scholarly journals OP0197 EVALUATION OF THE RELATIONSHIP OF LEPTIN WITH THE METABOLIC PHENOTYPE OF KNEE OSTEOARTHRITIS IN THE CONTEXT OF OBESITY THERAPY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 118.1-119
Author(s):  
E. Strebkova ◽  
L. Alekseeva

Background:Obesity and components of the metabolic syndrome (MS) play a key role in the pathogenesis of the metabolic phenotype of osteoarthritis (OA). Obesity is a process meta inflammation due to the synthesis of proinflammatory mediators (adipokines and adipocytokines). The severity of OA depends on the presence of obesity, adipokine activity, comorbidity, and the presence of MS. The problem of treatment of metabolic OA and obesity is very relevant, in connection with the obesity pandemic.Objectives:To evaluate the relationship of leptin with the clinical manifestations of OA and various components of MS in the context of obesity therapy.Methods:The study included 50 female patients aged 45-65 y.o. with Kellgren-Lawrence stage II-III knee OA and obesity (body mass index (BMI)>30kg/m2). The average age of the patients was 56.5 ± 5.86 years, the average duration of the disease was 7.43 ± 3.93 years. 62% of patients were diagnosed MS. Patients were randomly divided into 2 groups for the treatment of obesity. Patients from group 1 (n=25) took orlistat 120mg 3 times a day in combination with a hypocaloric diet and exercise for 6 months. Patients from group 2 (n=25) were on a hypocaloric diet in combination with exercise for 6 months. The groups were comparable in clinical parameters. The clinical course of OA was determined by the WOMAC and VAS. Anthropometric data (height, weight) were determined. All patients underwent a laboratory examination at 2 points (initially and after 6 months): a biochemical blood test, leptin was determined by PCR in peripheral blood.Results:8% of patients had 1 MS component, 34% - 2 MS components, 34% - 3 MS components, 22% - 4 MS components, and 2% - 5 MS components at the beginning of the study. High leptin levels (p=0.001) were determined in patients with more than 3 MS components. The correlation analysis showed direct correlations of high leptin levels with the severity of knee WOMAC pain (r=0.36, p=0.02) and VAS pain (r=0.51, p=0.01). A positive correlation was determined between high leptin levels and body weight (r=0.56, p<0.01) and waist circumference (r=0.38, p<0.01). Patients from group 1 had a significant decrease of body weight by 10.07% (p<0.05), the indicators of the WOMAC index improved: pain decreased by 52.5% (p<0.05), stiffness by 47.98% (p<0.05), joint functional failure by 51.55% (p<0.05) after 6 months of drug therapy for obesity. Patients of group 2 had a not significant decrease of body weight by 0.84% (p>0.05), and they were worse indicators of clinical manifestations of OA according to WOMAC compared to group 1 (p<0.05). 24% of patients from group 1 showed a decrease in the number of MS components. 12% of patients from group 2 had a decrease in the number of MS components and 12% patients increase in MS components. Patients from 1 group with a significant decrease in body weight, there was a decrease in the level of leptin (p = 0.05) (graphic 1), in contrast to patients without weight loss on the background of non-drug therapy (p = 0.64). We found direct correlations between a decrease in leptin levels and a decrease in the WOMAC index (pain, stiffness, joint functional failure, total WOMAC) (r=0.5, p=0.01; r=0.4, p=0.04; r=0.4, p=0.03; r=0.5, p=0.01, respectively). Patients with a decrease in the number of MS components had a significantly lower leptin levels (p=0.01).Graphic 1.Dynamic of leptin.Conclusion:Leptin is a predictor of a worse course of the metabolic phenotype of OA associated with MS and obesity. High levels of leptin were observed with more MS components, and were associated with the severity of knee pain and body weight. We observed a decrease in the level of leptin, a decrease in the number of MS components, and an improvement in the clinical manifestations of OA against the background of a significant decrease in body weight. Thus, the treatment of obesity in patients with the metabolic phenotype of OA and other interventions aimed at reducing the level of leptin may contribute to reducing the progression of knee OA.Disclosure of Interests:None declared

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1747.2-1747
Author(s):  
E. Strebkova ◽  
L. Alekseeva

Background:Obesity is an important socio-medical problem of mankind. Since the number of obese people in the world is increasing by about 1% per year, the immediate prospects do not look optimistic. One of the important risks of the development and progression of osteoarthritis (OA) is the metabolically unhealthy phenotype of obesity, which is accompanied by a violation of lipid and carbohydrate metabolism, a violation of cytokine regulation. An important step in the treatment of patients with obesity and OA of the knee joints is weight loss.Objectives:To evaluate the effectiveness of complex therapy of metabolic unhealthy phenotypes of obesity using orlistat (an intestinal lipase inhibitor) in the clinical manifestations of knee OA, dynamic markers of lipid and carbohydrate metabolism, dynamic CRP and leptin.Methods:The study included 50 female patients with knee OA Kellgren-Lawrence stage II-III and obesity (body mass index (BMI)>30kg/m2), aged 45-65yo. Group 1 (25 patients) was administered orlistat at 120 mg (1 capsule) 3 times a day for 6 month combined with low-calorie diet and therapeutic physical exercise. Group 2 (25 patients) was administered only life-modifying therapy for 6 month. The clinical parameters of the course of knee OA (WOMAC), an assessment of the quality of life (EQ-5D) were assessed at initially and after 6 months. Also initially and after 6 months a laboratory study of peripheral blood was performed glucose, HDL, LDL, TG, CRP, leptin, and the index of visceral obesity (IVO) was calculated.Results:Initially, all patients had signs of a metabolically unhealthy phenotype of obesity: waist circumference (WC) > 88cm, high IVO, dyslipidemia, arterial hypertension, hyperleptinemia. After 6 months of complex therapy of obesity using orlistat in patients of group 1, a significant decrease in body weight by 10.07% (p <0.05), a decrease in WC by 8 cm (p <0.05), a significantly significant decrease were achieved IVO (p <0.05), glucose (p <0.05). Analysis of cytokines showed a significant decrease in leptin (p <0.05) and CRP (p <0.05) in patients with a weight loss of more than 10%. The reduction in body weight in group 1 patients reduced pain by 52% (p <0.05), stiffness by 51% (p <0.05), improved joint functional failure by 51% (p <0.05) and improved quality life by 52% (p <0.05). In patients of group 2, against the background of non-drug therapy of obesity, body weight decreased by 0.84% (p> 0.05), slightly decreased WC (p> 0.05). Indicators of lipid metabolism, IVO, glucose, leptin remained unchanged (p> 0.05). The increase in CRP in patients of the 2nd group was determined by 24.54% (p <0.05).Conclusion:The results of our study demonstrate the effectiveness of the use of a comprehensive drug regimen for the treatment of metabolically unhealthy phenotype of obesity for the clinical manifestations of osteoarthritis of the knee joints; it contributes to the improvement of metabolic parameters: a decrease in WC, lipid and carbohydrate metabolism, CRP and leptin. Thus, the use of complex therapy using orlistat in patients with osteoarthritis and obesity leads to a decrease in the metabolic activity of adipose tissue, helps to reduce cardiometabolic risk and to improve the clinical course of osteoarthritis.Disclosure of Interests:None declared


1993 ◽  
Vol 264 (4) ◽  
pp. G596-G600 ◽  
Author(s):  
M. F. Stolk ◽  
K. J. van Erpecum ◽  
A. J. Smout ◽  
L. M. Akkermans ◽  
J. B. Jansen ◽  
...  

We examined the relationship of interdigestive gallbladder emptying with the different phases of the migrating motor complex (MMC) and with plasma levels of cholecystokinin (CCK) and motilin. In 10 volunteers 20 cycles of the MMC were recorded. In 11 cycles phase III occurred in antrum and duodenum (group 1). In nine cycles phase III was observed only in duodenum (group 2). In group 1 gallbladder emptying started at 30% of total cycle length and continued until the end of the cycle. Maximal gallbladder emptying was 33.3 +/- 3.3% (SE). In group 2 gallbladder emptying also started at 30% of total cycle length but ended at 60%. Maximal gallbladder emptying in this group was 24.3 +/- 3.1% (P < 0.05). Motilin levels were higher in group 1 than in group 2 during phase IIB (240.1 +/- 28.5 and 142.1 +/- 30.9 pg/ml, respectively, P < 0.05) and during phase III (210.8 +/- 24.3 and 93.5 +/- 12.5 pg/ml, respectively, P < 0.05). We conclude that: 1) phase III activities starting in the antrum are preceded by greater and prolonged gallbladder emptying, higher motilin levels, and higher intraduodenal bile acid concentrations than phase III activities starting in the duodenum and 2) no relationship between interdigestive gallbladder motility and CCK levels could be demonstrated.


2012 ◽  
Vol 4 (4) ◽  
pp. 259-267 ◽  
Author(s):  
Tuhina Neogi

Osteoarthritis (OA), the most common form of arthritis, is now understood to involve all joint tissues, with active anabolic and catabolic processes. Knee OA in particular is considered to be a largely mechanically-driven disease. As bone adapts to loads by remodeling to meet its mechanical demands, bone alterations likely play an important role in OA development. Subchondral bone changes in bone turnover, mineralization, and volume result in altered apparent and material density of bone that may adversely affect the joint’s biomechanical environment. Subchondral bone alterations such as bone marrow lesions (BMLs) and subchondral bone attrition (SBA) both tend to occur more frequently in the more loaded knee compartments, and are associated with cartilage loss in the same region. Recently, MRI-based 3D bone shape has been shown to track concurrently with and predict OA onset. The contributions of structural abnormalities to the clinical manifestations of knee OA are becoming better understood as well. While a structure-symptom discordance in knee OA is thought to exist, such observations do not take into account all potential factors that can contribute to between-person differences in the pain experience. Using novel methodology, pain fluctuation has been associated with changes in BMLs, synovitis and effusion. SBA has also been associated with knee pain, but the relationship of osteophytes to pain has been conflicting. Understanding the pathophysiologic sequences and consequences of OA pathology will guide rational therapeutic targeting. Importantly, rational treatment targets require understanding what structures contribute to pain as pain is the reason patients seek medical care.


2021 ◽  
pp. 1-7
Author(s):  
Emre Erdem ◽  
Ahmet Karatas ◽  
Tevfik Ecder

<b><i>Introduction:</i></b> The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. <b><i>Methods:</i></b> A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin &#x3c;800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin &#x3e;1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. <b><i>Results:</i></b> Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, <i>p</i> = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; <i>p</i> = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; <i>p</i> = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; <i>p</i> = 0.063). <b><i>Conclusion:</i></b> Time-averaged serum ferritin levels &#x3e;1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.


2021 ◽  
Vol 30 ◽  
pp. 096368972110249
Author(s):  
G Adas ◽  
Z Cukurova ◽  
K Kart Yasar ◽  
R Yilmaz ◽  
N Isiksacan ◽  
...  

The aim of this clinical trial was to control the cytokine storm by administering mesenchymal stem cells (MSCs) to critically-ill COVID-19 patients, to evaluate the healing effect, and to systematically investigate how the treatment works. Patients with moderate and critical COVID-19 clinical manifestations were separated as Group 1 (moderate cases, n = 10, treated conventionally), Group 2 (critical cases, n = 10, treated conventionally), and Group 3 (critical cases, n = 10, treated conventionally plus MSCs transplantation therapy of three consecutive doses on treatment days 0, 3, and 6, (as 3 × 106 cells/kg, intravenously). The treatment mechanism of action was investigated with evaluation markers of the cytokine storm, via biochemical parameters, levels of proinflammatory and anti-inflammatory cytokines, analyses of tissue regeneration via the levels of growth factors, apoptosis markers, chemokines, matrix metalloproteinases, and granzyme-B, and by the assessment of the immunomodulatory effects via total oxidant/antioxidant status markers and the levels of lymphocyte subsets. In the assessment of the overall mortality rates of all the cases, six patients in Group-2 and three patients in Group-3 died, and there was no loss in Group-1. Proinflammatory cytokines IFNγ, IL-6, IL-17A, IL-2, IL-12, anti-inflammatory cytokines IL-10, IL-13, IL-1ra, and growth factors TGF-β, VEGF, KGF, and NGF levels were found to be significant in Group-3. When Group-2 and Group-3 were compared, serum ferritin, fibrinogen and CRP levels in Group-3 had significantly decreased. CD45 +, CD3 +, CD4 +, CD8 +, CD19 +, HLA-DR +, and CD16 + / CD56 + levels were evaluated. In the statistical comparison of the groups, significance was only determined in respect of neutrophils. The results demonstrated the positive systematic and cellular effects of MSCs application on critically ill COVID-19 patients in a versatile way. This effect plays an important role in curing and reducing mortality in critically ill patients.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 409.2-409
Author(s):  
E. Strebkova ◽  
E. Tchetina ◽  
L. Alekseeva

Background:Currently, a large number of molecular biological and genetic markers are known to be involved in the development of osteoarthritis (OA). The mammalian target of rapamycin (mTOR) signaling pathway is responsible for chondrocyte proliferation, cartilage matrix production, and cell growth. OA is characterized by increased mTOR synthesis, which is accompanied by an increase in proliferative activity and destruction of chondrocytes. Obesity is an important factor in the progression of knee OA. The study of mTOR expression in patients with OA and obesity is an urgent task in the development of personalized OA therapy.Objectives:To determine the expression of mTOR in patients with knee OA in combination with obesity and normal body weight. To evaluate the effect of mTOR on the clinical manifestations of OA in patients with different body mass index (BMI).Methods:The study included 73 female patients aged 45-65 y.o. with Kellgren-Lawrence stage II-III knee OA. The patients were divided into 2 groups: group 1 (n=50) with obesity (BMI > 30 kg / cm2) and group 2 (n=23) with normal or increased body weight (BMI < 30 kg/cm2). The average age of patients with obesity is 56.5 ± 5.87 years, without obesity - 58.7 ± 5.43 years. Clinical manifestations were evaluated by a WOMAС. RNA was isolated from the patients ‘ blood samples, which was used to determine the expression of mTOR.Results:Patients with knee OA with and without obesity did not differ in age. OA develops at an earlier age in obese patients, than in non-obese patients (p < 0.001). Patients from 1 group had a high BMI > 30 kg/m2 at the onset of OA. Obese patients had more severe knee OA is significantly more often detected: Kellgren-Lawrence stage III was determined in 10% of obese patients and in 4.35% - without obesity (p < 0.001). Significantly higher values of the WOMAC index pain, stiffness, joint functional failure, and total WOMAC were observed in obese patients (p = 0.006, p = 0.039, p = 0.037, and p = 0.014, respectively). Obese patients had higher VAS pain scores (p < 0.05) compared to patients with a lower BMI. Obese patients had a higher mTOR expression (p < 0.05) of 8.02±8.62, compared to non-obese patients. High mTOR expression was associated with VAS knee pain (r=0.78; p < 0.05) and WOMAC pain (r=0.89; p<0.05) in obese patients (Table 1).Table 1.Correlation of m-TORParametersmTOR (1 group, n=50)mTOR (2 group, n=23)Body weightр > 0,05р > 0,05Pain (VAS)r=0,78; р<0,05p = 0,07; r = 0,45Pain (WOMAC)r=0,89; р<0,05р > 0,05Total WOMACр > 0,05р > 0,05Conclusion:Our study showed that patients with obesity and knee OA have higher rates of mTOR expression, compared to patients with normal body weight. High mTOR expression correlates with the severity of knee pain in obese patients. Thus, the evaluation of mTOR expression in obese patients and knee OA plays an important role in predicting the severity of clinical manifestations of OA, and may influence the choice of personalized therapy tactics for such patients.Disclosure of Interests:None declared


1964 ◽  
Vol 6 (2) ◽  
pp. 169-178 ◽  
Author(s):  
R. V. Large

1. Thirty Suffolk × Half bred lambs were slaughtered at the following ages: two twin lambs at birth and two singles and two twins at 1, 2, 3, 4, 6, 8 and 16 weeks of age.2. The following weights were recorded: live-weight immediately before slaughter; and carcass, head, skin, feet, alimentary tract, heart, liver, kidneys, lungs and trachea, and blood immediately afterwards.3. The alimentary tract was emptied and weighed in four separate parts; reticulo-rumen, omasum-abomasum, small intestine, large intestine.4. The volumes of the reticulo-rumen and the omasum-abomasum were measured by immersing in water and filling the organs with water to 2 cm. pressure.5. The in vitro digestive efficiency of rumen liquor from lambs of 1, 2, 3 and 4 weeks of age was assessed.6. Empty body weight was considered to be valuable in comparing animals of different ages or from different feeding regimes or at different times of the year because variations in gut ‘fill’ were eliminated.7. There were no differences between singles and twins in the relationship of the fresh weights of the parts of the body to empty body weight, except that development of the liver and the blood was rather slower for singles.8. Little evidence was found of a difference in rate of development of the alimentary tract between singles an d twins, although the log an d square root transformation suggested a possible difference in reticulo-rumen size in favour of twins, significant at the 5% level.


1987 ◽  
Vol 67 (4) ◽  
pp. 1033-1041
Author(s):  
F. A-R. SANKOH ◽  
R. J. BOILA

Injectable Cu and Zn were evaluated as mineral supplements using 37 purebred Herefords (Group 1) and 23 Angus-Charolais-North Devon crosses (Group 2). The 60 steers were carried through a 113-d grazing phase. This was followed by a 79-d finishing phase for all steers of Group 1 and seven steers of Group 2. Treatments were combinations of the non-dosing (0Cu, 0Zn) and dosing (+Cu, +Zn) of steers with injectable Cu or Zn at the start of the grazing phase: (1) 0Cu, 0Zn; (2) +Cu, 0Zn; (3) 0Cu, +Zn; and (4) +Cu, +Zn. Injectables were the sole source of supplementary Cu and Zn during grazing and finishing phases. Means (SE) for Cu and Zn, respectively, in forages as milligrams per kilogram dry matter (DM) during the grazing phase were: grasses, 4.4 (0.17), 15.7 (0.46); alfalfa, 6.9 (0.18), 16.5 (1.49); and birdsfoot trefoil 5.0 (0.76), 15.0 (3.41). Injectable Cu did not influence (P > 0.05) body weight during the grazing phase. Body weight responses were lower (P < 0.05) for +Cu steers in the finishing phase, when dietary Cu was low, but steers could not be classified as Cu-deficient based on liver Cu. Liver Cu increased to means greater than 140 mg kg−1 DM in all steers, but was higher (P < 0.05) in +Cu steers during the grazing phase. Serum Cu varied widely during the grazing phase, but was higher (P < 0.05) for +Cu steers only on day 84 of the grazing phase. Neither liver Cu nor serum Cu was influenced (P > 0.05) by injectable Zn. Injectable Zn decreased growth rates in the latter part of the grazing phase but did not affect (P > 0.05) the body weight response during the finishing phase. The concentrations of Zn in liver and serum were not influenced (P > 0.05) by injectable Cu or Zn. Key words: Cattle, grazing, copper, zinc, injectable copper, injectable zinc


2019 ◽  
Author(s):  
Champak Bhakat

In order to decide the optimum time of grazing for camels during hot summer months, 10 growing camel calveswere divided into 2 equal groups. First group was sent for grazing during 10:00 h to 16:00 h daily and second groupallowed for grazing during thermo neutral period. The climatic variables were recorded daily (April 2012 to March2013). The average daily gain and total body weight gain in calves sent for grazing during relatively cool parts ofday (group 2) was significantly higher as compared to group 1 calves sent as per routine farm schedule. Theaverage intake of fodder and water from manger was higher in group 1 calves. The average DMI from manger forgroup 1 calves was higher as compared to group 2 calves. The comparative biometrics of camel calves in differentgrazing management practices revealed that body length, heart girth, height at wither, neck length were significantly(P&lt;0.01) higher in group 2 calves as compared to group 1 calves. After 180 days of experimentation, humpcircumference vertical and hind leg length were significantly (P&lt;0.05) increased in group 2 as compared to group1. Analysis of recorded data of climatic parameters revealed that average maximum temperature was higher duringJune 2012. The values of THI also were higher in monsoon and post monsoon months hence the practice of sendingcamel calves during relatively comfortable part of hot and hot humid months was successful in getting good growth.The relative humidity was significantly higher during morning as compared to evening period for all months. TheTHI was significantly lower during morning as compared to evening hours for all months in different climate forwhole year. Economic analysis reveals that the cost of feed per kg body weight gain was quite less in group 2 ascompared to group 1. So the practice of grazing of camel calves during cool hours of day remain profitable forfarmers by looking at the body weight gain and better body conformation in climate change condition.


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