Assessment of Serum Spexin Levels In Obese Adolescents with Metabolic Syndrome Antecedents: Preliminary Results

Objective: Spexin (SPX) is a novel peptide implicated in food intake and satiety. Spexin levels are reduced in obese patients. Aim: To compare serum SPX levels in obese adolescents versus healthy controls and to assess the associations of metabolic syndrome (metS) antecedents with serum SPX levels. Methods: Eighty consecutive obese adolescents aged 10-18 years and 80 healthy peers were enrolled. Anthropometric measurements, pubertal examinations and clinical blood pressure measurements were performed. Fasting blood samples were drawn for glucose, insulin, lipids, uric acid, alanine aminotransferase (ALT) and SPX. Metabolic syndrome (metS) was diagnosed using International Diabetes Federation criteria. Associations of serum SPX with clinical and laboratory variables were assessed. Results: Obese adolescents had lower serum SPX levels than healthy peers (50 pg/mL [25%-75% IQR: 25-98 pg/mL] and 67.0 pg/mL [25%-75% IQR:32.5-126.0 pg/mL; respectively], p =0.035). Twenty (25 %) obese adolescents were diagnosed as having metS. Obese adolescents with metS had lower SPX than those without metS (24.5 pg/mL [25%-75% IQR: 15.3-49.5 pg/mL] and 69.0 pg/mL [25%-75% IQR: 42.0-142.0 pg/mL]; respectively p<0.0001). The frequencies of hyperuricemia, IR and elevated ALT were similar in obese adolescents with metS and those without metS (p > 0.05 for all). Serum uric acid levels were correlated significantly with serum SPX after correcting for BMI and HOMA-IR (r =-0.41, p<0.05). A serum SPX level at a cut -off level of 49.5 pg/mL predicted the presence of metS in obese adolecents with 75 % sensitivity and 71 % specifity. Conclusions: Obese adolescents have reduced SPX levels, and this reduction is more pronounced in those with metS. Further research is needed to verify the utility of SPX as a biomarker in the diagnosis of metS in obese adolescents.

The Effect of Dash Diet on the Blood Pressure of the Male Hypertensive Office Employees between 33-55 Years of Age

Aims: To determine the effect of the DASH Diet on the Blood Pressure of the male hypertensive office employees between 33-55 years of age. Place and Duration of Study: The study was conducted at Abhitex International Company, Panipat, Haryana, India between November 2018 to January 2019. Methodology: The Clinical blood pressure of the office employees of Abhitex International company, Panipat, between the age group of 35 to 55 years was recorded, following the international guidelines given by American Heart Association(AHA) and American College of Cardiology. Purposive sampling was done and the employees who had clinical blood pressure above 120/80 mm Hg were considered as the samples for the study. The dietary pattern of the samples was evaluated by checking the adherence to the DASH diet which was done through a questionnaire and 3 days 24-hour diet recall. Dietary adherence was assessed using a scoring scheme adopted by Folsom and colleagues. Samples were made aware of the DASH Diet and post one month the adherence to DASH Diet was again checked and the change in the clinical blood pressure was observed. Results: There were 50 study participants. The mean age of the participants was 41.5 years. The average Systolic blood pressure of the 50 participants in the pre-test was 149.3 mm of Hg and average diastolic blood pressure was 89.58 mm of Hg. Pre Nutrition Education Program, the total mean DASH adherence score was 4.3 out of 10 but post NEP and after following DASH Diet, the adherence score for the DASH Diet improved and resulted in 6.7 which indicated that the samples adhered more to the DASH Diet post NEP. There were reductions in systolic (149.30±18.98 mmHg to 146.12±14.85 mmHg) and diastolic (89.58±8.76 mmHg to 86.28±4.76 mmHg) blood pressures when the subjects adhered towards the DASH Diet. A significant difference at p=0.05(p=0.039*) in the pre and post-systolic blood pressure was observed in the study. A similar trend was also noticed in the pre and post-diastolic blood pressure which showed a highly significant difference at p=0.05(p=0.002**). Conclusion: It was concluded from the study that the improvement in the DASH Diet adherence score was associated with a reduction in the Clinical blood pressure. There was a reduction in systolic (149.30±18.98 mmHg to 146.12±14.85 mmHg) and diastolic (89.58±8.76 mmHg to 86.28±4.76 mmHg) blood pressures with an improvement of DASH Adherence Score (4.3±1.27 to 6.7±1.19).

Pilot Application of Varied Equipment and Procedural Techniques to Determine Clinical Blood Pressure Measurements

High blood pressure, screened with a patient’s blood pressure (BP), is found in 1 out of 3 adults in the United States. A cohort of 39 participants had BP measured following the American Heart Association (AHA) protocol, utilizing three different measurement devices: manual sphygmomanometer (MA), automated Midmark IQ vitals (IQ), and an automated Omron home unit (OM). All subjects had BP measured with the IQ device while not adhering to the AHA protocol. Two protocols were denoted PR (protocol following AHA guidelines) or TY (lacking protocol). Results demonstrated a mean systolic BP with IQ-TY > OM-PR > IQ-PR > MA-PR, all (p≤0.01). The mean diastolic BP for IQ-TY > IQ-PR, OM-PR, and MA-PR, with IQ-TY significantly higher than the other 3 (p≤0.01). Comparing participants categorized in each hypertension stage, IQ-TY categorized 7participants as stage 1 hypertensive while OM-PR categorized 3, and both MA-PR and IQ-PR only categorized 1. Study results suggest a potential for possible misclassification of patients based on BP protocol.

Differences in home blood pressure and pulse rates between singleton and twin pregnancies

Objectives To evaluate home blood pressure (HBP) measurements during pregnancy and postpartum and investigate differences between singleton and twin pregnancies. Methods This prospective study involved normotensive, pregnant women who were planning to give birth at Saitama Medical Centre, Saitama, Japan between September 2013 and March 2017. HBP and pulse rate were measured twice daily and clinical blood pressure values were determined from patient records. Results HBP values were available from 101 participants; 69 women with singleton and 32 women with twin pregnancies. Systolic BP was statistically significantly higher in twin pregnancies from 23 weeks of gestation until 8 weeks after delivery compared with singleton pregnancies. Pulse rate was also statistically significantly higher between 11 and 30 weeks gestation in women with twin pregnancies compared with those with singleton pregnancies. Conclusions BP monitoring is important in the management of twin pregnancies, especially during the later gestational weeks and postpartum period and HBP would facilitate this monitoring.