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Functional fitness and Vit. D levels in patients with hepatopathy
Brtková, Helena ; Novák, František (advisor) ; Meisnerová, Eva (referee)
Introduction: patients with hepatopathy are at risk of vitamin D deficiency. Vitamin D levels affect, among other things, metabolism and physiological functions of muscle tissue and thus functional fitness. The aim of this study is to assess muscle mass and strength in relation to vitamin D levels and other factors that affect functional physical fitness in patients with cirrhosis, compared to a control group of patients without hepatopathy and other chronic comorbidities. Methods: 11 patients with liver cirrhosis were enrolled in an observational cohort study compared with 11 controls without chronic comorbidities. Anthropometric and bioimpedance measurements were performed, functional tests, the 6MWT 6-minute walk test, hand grip strength assessment and calorimetry examination were also evaluated, and laboratory parameters were assessed. Study participants completed the CLDQ test, which assessed the quality of life of people with liver disease. Respondents answered questions regarding lifestyle, eating habits, physical activity and functional physical fitness. For patients with cirrhosis, the Child Pugh score and MELD score were used to assess the progression of cirrhosis. Results. At the time of the study, the vast majority of patients had a compensated form of liver cirrhosis, Child Pugh A...
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Changes in Bone and Mineral Metabolism and the Role of Vitamin D in Very Low Birth Weight Infants
Matějek, Tomáš ; Skálová, Sylva (advisor) ; Šumník, Zdeněk (referee) ; Kutílek, Štěpán (referee)
Changes in bone and mineral metabolism and the role of vitamin D in very low birth weight infants. Firstly, the aim of dissertation work was to estimate physiological parathyroid hormone (PTH) levels and their relationship with bone metabolism parameters in otherwise healthy preterm newborns with birth weight 1000-1500 g. Secondly, to evaluate vitamin D status in mothers and their very low birth weight infants (VLBW) at birth and at discharge with currently recommended supplementation of vitamin D. Thirdly, to compare clinical outcomes of VLBW infants with 25-hydroxy vitamin D [25(OH)D] levels ≤ and > 25 nmol/l in umbilical cord blood and finally to evaluate umbilical cord vitamin D as a risk factor for respiratory distress syndrome in preterm infants. It is a set of prospective observational studies involving immature newborns with birth weight below 1500 g. The parameters of mineral and bone metabolism were analysed in umbilical cord blood and newborn serum and urine during hospitalisation (PTH, 25-hydroxy vitamin D, S-Ca, S-P, ALP, U-Ca, U-P) and in pregnant women before delivery (25-hydroxy vitamin D). Bone mineralization was evaluated by bone densitometry. In a pilot study, from the total 134 examined serum samples for PTH levels the estimated reference range was 1.6 - 9.3 pmol/l. From the...
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Circadian rhythm of parathyroid hormone and bone remodeling: implication for the osteoporosis treatment with teriparatide (parathormone [1-34])
Rašková, Mária ; Zikán, Vít (advisor) ; Žofková, Ivana (referee) ; Perlík, František (referee)
Circadian rhythm of parathyroid hormone (PTH) is well documented, but its physiological role is not fully understood. In healthy individuals, biochemical markers of bone remodeling follow a similar circadian rhythm to PTH with a nocturnal rise in bone resorption and formation. The loss of PTH diurnal variation was observed not only in primary hyperparathyroidism, but also in patients with postmenopausal osteoporosis. Continuously elevated concentrations of PTH lead to excessive stimulation of bone resorption, whereas intermittent PTH administration has a strong osteoanabolic effect in patients with osteoporosis. It has not been examined whether the skeletal sensitivity to PTH action depends also on the time of its application. The aim of our study was to verify the hypothesis that the application of teriparatide (TPTD, recombinant human PTH [1-34]) at different times of the day in the context of its diurnal variability affects the physiological circadian rhythm of bone remodeling and also the bone mineral density (BMD) after the long-term TPTD treatment. Fourteen women with postmenopausal osteoporosis treated with 20 micrograms of TPTD daily, applied subcutaneously either in the morning or evening, were included in the first study. The concentration of serum C-terminal telopeptide of type I collagen...
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