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The role of adipose tissue in endothelial dysfunction, etherosclerosis and other complications of metabolic syndrome: influence of diet and pharmacotherapy
Doležalová, Radka ; Haluzík, Martin (advisor) ; Šenolt, Ladislav (referee) ; Kábrt, Jan (referee)
The metabolic effects of obesity have made this disease one of the most common risk factors for diabetes, hypertension, and atherosclerosis. Adipose tissue is now recognized as an active secretory and immune organ. Chronic inflammation is a common feature of the obesity, and inflammatory signals may originate within visceral adipose tissue as this fat depot expands in response to chronic positive energy balance. Both adipocytes and macrophages within fat secrete numerous hormones and cytokines that have local effects on WAT physiology but also systemic effects on other organs and may markedly contribute to the development of pathophysiological disorders associated with metabolic syndrome. On the contrary, leanness as well as significant weight reduction in obese patients increases production and circulating levels of metabolically beneficial factors and decreases production of proinflammatory and insulin resistance-inducing factors. Endothelial dysfunction and inflammation are important signs of vascular risk and worsened prognosis in patients with metabolic syndrome and type 2 diabetes. Measures of endothelial function remain invaluable for research into disease mechanism and response to new therapies. An interesting area of ongoing investigation is the role of thiazolidinediones in improving endothelial...
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The influence of severe illnes on the thermic effect of parenteral nutrition and substrates oxidation
Bajnárek, Jiří ; Sobotka, Luboš (advisor) ; Kábrt, Jan (referee) ; Wilhelm, Zdeněk (referee)
Objective: The thermic effect (TE) of parenteral nutrition (PV) is not known in severely ill patients. The aim of our study was to measure TE and the dynamics of substrates oxidation during PV in this population. Type of the study: prospective Material and methods: After a fastening period of 12 hours (infusion of saline) we administered to ICU patients (N=21) total PV of the following composition: amino acids 1.2 mg, fat 0.5 mg, glucose 4.0 mg per minute per kilogram of ideal body weight. Prior to PV administration and subsequently 2, 5, 12, and 24 hour later energy expenditure (EV) and oxidation of energy substrates were measured by indirect calorimetry. The correlation between assessed parameters and APACHE II score was searched. Results: TE reached its maximum 5 hours after the onset of PV (6.6 ± 9.5 % (p=0.004)) and then it gradually declined. It was not influenced by disease severity. Lipid oxidation was suppressed from the fasting level of 0.88 ± 0.60 to the minimum of 0.02 ± 1.0 mg.kg-1 .min-1 (p<0.001), whereas glucose oxidation increased from 1.19 ± 1.67 to the maximum of 3.46 ± 2.14 mg.kg-1 .min-1 (p<0.001) in the 12th hour. The rate of suppression of lipid oxidation by PV was directly correlated with APACHE II score (R=0.56; p=0.018) Conclusions: The TE of PV administered to medical ICU...
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The role of adipose tissue in endothelial dysfunction, etherosclerosis and other complications of metabolic syndrome: influence of diet and pharmacotherapy
Doležalová, Radka ; Haluzík, Martin (advisor) ; Šenolt, Ladislav (referee) ; Kábrt, Jan (referee)
The metabolic effects of obesity have made this disease one of the most common risk factors for diabetes, hypertension, and atherosclerosis. Adipose tissue is now recognized as an active secretory and immune organ. Chronic inflammation is a common feature of the obesity, and inflammatory signals may originate within visceral adipose tissue as this fat depot expands in response to chronic positive energy balance. Both adipocytes and macrophages within fat secrete numerous hormones and cytokines that have local effects on WAT physiology but also systemic effects on other organs and may markedly contribute to the development of pathophysiological disorders associated with metabolic syndrome. On the contrary, leanness as well as significant weight reduction in obese patients increases production and circulating levels of metabolically beneficial factors and decreases production of proinflammatory and insulin resistance-inducing factors. Endothelial dysfunction and inflammation are important signs of vascular risk and worsened prognosis in patients with metabolic syndrome and type 2 diabetes. Measures of endothelial function remain invaluable for research into disease mechanism and response to new therapies. An interesting area of ongoing investigation is the role of thiazolidinediones in improving endothelial...
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