Sensitivity,specificity of biochemical markers for early prediction of endothelial dysfunction in atherosclerotic obese subjects

BackgroundThe obesity increased incidence of diabetes, hypertension and atherosclerosis and rate of morbidity and mortality. The main cause of atherosclerosis is endothelial dysfunction and formation of foam cells and macrophage that lead to unfavorable complications. This study evaluated specific biomarkers for endothelial dysfunction as sensitive indices for early predication of atherosclerosis in obese subjects.Study DesignOne hundred fifty male age and sex matching were included in the current study divided into three groups according to body mass index (BMI): Control (BMI ≤ 22), obese (BMI> 28) and obese with atherosclerosis (BMI> 28). Fasting serum was subjected for determination of adhesion molecules, sICAM-1, sVCAM-1, E-selectin, oxo-LDL and 8-iso-PGF2α by ELISA technique.ResultsData obtained showed that, a significant elevation of serum inflammatory markers CRP, IL-6 and TNF-α and adhesion molecules sICAM-1 (p<0.001) with sensitivity 96%, sVCAM-1 (p <0.01) with sensitivity 92%, E-selectin (p<0.001) with sensitivity 94%, oxo-LDL (p <0.05) and 8-iso-PGF2α (p < 0.001) with sensitivity 97% in obese with atherosclerosis compared with obese and control.ConclusionThe levels of serum adhesion molecules contributed in the pathogenesis of endothelial dysfunction can be used as sensitive biomarkers for early prediction of atherosclerosis in obese subjects.     

Prevalence of echocardiographic left atrial enlargement among hypertensive Nigerian subjects

BackgroundLeft atrial enlargement (LAE) predispose to arrhythmias, atrial thrombogenesis and cardioembolic stroke. Whether LAE constitute a major risk among African hypertensive subjects is not well described. This study was aimed to describe the epidemiologic pattern of LAE among hypertensive subjects and determine their correlates.MethodsClinical and demographic details of 414 hypertensive subjects used were taken. Echocardiography was done. LAE was defined as Left atrial dimension (LAD)>3.7 cm. Statistical analysis was done using SPSS 17.0.Result414 subjects including 258 (62.3%) males were recruited. The mean age was 56.8±16.8 years. LAE was present in 57.73% of hypertensive subjects. Those with LAE were likely to be older (58.23±14.5 vs. 54.8 ±19.7 years, p<0.05), had a higher waist circumference (88.1 ±26.8 ±75.8 ±28.4 cm, p<0.05), left ventricular mass index (79.2 ± 12.4 vs. 48.7 ±15.5g/m2.7, p<0.05) and a higher frequency of left ventricular hypertrophy (LVH) (65.3% vs. 40.0 %, p<0.05) respectively than those without LAE. LAD was significantly higher among those with LVH than those without LVH (41.4 ±8.4 vs. 35.6 ±5.9 mm respectively, p<0.05).ConclusionLAE is common among Nigerian hypertensive subjects. Age, waist circumference, left ventricular wall dimension and mass index are the important correlates of LAE in hypertensive Nigerians.     

Influence of gender on the distribution of type 2 diabetic complications at the obafemi awolowo teaching hospital,Ile-Ife,Nigeria

BackgroundSex specific differences appear particularly relevant in the management of type 2 DM.ObjectiveWe determined gender specific differences in cardio-metabolic risk, microvascular and macrovascular complications in patients with type 2 diabetes.MethodsFour hundred type 2 diabetes patients, males and females, matched for age and disease duration were recruited from the diabetes clinic. Relevant clinical and laboratory information were obtained or performed.Results190(47.5%) were male and 210 (52.5%) were female respectively. The mean age of the study population was 60.6 + 9.93 years. Women had higher prevalence of hypertension (and obesity. Mean total cholesterol was significantly higher in women but men were more likely to achieve LDL treatment goals than women (69.5% vs 59.0%, p<0.05). More women (47.1% & 31.4%) reached glycaemic goals of <10mmol/l for 2HPP and HBA1c of <7.0%.There were no gender differences in the distribution of microvascular and macrovascular complications (p>0.05) but women were more likely to develop moderate and severe diabetic retinopathy (p= 0.027).ConclusionWomen with T2DM had worse cardiometabolic risk profile with regards to hypertension, obesity and lipid goals. Men achieved therapeutic goals less frequently than did women in terms of glycaemia. Microvascular and macrovascular complications occurred commonly in both sexes.     

Relationship between plasma homocysteine and blood pressure in hypertensive Northern-Nigerians

AimThe study sought to determine whether there is any relationship between plasma homocysteine and blood pressure levels in Nigerians with essential hypertension.MethodIt was a cross-sectional analytical study done on 120 randomly selected hypertensive patients and 120 normal healthy controls seen at the large Conference hall of the Ahmadu Bello University (ABU) Medical Centre, Zaria as well as the ABU Teaching Hospital, Zaria, Northern-Nigeria. Pearson''s Correlation and Binary Logistic Regression analysis determined the relationship between homocysteine and hypertension.ResultsHyperhomocysteinaemia found in the hypertensive patients (22.8 ± 6.6 µmol/L) differed significantly (p<0.001) from controls (10.9 ± 2.8 µmol/L) with significant (p<0.001), blood pressure difference between both groups. Homocysteine significantly positively correlated with systolic (r = 0.51, p<0.001) and diastolic (r = 0.47, p<0.001) blood pressures in hypertensive subjects. The relation of plasma hcy to hypertension was statistically significant for SBP; OR: 1.08 (95% CI, 1.05–1.11) and DBP; OR: 1.08 (95% CI, 1.03–1.13) in the unadjusted model. When adjusted for confounding variables, hcy was significantly related to SBP; OR: 1.1 (95% CI, 1.04–1.18) but not DBP (p=0.25; OR: 1.06 (95 % CI, 0.96–1.18). The mean plasma folate level was high (115.2 ± 48.0 ng/mL) in the hypertensive subjects. The hyperhomocysteinaemic subjects showed a 2.8 times Odds of developing hypertension.ConclusionThis study showed higher mean plasma homocysteine levels in hypertensives than controls not accounted for by sub-optimal folate levels. Hyperhomocysteinaemia showed a positive relationship to systolic hypertension after adjusting for confounders.     

Gender specific pattern of left ventricular cardiac adaptation to hypertension and obesity in a tertiary health facility in Nigeria

Background

Cardiac adaptation to hypertension and obesity may be related to many factors such as race, gender and haemodynamic status. Some gender specific associations with left ventricular structure and function have been described among Caucasians.

Objectives

To describe the sex specific pattern of left ventricular adaptations to obesity and hypertension among Nigerians.

Methodology

It was a cross sectional study carried out at LAUTECH Teaching Hospital, Osogbo, Nigeria. 313 subjects had full echocardiography performed. Participants were divided into four groups: normal, obese, hypertensives and obese-hypertensives. Indices of LV adaptation were compared between the groups. SPSS 16.0 was used for analysis.

Results

Relative to normal subjects, LV mass (LVM), LV mass index (LVMI) and wall thickness were significantly higher among hypertensive men and obese hypertensive men. They were similar between normal and obese men. However, LVM, LVMI and wall thickness were increased among obese women compared to normal women while they were similar among obese, hypertensive and obese-hypertensive women. Men with concurrent obesity and hypertension presented with a further increase of LVM and wall thickness above values in the merely obese or hypertensive subjects. Female obesehypertensive seem to present more with eccentric hypertrophy than male obese-hypertensive subjects (17.2% vs. 9.1% respectively, p<0.05) while male obese-hypertensive seem to present more with concentric hypertrophy (54.5% vs. 43.1% respectively, p>0.05) than female obese-hypertensive subjects.

Conclusion

Structural, functional and geometric LV adaptation to obesity and hypertension varies between the two genders among Nigerians. The impact of isolated obesity on LV adaptation in women appears very significant.     

Evaluation of circulating zonulin as a potential marker in the pathogenesis of nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is a spectrum of liver disorders ranging from simple hepatic steatosis up to nonalcoholic steatohepatitis (NASH) evolving to cirrhosis and hepatocellular carcinoma (HCC). Liver biopsy is still the gold standard modality for diagnosing and staging NAFLD. The linkage between intestinal microbiota and NAFLD, might suggest a potential role of serum zonulin in NAFLD diagnosis. To appraise the role of circulating zonulin in NAFLD pathogenesis, 56 subjects with proved NAFLD by ultrasonography and liver biopsy, as well as 20 healthy controls were tested. Liver function tests, serum glucose, fasting insulin, C peptide, lipid profile, homeostasis model assessment of insulin resistance (HOMA‐IR), IL‐6, and circulating zonulin were performed to all subjects. Aspartate transaminase (AST), alanine transaminase (ALT), gamma‐glutamyl transferase (GGT), triglycerides, HDL‐c, fasting insulin, C peptide, HOMA‐IR, IL‐6, and serum zonulin were higher in NAFLD group than in controls (p < 0.05), and in NASH patients than those with simple steatosis (p < 0.05). Zonulin was positively correlated with body mass index (BMI), ALT, triglycerides, fasting insulin, HOMA‐IR, liver histopathology, and serum IL‐6 (p < 0.05), with inverse correlation to HDL‐C (p < 0.05). At cut off 8.3 pc/mL, serum zonulin was found to be of diagnostic value of NASH occurrence with 100% sensitivity and specificity (AUR = 1.000, p‐value = <0.001). The increasing zonulin levels in NAFLD patients with steep rise in NASH group denotes a possible role in pathogenesis of NAFLD occurrence and progression. This could open a new avenue of implicating zonulin antagonists as targeted therapies in NAFLD prevention.     

The Relationships between Thyroid Hormones and Thyroid-stimulating Hormone with Lipid Profile in Euthyroid Men

Background and Aim: Alteration in lipid profile is a common observation in patients with thyroid dysfunction, but the current knowledge on the relationship between lipids and thyroid hormone levels in euthyroid state is insufficient. The current study aimed to determine the association between thyroid hormones and thyroid-stimulating hormone (TSH) with lipid profile in a euthyroid male population.Methods: A total of 708 Chinese and Malay men aged 20 years and above were recruited in this cross-sectional study. Their blood was collected for the determination of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), free thyroxine (FT4), free triiodothyronine (FT3) and TSH levels. The association was analyzed using multiple regression and logistic regression models with adjustment for age, ethnicity, body mass index and FT4/FT3/TSH levels.Results: In multiple regression models, TSH was positively and significantly associated with TG (p<0.05). Free T4 was positively and significantly associated with TC, LDL-C and HDL-C (p<0.05). Free T3 was negatively and significantly associated with HDL-C (p<0.05). In binary logistic models, an increase in TSH was significantly associated with higher prevalence of elevated TG in the subjects (p<0.05), while an increase in FT4 was significantly associated with higher prevalence of elevated TC but a lower prevalence of subnormal HDL in the subjects (p<0.05). Free T3 was not associated with any lipid variables in the logistic regression (p>0.05).Conclusions: In euthyroid Malaysian men, there are positive and significant relationships between TSH level and TG level, and between FT4 level and cholesterol levels.     

Hepatic Steatosis Is Associated with Elevated Serum Iron in Patients with Obesity and Improves after Laparoscopic Sleeve Gastrectomy

BackgroundIron is closely related to metabolism. However, the relationship between iron and hepatic steatosis has not been fully elucidated.ObjectiveWe aimed to investigate the triangular relationship between iron and hepatic steatosis and laparoscopic sleeve gastrectomy (LSG) in patients with obesity.MethodsA total of 297 patients with obesity and 43 healthy individuals with a normal BMI were enrolled. Eighty-two patients underwent LSG. Anthropometrics, glucose-lipid metabolic markers, and hepatic steatosis assessed by FibroScan (CAP value and E value) were measured at baseline, and again at follow-up time intervals of 6 months and 1 year after surgery.Results(1) Iron was significantly higher in patients with obesity or overweight than in the individuals with normal BMI (8.18 ± 1.47 vs. 7.46 ± 0.99 mmol/L, p = 0.002). Iron was also higher in subjects with high blood pressure, dyslipidemia, and hyperuricemia than non-corresponding disorders (all p < 0.05). Moreover, iron was significantly higher in the severe than mild or moderate non-alcoholic fatty liver disease (NAFLD) group (p = 0.046 and 0.018). (2) Iron was positively associated with body weight, BMI, waist-to-hip ratio, uric acid, liver enzymes, postprandial blood glucose, fasting insulin, HOMA-IR, triglycerides, free fatty acid, and hepatic steatosis (CAP value), and negatively associated with high-density lipoprotein cholesterol (all p < 0.05). Iron was also positively associated with the visceral adipose area in patients with obesity and negatively associated with the subcutaneous adipose area in patients with overweight (all p < 0.05). (3) Iron levels and CAP values were decreased gradually 6 months and 1 year after surgery (all p < 0.05).ConclusionsOverall, our results indicated that iron is associated with hepatic steatosis in obesity. The iron level was significantly higher in patients with severe NAFLD than with mild or moderate NAFLD. LSG may reduce iron levels while improving fat deposition in the liver.     

Abdominal Obesity in German Adolescents Defined by Waist-to-Height Ratio and Its Association to Elevated Blood Pressure: The KiGGS Study

ObjectiveThe aim of this study was to compare the fixed 0.5 cut-off and the age- and sex-specific 90th percentile (P90) for waist-to-height ratio (WHtR) in German adolescents with respect to the prevalence of abdominal obesity and to compare the screening ability of WHtR and BMI to identify hypertensive blood pressure (BP) values.MethodsBetween 2003 and 2006, the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) was carried out including 3,492 boys and 3,321 girls aged 11-17 years. Abdominal obesity was assessed by two WHtR cut-points (P90; 0.5). Hypertensive BP was defined as BP exceeding age-, sex- and height-specific 95th percentiles or the adult threshold for hypertension (140/90 mm Hg).ResultsAgreement between the WHtR cut-offs was very good (Kappa 0.89 for boys; 0.81 for girls), and the prevalence of abdominal obesity was slightly higher using P90 (boys 12.0%; girls 11.3%) compared to 0.5 (boys 10.7%; girls 8.0%). WHtR and BMI-for-age had equivalent ability to discriminate hypertensive BP (ROC-AUC < 0.7; sensitivity of the 0.5 cut-off for detecting hypertensive BP < 30%).ConclusionThe fixed 0.5 WHtR cut-off can be used in German adolescents to characterize abdominal obesity. However, WHtR is not suitable as a screening tool for hypertensive BP in adolescents.Key Words: Body mass index, Waist-to-height ratio, Abdominal obesity, Blood pressure, Adolescents     

Socio-demographic determinants of neonatal mortality in Algeria according to MICS4 data (2012–2013)

BackgroundNeonatal mortality remains a public health problem in developing countries, including Algeria. Information on this indicator makes it possible to assess government efforts to improve the living conditions of target populations.ObjectivesThis study aims to identify some determinants associated with this mortality from data of multiple indicator cluster survey conducted in Algeria in 2012–2013 (mics 4).MethodsA retrospective case-control study including 1047 cases and 1041 controls. From a logistic regression model, we appreciated the role of different factors, socio-demographic, economic and geographic (Mother''s age, level of education, wealth index, area of residence) in newborn survival.ResultsThe main factors associated with neonatal mortality were rural residence (p<0.01; OR= 1.3; CI 1.08–1.54), South geographical area (p<0.05; OR=1.5; CI 1.18–1.84), low education level of mother (p<0.01; OR= 2.10; CI 1.35– 3.29), early age of maternal procreation (p<0.001; OR=4.34; CI 2.19– 14.40), the birth rank “7 and over” (<0.01; OR = 1.57; CI 1.13 – 2.44) and the two lowest wealth indices (p <0.001; OR = 2; 1.45–2.62 and p <0.01; OR = 1.66; CI 1.23–2.26).ConclusionIn addition to the various reproductive health strategies already adopted by the authorities for health promotion and family planning, action should be taken to evaluate their implementation with sustained assistance for disadvantaged people and in risk areas.     

Trace elements in type 2 diabetes mellitus and their association with glycemic control

BackgroundAlterations in serum levels of trace elements reported in type 2 diabetes mellitus (T2DM) have been linked with induction of T2DM and associated complications.ObjectivesTo assess serum levels of copper (Cu), zinc (Zn) and selenium (Se) in T2DM patients with adequate and poor glycemic control.Patients and methodsThis study was performed at King Khalid University Hospital, Riyadh. A total of 100 consenting T2DM patients comprising of 50 patients with glycated hemoglobin (HbA1c) less than 6.5% and 50 patients with HbA1c more than 6.5% along with a group of 50 normal healthy individuals were included in the study. Serum levels of Cu, Zn and Se were measured by inductively coupled plasma-mass spectrometry (ICP-MS) instrument.ResultsAmong T2DM patients with HbA1c <6.5%, mean serum Cu levels (13.4+4.3µmol/L) were not different from the controls (14.5+1.92µmol/L) whereas Zn (9.9+2.7µmol/Lvs15+3.2µmol/L;p<0.0001) and Se levels (1+0.2µmol/Lvs1.62+0.2µmol/L; p<0.0004) were lower than the controls. Among T2DM patients with HbA1c >6.5% mean serum Cu (18.1+4.1µmol/Lvs14.5+1.9µmol/L; p<0.0001), Zn (15+3.2µmol/Lvs13.5+1.9µmol/L; p<0.009) and Se (1.62+0.2µmol/Lvs1.17+0.16µmol/L;p<0.0001) were significantly higher than the controls. HbA1c% negatively correlated with HbA1c >6.5% (r = -0.302; p<0.03).ConclusionCu, Zn and Se homeostasis was altered in T2DM patients and varied with glycemic control.     

Eccentric Cycling Training Improves Health-Related Quality of Life in Adolescents with Obesity

IntroductionWhile eccentric (ECC) training appears to be more efficient than concentric (CON) training at improving body composition in adolescent with obesity, its impact on health-related quality of life (HRQOL) has never been studied.ObjectiveThe aim of this study is to compare the effects of 2 cycling training modalities, i.e., ECC vs. CON, in adolescents with obesity on HRQOL and health perception (HP).MethodsA total of 24 adolescents with obesity, aged 12–16 years, were randomized to either a 12-week ECC or a CON cycling training program performed at the same oxygen consumption (VO₂). Anthropometric measurements, body composition, maximal incremental tests, HRQOL (Vécu et Santé Percue de l''Adolescent [VSP-A], Medical Outcome Study Short Form [SF-36]), and HP were assessed at before and after training.Results and ConclusionBoth CON and ECC cycling trainings promoted significant improvements in BMI, VO_2peak, total fat mass, and fat-free mass, with better improvements in body composition parameters in the ECC group (p < 0.05). The VSP-A total score increased after CON (p < 0.01) and ECC (p < 0.001) training, with better enhancement for the ECC group (p < 0.05). The SF-36 physical score increased after both CON (p < 0.01) and ECC (p < 0.001) trainings. The global HP score increased only after ECC training (p < 0.001). Except for the energy-vitality item, no significant correlation was found between changes in HRQOL and its subdomains and anthropometric, body composition, and functional parameters. Both ECC and CON cycling trainings are associated with positive changes in HRQOL and HP. However, ECC seems to induce greater improvements in HRQL and HP than CON cycling training, which is probably not due to the anthropometric, body composition, and functional changes.     

Propofol inhibits burn injury-induced hyperpermeability through an apoptotic signal pathway in microvascular endothelial cells

Recent studies have revealed that an intrinsic apoptotic signaling cascade is involved in vascular hyperpermeability and endothelial barrier dysfunction. Propofol (2,6-diisopropylphenol) has also been reported to inhibit apoptotic signaling by regulating mitochondrial permeability transition pore (mPTP) opening and caspase-3 activation. Here, we investigated whether propofol could alleviate burn serum-induced endothelial hyperpermeability through the inhibition of the intrinsic apoptotic signaling cascade. Rat lung microvascular endothelial cells (RLMVECs) were pretreated with propofol at various concentrations, followed by stimulation with burn serum, obtained from burn-injury rats. Monolayer permeability was determined by transendothelial electrical resistance. Mitochondrial release of cytochrome C was measured by ELISA. Bax and Bcl-2 expression and mitochondrial release of second mitochondrial-derived activator of caspases (smac) were detected by Western blotting. Caspase-3 activity was assessed by fluorometric assay; mitochondrial membrane potential (Δψ_m) was determined with JC-1 (a potential-sensitive fluorescent dye). Intracellular ATP content was assayed using a commercial kit, and reactive oxygen species (ROS) were measured by dichlorodihydrofluorescein diacetate (DCFH-DA). Burn serum significantly increased monolayer permeability (P<0.05), and this effect could be inhibited by propofol (P<0.05). Compared with a sham treatment group, intrinsic apoptotic signaling activation - indicated by Bax overexpression, Bcl-2 downregulation, Δψ_m reduction, decreased intracellular ATP level, increased cytosolic cytochrome C and smac, and caspase-3 activation - was observed in the vehicle group. Propofol not only attenuated these alterations (P<0.05 for all), but also significantly decreased burn-induced ROS production (P<0.05). Propofol attenuated burn-induced RLMVEC monolayer hyperpermeability by regulating the intrinsic apoptotic signaling pathway.     

Profile of new vascular damage biomarkers in middle-aged men with arterial hypertension

PurposeNormal endothelial function is important for the homeostasis of the cardiovascular (CV) system. The aim of the present study was to determine the profile of key parameters of endothelial dysfunction in middle-aged men that play a significant role in the functioning of endothelial vessels, which seems to be crucial for the early diagnosis of cardiovascular disorders.Materials and methodsThe study included 53 men, 20 with hypertension (HTN), 18 with HTN and related diseases, 15 healthy controls Apart from general testing (BMI, biochemical analysis, SBP, DBP), we used the Griess reaction to assess the total amount of nitric oxide (NO), and used ELISA to verify the concentrations of malondialdehyde (MDA), nitrotyrosine (NT), asymmetric dimethylarginine (ADMA), tumor necrosis factor-alpha (TNF-α), monocyte chemotactic protein 1 (MCP-1), and myeloperoxidase (MPO). Furthermore, we assessed the concentration of circulating free DNA (cfDNA) using the fluorescence method.ResultsThe values of MDA, ADMA, cfDNA, and MPO observed in samples from men with HTN were determined to be higher compared to those from men without HTN. In the group of men with HTN and other concomitant cardiovascular disorders, we observed low concentrations of NO, MDA, and ADMA with high concentrations of cfDNA.ConclusionsThe results obtained for parameters selected for the study, should be considered by cardiologists as a prompt to include in the diagnostic profile the assessment of NO and cfDNA concentrations for risk evaluation and/or diagnosis of endothelial dysfunction in patients suffering from HTN or related complications.     

Plasma asymmetric dimethylarginine predicts restenosis after coronary angioplasty

Introduction

Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of endothelial nitric oxide synthase. Asymmetric dimethylarginine may influence the process of restenosis after coronary angioplasty. The aim of the study was to determine if initial plasma ADMA level could predict restenosis after coronary angioplasty and stenting.

Material and methods

The study group consisted of 60 consecutive patients (10 women and 50 men, average age 58.9 ±10.4 years old), who underwent percutaneous coronary angioplasty with bare metal stenting for stable coronary artery disease. All patients underwent follow-up coronary angiography after a 6-month period. Patients were divided into two groups, one with restenosis (n = 22), and the other one without restenosis (n = 38). In addition to measuring acknowledged restenosis risk factors, plasma ADMA level was measured before initial angiography.

Results

Asymmetric dimethylarginine plasma level was significantly higher in the group with restenosis than in the group without restenosis (1.94 ±0.94 µmol/l vs. 0.96 ±0.67 µmol/l; p < 0.05). L-arginine/ADMA ratio was also decreased in the group with restenosis, when compared with the group without restenosis (p < 0.05). Multivariate logistic regression revealed that independent restenosis risk factors were characterised by an initially high ADMA level (p < 0.01), advanced age (p < 0.05) and low level of HDL cholesterol (p < 0.05).

Conclusions

Pre-procedural elevated plasma ADMA level increases the risk of restenosis in patients who underwent coronary angioplasty and stenting with bare metal stents.     

Acceptability of self-collected vaginal samples for HPV testing in an urban and rural population of Madagascar

ObjectiveTo evaluate the acceptability of self-collected vaginal samples for HPV testing in women living in rural and urban areas of Madagascar.ResultsA total of 300 women were recruited. Median age was 44.1 years (range 29–65 years) in the urban group and 40.9 years (range 29–65 years) in the rural group. Urban women had improved knowledge on HPV, cervical cancer and cervical cancer screening (p<0.05) as compared to rural women. Urban women lived closer to a health care center (P<0.05), had fewer different sexual partners (P<0.05) and later first sexual intercourse (p=0.07). Unlike urban women, most rural women were married (p<0.05).ConclusionAcceptability of self-sampling for HPV testing was similarly excellent in both groups despite their difference in terms of socio-demographic factors and knowledge about cervical cancer.     

Asymmetric and Symmetric Dimethylarginine in Adolescents with Hyperuricemia

The purpose of this work was to investigate if in adolescents with hyperuricemia serum levels of asymmetric and symmetric dimethylarginine (ADMA, SDMA) are increased and if their levels correlate with serum uric acid (UA). Patients and Methods. The study group consisted of 58 hyperuricemic patients aged median 16.15 Q1–Q3 (14–17). The reference group contained 27 healthy individuals with normal serum UA level. ADMA and SDMA were measured by immunoenzymatic ELISA commercial kits and expressed in μmol/L. Serum UA was measured by the colorimetric method. Results. In hyperuricemic patients serum ADMA values did not differ between two estimated groups (P > 0.05); however, SDMA was significantly higher than in reference group (P < 0.01). Serum ADMA and SDMA correlated positively with UA (r = 0.34, P < 0.01) (r = 0.31, P < 0.01) and hs-CRP (r = 0.20, P < 0.05) (r = 0.36, P < 0.01), respectively. Conclusion. We demonstrated increased SDMA but not ADMA levels in adolescents with hyperuricemia and their correlation with serum uric acid levels. However, at the moment it is difficult to answer the question if it is just coexistence of these factors or any mechanism linking uric acid and methylated arginines really exists.     

Dietary Habits and Cardiometabolic Health in Obese Children

BackgroundPrevalence rates of cardiometabolic risk factors vary largely among overweight children. This study investigated the relationships between dietary habits and cardiometabolic health among obese children living in a city of Northern Italy.MethodsDietary habits were collected in 448 obese subjects aged 6-18 years, attending an obesity outpatient center in Milan. Anthropometry, blood pressure (BP), lipids, fasting and post-load glucose, and insulin were measured. Physical activity was assessed in adolescents using a questionnaire.ResultsFrequency of glucose intolerance, hypertension and dyslipidemia was 0.7%, 13% and 27.2%, respectively. Plausible reporters consumed more animal protein and sodium and less legumes than recommended in nutritional recommendations and adequate amounts of fiber mainly derived from whole grains. Subjects skipping breakfast had unhealthy diets and greater body fatness. After adjustment for confounders, waist/height and fasting glucose were associated with sodium intake (r =0.149 and r = 0.142, respectively; p < 0.05), 2-hour glucose with fiber (r = −0.172; p < 0.01), and BP with vegetable protein intake (systolic r = −0.120 (p < 0.05); diastolic r = −0.267 (p < 0.01)). Hypertensive children consumed less vegetable protein than normotensive children.ConclusionsThe cardiometabolic health of obese children improves with vegetable protein and whole grain intake, whereas dysglycemia and adiposity increase with sodium intake.Key Words: Dietary habits, Childhood obesity, Glucose metabolism, Hypertension, Cardiometabolic risk