ACTA ENDOCRINOLOGICA (BUC)

Context. With more studies investigating effects of high serum lipid levels, new findings are emerging regarding the damage these biomolecules may cause. Aim. In this study we aimed to find a relation between neuropathy and hypertriglyceridemia in patients with metabolic syndrome (MS). Material and methods. One hundred and twenty subjects (Ninety subjects with metabolic syndrome and 30 healthy controls) were included in the study. Subjects with MS were divided into three groups. HbA1C levels of the subjects were < 5.7% in group A, ≥ 5.7% - < 6.5% in group B, and ≥ 6.5% - < 8.0% in group C. Pin-Prick test and Semmes- Weinstein Monofilament were used for neurological examination. Electromyography was performed to patients with neuropathy to support the diagnosis. Results. Neuropathy prevalence was found to be higher in the subjects with metabolic syndrome compared to control group. (9.9 %; 16.65 %; 23.31 % vs. 3.3%; in group A, group B, group C vs. healthy control group respectively) (p=0.003 for group A, p=0.0002 for group B, p=0.0002 for group C). There was an association between triglyceride levels and neuropathy in group C. Conclusion. Patients with MS may have more neuropathy risk than we estimate.

Background. Lipoprotein-associated phospholipase A2 is a novel inflammation marker that generates pro-inflammatory\r\nmolecules from oxidized LDL.\r\nAim. We aimed to investigate its role in individuals with insulin resistance and metabolic syndrome which is representative of early stages of atherosclerosis.\r\nMethods. We evaluated 114 subjects with metabolic syndrome in a cross-sectional pattern. Waist circumference was measured. Fasting plasma glucose, total cholesterol,\r\ntriglycerides, high-density lipoprotein cholesterol (HDL-C), LDL-cholesterol (LDLC), fasting insulin were measured by standard assays. Oral glucose tolerance test was applied\r\nto patients with fasting blood glucose < 126 mg/dL. Patients were classified to tertiles according to their insulin resistance states. Lp-PLA2 mass levels were measured.\r\nResults. There was a correlation between hypertension and HOMA tertiles; HDL-C, hypertriglyceridemia, hyperglycemia\r\nwere not correlated with HOMA tertiles (p = 0.024, p=0.66, p=0.66, p = 0.18, respectively). We cannot find any association between HOMA tertiles and Lp-PLA2 levels. Triglyceride was negatively correlated with Lp-PLA2.\r\nConclusion. Lp-PLA2 is not correlated with insulin resistance in subjects with metabolic syndrome.

Introduction. Our aim was to compare the effects of conventional diabetic diet with refined carbohydrate restricted diet on glycemic and metabolic parameters in type 2 diabetic patients who were treated by insulin.\r\nMaterials and methods. A hundred type 2 diabetic patients treated by insulin, randomized into two groups. The first group (n:50) was given a low refined carbohydrate\r\ndiet , the second group was given conventional diabetic diet. Metabolic parameters were evaluated at the beginning and at the end of the 3rd month of randomization.\r\nResults. There were no statistically significant weight change differences between groups (p=0,237). Changes in the HbA1C level (&#916; HbA1C) in the basal insulin-refined\r\ncarbohydrate restricted diet group, in the basal insulin-conventional diet group and in the premixed insulin-conventional diet group were -1.22% (p<0.001), -0.51% (p=0.13) and -0.66%(p=0.155), respectively. Symptomatic hypoglycemic episodes were reported only by the\r\npatients in premixed insulin group.\r\nConclusion. A diet rich in nutrients with sole exclusion of refined carbohydrates has been shown to be as effective as a stricter conventional diet and therefore it has to be\r\nconsidered as a preferable treatment option.

Introduction. Vinegar is known with its positive impact on post-prandial dysmetabolism. The aim of this study was to\r\nelucidate the acute effects of high amount vinegar on blood glucose and lipid parameters.\r\nMaterial and Methods. Sixteen type 2 diabetic patients who had been treated with metformin only, were served a\r\nstandardized meal to which 50 g vinegar was added on the first day but not on the second day. Blood glucose, insulin and lipid levels were measured during fasting and at the second hour after intake of the meal.\r\nResults. Postprandial increase in the levels of venous blood glucose measurements was not different in the vinegar group when compared with the reference group (p=0.163). There was no significant difference on postprandial insulinemia (p=0.796). While investigating the effect of the vinegar on postprandial lipemia, no differences in triglyceride\r\nchanges was found between vinegar and reference group (p=0.816).\r\nConclusion. In this study in which we have tried to find an answer to the question about the effect of high amount grape\r\nvinegar on postprandial metabolism, no favorable or deleterious effect on postprandial changes of glycemia and\r\nlipemia was found.

Objective. The aim of this study was to compare the clinical effects of a triple oral antidiabetic combination versus basal insulin and metformin combination treatment in patients with poorly controlled type 2 diabetes.\r\nMethods. Eighty patients with type 2 diabetes, who were treated by metformin and sulphonylurea combination, and had\r\nHbA1c values between 7.5 and 10 % (58 and 86 mmol/L), were randomized into two groups. The first group was given triple oral antidiabetic therapy (pioglitazone, metformin, and sulphonylurea) and the second group was given metformin and a bedtime basal insulin (insulin detemir) combination for 12 weeks. Metabolic parameters were evaluated.\r\nResults. The mean fasting plasma glucose and HbA1c levels decreased in both groups. The decrease in HbA1c was slightly\r\nhigher in triple oral antidiabetic group (p=0.046). The patients in triple oral combination group gained 0.2 kg (p=0.881) and those in the metformin-insulin detemir combination group lost 1.7 kg (p=0.001) in 12 weeks (p=0.29 between groups). The frequency of hypoglycemia was higher in\r\ntriple oral antidiabetic group (11 vs. 2 episodes, respectively).\r\nConclusion. Both sulphonyureametformin-pioglitazone and insulin detemir-metformin therapies provided significant improvements in glycemic control. However, sulphonylurea,\r\npioglitazone and metformin combination led to more frequent hypoglycemic events, and weight management seemed in favor of insulin detemir-metformin combination.