for patients with metabolic syndrome.Design: A total of 635 elderly people (298 males and 337 females) aged 60 years or more attending family practice clinic at Jordan University Hospital.Materials and methods: Elderly patients included were studied regarding the frequency of metabolic syndrome and its individual components according to the ATPIII criteria. Antihypertensive medications used by elderly patients with metabolic syndrome were also investigated.Results: The frequency of metabolic syndrome was found to be 46.6%. Hypertension was the most frequent risk factor among all patients including males and females (58% in the whole sample, 58.7% in males and 57.3% in females). All risk factors except hypertension were significantly more frequent among patient with metabolic syndrome compared to those with no metabolic syndrome. The most commonly used antihypertensive medications were the angiotensin converting enzyme inhibitors (41.5%), followed by beta blockers (34.6%), calcium channel blockers (33%), and finally angiotensin receptor blockers and thiazide diuretics (both 13.3%).Conclusion: The frequency of metabolic syndrome was relatively high, which highlights the need to take some action to combat the syndrome. Hypertension in particular showed the highest frequency among all risk factors. Optimum control of hypertension by following the guidelines is essential in this context to better achieve control without adversely affecting the metabolic syndrome out come. Introduction: Metabolic syndrome is associated with a significantly increased risk of morbidity and mortality.Objective: To assess incidence of the metabolic syndrome in patients of the Team 1 in the Family Medicine centre in Kalesija through the medical audit.Patients and methods: We have analyzed the medical records of all the patients with Team 1 with 20 years of age and over (1200 records).We have used the International Diabetes Federation and the American Heart Association (AHA) criteria for the definition of metabolic syndrome diagnosis. The analysis is done separately by sex, age and body mass index (BMI).

The results of this study shows that 375 (31%) of adults meet the criteria for the metabolic syndrome. Of these, 245 (65%) were women and 130 (35%) men. 32% of patients in age group of 40-59 years meets the criteria for the metabolic syndrome. 12% of patients 20-39 years old, and 56% of patients ages 60 and older, meets the criteria for the metabolic syndrome. Out of the total number of female patients who meet the criteria for the metabolic syndrome, 78% had increased and 22% had normal BMI. From the male patients who met the criteria for metabolic syndrome, 67% had increased, and 33% had normal BMI.Conclusion: The incidence of the metabolic syndrome in family medicine is high. Metabolic syndrome is prevalent and significantly increased with age and BMI. More effective interventions in primary care are needed in order to reduce cardiovascular morbidity and mortality. Methods: After 15 weeks of high-fat diet, DIO mice (n = 40) were divided into two groups received either intraperitoneal (ip) injection of TS (10 mg/kg, daily) or saline for 20 days. Another group of mice were fed low-fat diet (LF) as control (n = 20). Then both DIO mice and LF mice were given intracerebroventricular (i.c.v.) injection of leptin or saline.

Results: TS significantly decreased final body weight gain (À210%, P < 0.001) and average EI (À24%, P < 0.001) in DIO mice. TS significantly decreased pro-inflammatory markers (TNF-a, IL-6, IL-1β, p-IKK and p-IjBa) in epididymal fat, liver and hypothalamus of DIO mice. In LF mice, i.c.v. injection of leptin significantly suppressed EI compared to saline injection (À29%, P = 0.001). However, central leptin sensitivity was blunted in DIO mice evidenced Aim: Non-alcoholic fatty liver disease (NAFLD), which is characterized by the accumulation of fat in the liver in the absence of alcohol intake, strongly linked to metabolic syndrome. Recently, proinflammatory cytokines and oxidative stress mechanisms have been implicated in the pathogenesis of psychiatric disorders. In addition, patients with drug-free schizophrenia have significantly higher body mass index than in aged-matched healthy controls. The purpose of the study was to investigate the effects of metabolic syndrome on the apomorphine-induced stereotypy in a rat model of NAFLD.Materials and methods: Eighteen male Sprague-Dawley rats were included in the study. In order to develop NAFLD model, rats (n = 12) were provided with drinking water containing with 35 % fructose for 8 weeks, while control group (n = 6) received only tap water. After the verification of fatty liver by ultrasonography, apomorphine-induced stereotypy was investigated as described by Kenneth and Kenneth (1984) . Then, all rats were sacrificed; homovanillic acid (HVA), a dopamine metabolite, levels were measured in brain homogenates. Prefrontal cortical IL-2 immunoexpression was evaluated by immunohistochemistry and hepatocellular changes were determined histologically.Results: Histological evaluation of liver sections confirmed macrovesicular steatosis in NAFLD rats. Moreover, the stereotyped behavior scores, brain HVA levels and IL-2 expression were found significantly higher in NAFLD group than in the control group (P < 0.05).

Our results suggest that metabolic syndrome and fatty liver significantly induce dopaminergic activity and stereotyped behavior in rats. The neuromodulatory effects of pro-inflammatory cytokines and imbalance between oxidative and anti-oxidative status may underlie these alterations. The classical thinking in type 2 diabetes is that the plasma glucose levels are regulated by interplay between insulin, glucagon and other peripheral mechanisms. A combination of insulin resistance and relative insulin insufficiency is considered to be causal to hyperglycemia. This traditional wisdom is now being challenged and an alternative model is proposed where the central nervous system (CNS) plays a vital role in plasma glucose regulation. The role of CNS in glucose regulation is well known. For example it has been shown that intracerebroventricular injection of glucose results in a decrease in plasma glucose level in rats. However whether and to what extent the CNS has an active role in diabetic hyperglycemia is not known. We make mathematical models of different versions of the peripheral and central mechanisms and make differential correlational predictions which can be tested on oral glucose tolerance test ( 

Background and aims: High calorie diets leads to fat liver and changes in the metabolic pathways. Therefore the gluconeogenic capacity of the livers in a condition of high levels of exogenous fatty acids was evaluated in cafeteria-fed rats.Methods: Two groups of weaned Wistar rats received cafeteria or balanced diet during 98 days. The fasted livers were perfused with 2 mmol/l lactate plus 0.2 mmol/l pyruvate in absence or in presence of 2 mmol/l stearate plus traces of [1-14 C]-stearate. Measured parameters: glucose, ketone bodies, [ 14 C]CO 2 , oxygen uptake, hepatic contents of lipids and glycogen.Results: Cafeteria-fed rats presented increase in: body and liver weight, fat in the tissues and hepatic glycogen. Perfusion experiments revealed that in cafeteria-fed rats the gluconeogenic flux was lower than in the control, but the infusion of stearate, caused a higher stimulus on glucose production. The 14 CO 2 and ketone bodies production was reduced during the active gluconeogenesis in cafeteriafed and control rats, being the former less sensitive, whereas no differences were found after stearate infusion.

Background: Despite advances in option of treatement diabetes, optimal glycemic control is not often achieved. Glucose homeostasis is dependent on a complex interplay of multiple hormones and glucagon like peptide-1 (GLP-1) receptor agonists are a new class of drug for the treatment of type 2 diabetes. They are not considered as initial therapy for the majority of patient with type 2 diabetes and their clinical use, long-term benefits, risks and their role in combination with other diabetes medication are still under investigation.Study: In the retrospective study in 2011 we enrolled 51 patients with poorly controlled type 2 diabetes on one or two oral agents, who received additional therapy with GLP-1 receptor agonist: liraglutide or exenatide. We monitored HbA1c value and body weight before and after modification of therapy.Results: Fifty-one patients, 26 men, were 27-78 years old (mean 58 years). Their mean body weight was 116.24 kg (SD AE 24.8) and mean HbA1c 8.2% (SD AE 2). After 3-6 months of combined therapy with metformin and/or sulfonylurea and GLP-1 agonist their mean HbA1c dropped to 7.1% (SD AE 1.4) and their body weight reduced to 107.56 kg (SD AE 33.3).

In patients with type 2 diabetes and suboptimal control on one or two oral agents adding GLP-1 receptor agonist was effective in improving glycemic control and body weight reduction. Despite lack of evidence on their clinical use, long-term benefits and side effects these agents have the potential to change the diabetes treatment by replacing traditional secretagogues because of superior control and association with weight loss. 

Objective: The metabolic syndrome (MS) is a particular affection that has been associated with so many factors such as hypertention. Both increase cardiovascular diseases. Due to the higher prevalence of hypertension in our country, this study aim to determine the frequency of MS in newly diagnosed hypertensive patients in oder to improve the follow -up of these subjets.Methodology: Over a period of 5 months, we conducted a crosssectional and descriptive study on patients recently diagnosed as hypertensive for <3 months. The selection of patients was done during external consultation in the cardiology unit at the University Teaching Hospital of Yaounde. It was based on high blood pressure, anthropome´tric parameters such as weight, BMI, waist, abdominal circonference and biological values (lipid profile, blood glucose, uric acid).

We identified 74 patients aged between 21 and 83 years, with a mean age of 52 years. People aged more than 39 years were mostly affected. Stage 3was the prominent stage of hypertension.The prevalence of metabolic syndrome was 64.9% with a higher rate in female.The cardiovascular risk factors were obesity, alcoholism, sedentarity and hypo HDLC Factors differenciating population with metabolic syndrom was obesity (P = 0.00), hyperglycemia (P = 0.00), hypo HDLC (P = 0.00) while the phenotypes most represented were hyperglycemia, abdominal obesity and hypo HDLC respectively.

The metabolic syndrome is frequent in newly diagnosed hypertensive subjects; the females were most affected. Metabolic syndrome should be investigated systematically in all hypetensive patients. Background: Although mainly inhibits osteoclastogenesis, osteoprotegerin is produced by vasculature too. Serum OPG (sOPG) is elevated in both diabetics and patients with coronary artery disease (CAD) but there are still insufficient data for its concentrations in impaired glucose tolerance (IGT) subjects.

Aims: To determine sOPG in males with IGT and concomitant CAD and to investigate its relationship with certain glucometabolic parameters.Materials and methods: sOPG was measured in 26 males with performed percutaneous coronary interventions for CAD-14 with IGT and 12 normoglycemic, and in 11 age-and BMI-matched healthy normoglycemic controls. Glucose abnormalities were screen-detected using a standard OGTT. Mean intima-media thickness (IMT) of common carotid arteries was measured by B-mode ultrasonography. OPG was measured by ELISA.Results: sOPG was significantly higher in IGT patients compared to controls (5.09 AE 0.7 vs. 2.87 AE 0.29 pmol/l; P = 0.01) but did not differ between IGT and normoglycemic CAD patiens (5.09 AE 0.7 vs. 3.79 AE 0.6 pmol/l, P = 0.2). In all participants, sOPG correlated positively with IMT (P 0.008; Pr 0.58). Similarly, in IGT males with CAD, sOPG correlated only with IMT (P 0.02; Pr 0.75). There were no associations with fasting and postchallange plasma glucose, HbA1c, fasting insulin, HOMA-IR, lipid parameters, blood pressure, BMI or waist circumference.

We found higher sOPG in males with IGT and CAD compared to the controls. OPG did not correlate with glucose parameters but rather with markers of atherosclerosis. We speculate in CAD patients with IGT, the increased sOPG might reflect the vascular damage and not glycemic status which requires further investigations. Internal Medicine, UMF Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, 2 UMF 'Victor Babes' Timisoara, Timisoara, Romania Objective: The Pro12Ala polymorphism in the PPARG2 gene (C>G) is associated with less weight loss after treatment for obesity. This study aimed to investigate the association of rs 1801282 polymorphism with weight loss 1 year after bariatric surgery.

The sample was composed of individuals with grade III obesity undergoing Roux-en Y gastric bypass. Anthropometric data were collected in the preoperative period and 1 year after surgery. Genotyping was performed by the method of allelic discrimination in real time PCR (Polymerase Chain Reaction) using the TaqMan predesigned SNP Genotyping Assays kits (Applied Biosystems, Foster City, CA, USA). Individuals with at least one variant allele were grouped and compared with those with the reference genotype.Results: 173 subjects (79.2% females, mean age 40.8 AE 10.3 years) participated in the study. Genotyping showed 82% (n = 142) of individuals homozygous for the C allele (C/C) and 18% (n = 31) heterozygous (C/G). There was no homozygous mutant (G/G). Individuals with the C/C and C/G genotypes respectively showed a loss of 47.7 AE 15.8 and 48 AE 18.8 kg; 34.4 AE 8 and 33.6 AE 10.3% of initial weight and 61.3 AE 15 and 59.5 AE 18.2% of excess body weight. There was no difference in weight loss between groups.Conclusion: The PPARg Pro12Ala genotype seems to have no association with weight loss 1 year after bariatric surgery. Objective: Evaluated determine the prevalence of IR, MS and associated factors among banking workers in southeastern Brazil.Methods: Out of 501 males and females banking employees, 20 years old were evaluated by cross-sectional study including demographic, biochemical, anthropometric and hemodynamic. The MS was determinate by NCEP and IDF. The IR was determined by HOMA-IR, with the cut off >2.71.Results: 86 (17.2% 95% CI 13.8-20.6) and 113 (22.6% 95% CI 18.8-26.3) of employees with MS, according to the NCEP and IDF, respectively and 52 (10.4%) with RI. The likelihood of developing the syndrome is greater in individuals with high level of education (OR 2.16 (95% CI 1.11-6.13) and among those with overweight and obesity, the possibility of having MS is 12, 6 (95% CI 4.80-33.26, P = 0.000) and 43.6 (95% CI 16.05-118.88, P = 0.000) times over, respectively. Persons who are overweight are at risk of 4.97 (95% CI 1.31-18.83) times more likely to have elevated HOMA, and among those who are obese, the risk rises to 17.87 (95% CI 40.36-73.21).Conclusion: This study showed the higher number of employees who have similar characteristics of the total active working, that despite high education, also have MS and IR, and the consequent risk of developing cardiovascular disease. Prediabetes is considered as a strong risk factor for type 2 diabetes (DM2). TCF7L2 is a gen involved in DM2 susceptibility related with GLP-l.

Objective: Study the relationship of rs7903146 and rs12255372 variants of the TCF7L2 gene with insulin levels, C-peptide and GLP-1in normoglycemia and prediabetes subjects.

We included 108 pre-diabetic and 54 normoglycemic subjects. We measure fasting glucose, lipids, insulin, C-peptide and GLP-1). Insulin resistance and beta-cell function were calculated with the HOMA model. TCF7L2 polymorphisms rs7903146C/T and rs12255372G/T were determined by PCR-RFLP. For analyses two groups were compared: Wild-type and carriers of two allele risk.

We included a total of 162 subjects aged 44 AE 12 years. Weight, BMI, systolic and diastolic blood pressure and triglycerides were significantly lower in the group of healthy subjects. GLP-1 was higher in normoglycemic subjects. The frequency of rs7903146T allele was higher in pre-diabetic subjects, while the allele frequency of rs12255372T was not significantly different between the groups. In carriers of rs7903146T, serum insulin and HOMA-beta were significantly higher. Plasma levels of GLP-1 were lower in prediabetic subjects with and without the risk allele variant. In prediabetic subjects carriers of the rs12255372G/T or TT had also lower levels of serum insulin, HOMA-IR and HOMA-beta. The GLP-1 concentrations were lower in both groups.Conclusions: In this work the rs7903146 polymorphism TCF7L2 gene was associated with prediabetes. The frequency of the rs12255372T allele TCF7L2 gene was not different between groups. Objective: Determine HbA1C, IGFBP1, FGF21 and other metabolic markers in non-diabetic, prediabetic, type 2 diabetics (T2DM) of recent diagnosis.

Material and methods: A cross-sectional population based study was carried in 35-65 years old subjects classified with fasting glucose (FG) and after 2 h 75 g oral glucose load (GT), as normal with impaired FG (IFG), impaired GT (IGT), with both alterations (IFG/IGT) and DM2. After 3-4 weeks subjects were re-classified and registration of anthropometric data, food intake and determination of A1c, lipids, insulin, FGF21 and IGFBP1.Results: We found 25.1% for prediabetes and 10.1% for DM2 (n = 174). In the re-classification we classified: 35 normal, 48 IFG, 3 IGT, 32 IFG/IGT, 32 DM2. With ANOVA analysis we found that HbA1c in DM2 patients was different from normal, IFG, IFG/IGT subjects (P < 0.002, P < 0.011 and P < 0.004 respectively). FGF21 levels was different among all groups (P < 0.05). Normoglycemic subjects were better educated and had higher income than the prediabetic and DM2 subjects. DM2 subjects reported more screen time. Prediabetic subjects had higher HDL-cholesterol. With multiple regression analysis we found IGFBP1 positively correlated with daily caloric intake and triglycerides and negatively with BMI. The FGF21 correlated positively with insulin.

The prevalence of pre-diabetes is more than twice of that of undiagnosed diabetes. We find FGF21 and insulin related with the metabolic status. IGFBP1 was negatively correlation with BMI finding compatible with an association with insulin resistance. We have previously found that the expressions of several homeobox transcription factors, including IRX5, were reduced in subcutaneous fat in human obesity. A knock-out (KO) mouse line was acquired for the purpose of investigating the in vivo effects of Irx5 deficiency with the main perspective on how these mice would handle a high-energy dietary intake. Though initially undersized, male Irx5 KO mice fed a high-fat (45 %) diet approached similar weight and size as their wildtype (WT) littermates. Yet, MRI show that the Irx5 KO mice have smaller adipose tissue depots and store less fat around organs in

Aim: To examine the role of miR-21 in the pathogenesis of diabetic cardiomyopathy.Objectives: To study the cardiac expression of miR-21 and its effect on regulation of genes involved in Akt-PKB signalling pathway in animal model of diabetic cardiomyopathy (DCM).Methods: Type 2 diabetes was induced in adult Wistar rats by high fat diet and i.p streptozotocin injections. The animals were sacrificed at 12 weeks and development of cardiomyopathy was confirmed by heart/body weight ratio, histopathological examination, myocardial fibrotic and hypertrophic genes. Cardiac tissues were examined for expression of miR-21, its target genes by Real Time PCR.Results: Myocardial expression of miR-21 was significantly increased and showed a positive correlation with myocardial mRNA levels of fibrotic genes (CTGF, FGF-b & TGF-b) in diabetic rats. Myocardial mRNA levels of potential targets of miR-21, Phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and Programmed cell death protein 4 (PDCD-4), were increased and their protein expression was decreased in DCM group and in fibroblasts exposed to high glucose (P < 0.05). Increasing miR-21 levels promoted, whereas knocking down miR-21 attenuated, PTEN, PCDC-4 activity in cardiac fibroblasts.

Our results suggest that miR-21 contributes to cardiac fibrosis in DCM by modulating activity of Akt/PKB pathway through PTEN and PCDC-4.

Objectives: Many studies have revealed that prevalence of metabolic syndrome may be related to lifestyle components. The aim of this study was to investigate the influence of dietary patterns on prevalence of metabolic syndrome (MetS).

The data was based on health and nutrition survey for 534 Japanese men and women aged 20-69 year. Factor analysis was used to obtain dietary patterns applying to intake of food groups. The definition of MetS was followed by the modified version of the criteria of IDF that is applied to Japanese population. Values of waist circumference, HDL-cholesterol, blood pressures, and HbA1c were used to identify MetS. Logistic regression analysis was used to examine the association between dietary patterns and prevalence of MetS.Results: Three dietary patterns of "fruits", "rice", and "meat" were identified. In males, greater values of "fruits" pattern was associated with a significantly lower prevalence of MetS after adjustment for age, physical activity level, smoking and drinking status and other confounding variables (OR = 0.62, 95% CI 0.34-0.96).Conclusions: Fruits consumption was inversely associated with MetS and this association may be explained by much intake of mandarin orange specific to this surveyed population. This finding necessitates further investigation on the mechanisms of fruits consumption on health benefits. 

Introduction: The impaired glucose regulation shows a double risk of cardiovascular morbimortality and development of type 2 diabetes, especially in patients with high cardiovascular risk.Objective: Identify the carbohydrate abnormalities in unknown diabetic patients with high cardiovascular risk.Patients and methods: Hundred and forty-eight non-diabetic patients were involved in this single-center study, with at least three known vascular risk factors, metabolic syndrome or with known cardiovascular event over 3 months.All had a test load of 75 g oral glucose (OGTT) followed by 2 h after dosing plasma glucose, serum glycated hemoglobin (HbA1c) and lipid abnormalities exploration. Cardiovascular exploration also concerned all patients.Results: Among these patients, 64 were in primary prevention and 84 in secondary prevention. 95 cardiovascular events were reported to be dominated by myocardial infarction (35.7%) and stroke (38.09%).Dysglucoregulation concerned 77 patients (52%); the sex ratio was 0.97 and the average age was 59, 73.33 unknown diabetes, 34 IFG and 42 IGT were diagnosed.These glucose abnormalities were found equally in both primary and secondary prevention.In the family, diabetes was concerned with 38% and cardiovascular events mainly expressed by early myocardial infarction and stroke were observed in 40%.The vascular risk factors were more present in IGT group.Hypertension was found in 90%, followed by dyslipidemia in 49%; 68% met metabolic syndrom's criteria (IDF 2005) .Conclusion: In primary prevention context, OGTT not only detects unknown diabetics but identifies IGT patients who dysplay a high risk of cardiovascular events. The aim was to study some indicators of inflammatory process and oxidative metabolism in the patients arriving for surgical treatment of pathological obesity.

Laboratory tests have been carried out by conventional methods in 17 patients with pathological obesity of abdominal type with a body mass index >40 kg/m 2 before and after biliopancreatic shunting operation.Rise of blood glucose level up to 139.3% (P < 0.001), uric acid level up to 157.9% (P < 0.001), as well as dyslipidemia were determined in patients. The content of malondialdehyde (MDA) increased 1.6 times, the general antioxidant activity (AOA) decreased 1.8 times. Concentration of C-reactive protein (CRP) exceeded 2.6 times the control value. The long-term results in these patients within 6-20 months have shown normalisation of level of blood glucose, uric acid, high and very low density lipoprotein cholesterol, a tendency of decrease in the general cholesterol concentration. Triglycerides decreased by 17 %, still remaining at sufficiently high level. MDA concentration decreased by 32.4 %, AOA increased by 38.0 %. CRP level which was considerably raised before operation decreased within the next months but in 9 months its average value increased five times in relation to normal rate.The obtained results are evidence of the interrelation of inflammation process and oxidative stress in patients with pathological obesity and metabolic syndrome. Efficiency of surgical treatment was shown in The insulin resistance syndrome includes well-recognized cardiovascular risk factors such as low HDL levels, hypertension, hypertriglyceridemia, which is highly correlated with small dense LDL and increased Lp(a) levels, which is cardiovascular risk factor. we aimed to study Dyslipidemia, especially Lp(a) level in addition to Carotid intima media thickness (CA-IMT) as a marker of atherosclerosis in normal and impaired glucose tolerance offspring of type 2 DM. 150 subjects were included and divided into two main groups; Group(I) 50 apparently healthy subjects with no family history of diabetes mellitus, as control group, Group(IIa) 50 non diabetic offspring of type 2 DM with normal glucose tolerance and Group(IIb) 50 non diabetic offspring of type 2 DM with impaired glucose tolerance. A statistically significant increase in mean AE SD of serum level of Lp(a) and CA-IMT in non diabetic impaired glucose tolerant offspring of type 2 diabetes as compared to non diabetic normal glucose tolerant group, significant positive correlation between Lp(a) and CA-IMT vs. each of LDL-Ch, triglycerides and cholesterol. Also, a significant positive correlation between Lp(a) and CA-IMT and HDL-Ch. in non diabetic impaired glucose tolerant offspring of type 2 diabetes as compared to non diabetic normal glucose tolerant group. In conclusion the increase in serum level of Lp(a) and Increase of CA-IMT in non diabetic offspring of type 2 DM were associated with increasing severity of insulin resistance and increasing the degree of atherosclerosis explaining the high prevalence of cardiovascular diseases in subjects who are genetically prone to the development of diabetes.

A. Kostrzewa-Tarnowska, M. Człapka-Matyasik, M. Fejfer, J. Jeszka

Weight loss can be achieved by any means of energy restriction, but the challenge is to achieve sustainable weight loss and prevent from weight gain without increasing the risk of chronic diseases. Conventional high carbohydrate diets, even when based on wholegrain foods, increase insulinemia and may compromise weight control via mechanisms related to appetite stimulation and metabolic rate. The success of low fat diets has given a push for researches on alternative dietary strategies, including high content of bioactive compounds and low glycemic index (GI) diets.The aim of this study was to determine if high content of bioactive compounds using capillary blood sampling lead to any significant difference between the GIs of the products mentioned. Investigated group consisted of 25 healthy people with normal weight, aged 20 AE 2 years (BMI 23.5 AE 1.5 kg/m 2 ).Foods with a low GI produce a lower peak in postprandial glucose and a less overall blood glucose increase during the first 2 h after consumption compared with foods with a high GI. Studies have shown that bioactive products lead to increased satiety, delayed return of hunger, and decreased food intake after ingestion of low-GI compared with high-GI foods.Low-GI products may also play an extensive role in weight loss. This strategy can be associated with reducing total energy intake, modifying the macronutrient composition of the diet and lower postprandial glycaemia.Research funded within the framework of the project PO IG 01.01.02.00-061/09.

Physiology, School of Medicine, National University of Ireland, Galway, Ireland Introduction: Current diagnostic criteria for type 2 diabetes mellitus rely on increased blood glucose concentration following an oral glucose tolerance test (OGTT) or increased glycated haemoglobin. Changes in these parameters occur long after insulin resistance manifests as plasma glucose concentration is homeostatically defended. In contrast, glucose oxidation measured by the 13 C-glucose breath test ( 13 C-GBT) is reduced as a direct consequence of insulin resistance. It is important to establish normative data and define the reliability of any diagnostic or scientific test therefore the aim of this study was to determine the reliability of the 13 C-GBT as a diagnostic tool for type 2 diabetes.Methods: Sixteen apparently-healthy controls {21.7(0.5) yrs, 79.6 (12.6) kg, 168.5(12.0) cm, all data mean (SD)} underwent simultaneous OGTT and 13 C-GBT on two separate occasions following a 12 h overnight fast. Mixed capillary blood and breath samples were collected at baseline and every 15 min for 4 h following ingestion of a 63.35 g glucose solution (Shamrock, Ireland) labelled with 0.15 g 1-13 C glucose.Results: Mean baseline 13 CO 2 was 23.8 AE 0.6 Delta ViennaPeeDeeBelemnite (d-VPDB) and peak 13 CO 2 was À11.9 AE 2.1 d-VPDB. Fasting and 2 h mixed capillary glucose concentrations were 4.9 AE 0.5 mmol/l and 5.6 AE 0.9 mmol/l respectively. Per cent dose recovered 13 C had a Cronbach's alpha of 0.656, while fasting and 2 h glucose concentration were 0.682 and 0.403 respectively.

We established normative data for the 13 C-GBT. The 13 C-GBT is a reliable test of whole body glucose oxidation which has the potential to be developed as a diabetes diagnostic test. Introduction: Outcome studies in morbidly obese patients (MO) have shown that diabetic patients have the highest benefit from bariatric surgery interventions. Therefore it was of interest to study a variety of cardiovascular risk factors in a very large group of patients with MO (n = 1498), who were investigated in our center.

We included 1498 patients with MO, of whom 22.9% (n = 343; mean HbA1c 7.7 AE 1.6%) were diabetic. In a subset (n = 300), patients were followed up 2 years after bariatric surgery of whom 25.3% (n = 76) were diabetic. All patients without manifest type 2 diabetes underwent a 75 g oral glucose Tolerance Test, Insulin levels were assessed, HOMA-Insulin resistance (IR) was calculated. Diabetes was diagnosed after ADA criteria. Apart from that demographic, cardiovascular risk-markers (blood pressure, lipids) renal and inflammation parameters were assessed. 

Background: Obex â is a dietary supplement to help lose weight. In addition, this supplement is specifically made with natural antioxidants molecularly activated to enhance their biological properties without altering their molecular structure.Objectives: The purpose of this study was to evaluate the effect of Obex â on anthropometric measurements and metabolic disorders in overweight and obese subjects.

This was an open label pilot study conducted with 29 overweight and obese adults (BMI > 25 kg/m 2 and <45 kg/m 2 ), aged between 23 and 61, who took Obex â (without changes in lifestyle), at a dose of two sachets before the two main meals of each day for 3 months. In addition to anthropometric measures and blood pressure, fasting plasma glucose, lipid profile, insulin, creatinine and uric acid were determined. Insulin resistance by HOMA-IR and betacell function by HOMA-B were assessed. Three indirect indexes were used to calculate insulin sensitivity.Results: Compared to baseline, Obex â significantly reduced body weight (P = 0.012), body mass index, waist circumference, waist/hip ratio, waist/height ratio (P < 0.0001, respectively) and conicity index (P = 0.001). There was also a reduction in fasting glucose levels. Compared to baseline, the use of Obex â improved insulin secretion (HOMA-B) and HDL-c concentration (P < 0.005). No adverse effects were seen in any of the participants during the pilot study.Conclusion: Short-term treatment with Obex â improved visceral and abdominal obesity, as well as ameliorating levels of select markers of metabolic disease risk in overweight and obese adults, indicating that further studies are warranted. Methodology: A descriptive cross sectional study was conducted with 84 families. The sample was 258 family members (partner, offspring, blood family members and not family related individuals-all living in the same house). Body mass index (BMI), lipid profile and glucose measured. Also, the family functionality (FF) and perceived health status (PHS).

Results: Age mean was 40.02 years (SD, 20.08); 151 female (58.5%) and 107 males (41.7%). The RF were analyzed by the role in the family. Seventy-five percent of the housewives were overweight, with high levels of glucose (15.8%), cholesterol (31.9%), triglyceride (38.6%) and low HDL (21.30%). Husbands had overweight (85%), with high levels of glucose (16.2%), Cholesterol (51.4%), and triglyceride (37.8%). The children aged between 10 and 24 years, had glucose and cholesterol normal, but were overweight (21.9%), and had high level of triglyceride (15.5%) as well as low HDL (37.5%). Additionally, children and parents had only 1-2 portions of vegetables intake in 1-3 days in 1 week; similarly 61.8, had 1-2 portions of fruits or juice, but only 1-3 days by month. Family functionality was reported with a mean of 69.69 (SD, 12.67)-0-100 scale and 71.72 (SD, 19.85) in PHS.

The family members in the UA are at high risk for developing DT2. Among them are underscored obesity, high levels of lipids, low consumption of vegetables and fresh fruits. FF and PHS are also risk factors in these families. This study designed to compare the effect of three dietary oils: Canola, rice bran and grape seed on lipid profile and paraoxanase activity of hyperlipidermic rats.

Method: Hyperlipidemia was induced in 40 wistar male rats by atherogenic diet. Once hyperlipidemia was reached, the rats were randomly divided in four groups of 10 animals according to the treatment received. Treatment groups were fed canola, rice bran and grape seed oil for 7 weeks. Control rats fed regular rat chow diet which contains corn oil. Baseline fasting blood lipid profile and paraxonase activity of experimental and control rats were compared at the beginning and at the end of the experiment.Result: After 7-weeks of treatment, a significant decrease was found in serum Triglyceride, Total cholesterol and LDL-C concentration of rice bran and grape seed oil fed rats (P < 0.05), serum HDL-C concentration also increased significantly (P < 0.05). Canola oil fed rats showed a significant decrease in Total cholesterol, and Triglyceride level and an increase in paraoxanase activity (P < 0.001), however, no significant differences were found in LDL-C and HDL-C concentration.

The present study suggest that consumption grape seed, canola and rice bran oil may have beneficial effect on serum lipid profile, but in comparison of the tree dietary oils grape seed oil showed more beneficial effect in reducing hyperlipidemia.