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Biomedical subjects

A Wiecek

Publications and source records attributed to A Wiecek.

At least 37 records · Page 2Linked to original sources
PubMed2000

Amino-acid-based dialysis solution changes leptinemia and leptin peritoneal clearance.

In continuous ambulatory peritoneal dialysis (CAPD) patients, nutritional parameters, appetite, and transperitoneal solute movement can be modified by treatment with amino-acid-based dialysis solution (AADS). Because leptin is involved in energy expenditure and appetite regulation, we decided to examine the influence of AADS on serum and dialysate leptin concentrations. We prospectively evaluated AADS influence on leptinemia and peritoneal transport indices in CAPD patients. Nine clinically stable patients (7 males, 2 females), mean age 55.4 +/- 10.5 years, who had been treated with CAPD for 6.1 +/- 5.8 months, were studied. Examinations were conducted before treatment with 1.1% AADS (period I), after 3 months of AADS administration (period II), after 6 months of AADS administration (period III), and at 3 months after AADS discontinuation (period IV). The primary outcome measure was concentration of leptin in serum and dialysate. Secondary measures included anorexia incidence, nutrient intake, and nutritional parameters. Dialysate-to-plasma ratio (D/P), peritoneal excretion, and clearance (PCl) of leptin were calculated. After 3 months of AADS administration (period II), leptinemia was transiently lower (9.8 +/- 6.2 ng/mL vs 17.1 +/- 14.2 ng/mL, p = 0.017), while D/P (0.51 +/- 0.44 vs 0.23 +/- 0.19, p = 0.012), peritoneal excretion (72.9 +/- 85.4 micrograms/day vs 37.2 +/- 32.3 micrograms/day, p = 0.015), and PCl (4.02 +/- 3.40 mL/min vs 1.75 +/- 1.32 mL/min, p = 0.008) of leptin were higher than measurements obtained at entry. Anorexia incidence and daily protein and energy intakes showed no significant changes during the study. Total body mass, body mass index, and plasma concentrations of total protein and of albumin increased significantly during AADS treatment. A significant positive relation of leptinemia to total fat mass was observed when AADS was not used (periods I and IV). We conclude that administration of AADS in CAPD patients causes a transient decrease in leptinemia and increases in peritoneal excretion and in PCl of leptin, as well as dissociation of the physiological relationship between serum leptin level and total fat mass.

Adult↗
PubMed2000

[Influence of gluten free diet on bone mineral density (BMD) in children with celiac disease].

UNLABELLED: In children with celiac disease (CD) bone metabolism and mineralization are frequently disturbed. The present study aimed to assess the influence of gluten free diet (GFD) on bone mineral density (BMD) in 73 children with CD, mean age of 12.4 +/- 0.4 years and mean body mass index (BMI) 17.9 +/- 0.4 kg/m2 (mean +/- SEM). Diagnosis of CD was established according to ESPEGAN criteria. Compliance to the GFD was verified on the basis of interview and by estimation of antiendomysial antibodies (IgAEmA/IgGEmA) in blood serum. BMD was measured by dual energy X-ray absorptiometry (DEXA). Plasma calcium (Ca) and phosphorus (P) concentrations, alkaline phosphatase (AP) and its bone fraction (BAP) were estimated before BMD measurement. All children were divided into two groups. Group A consisted of 33 children where gluten free diet was strictly respected for 11.7 +/- 0.6 years. The second group (Group B) comprised 40 children without strictly respected GFD. Children who strictly followed GFD showed statistically higher BMI, AP-spine BMD and total body BMD in comparison with children without GFD (BMI 19 +/- 0.52 kg/m2 vs 17.3 +/- 0.4 kg/m2; p < 0.01, AP-spine BMD 0.951 +/- 0.04 g/cm2 vs 0.767 + 0.03 g/cm2; p < 0.005, Total Body BMD 1.013 +/- 0.02 g/cm2 vs 0.933 +/- 0.01 g/cm2; p < 0.05) respectively. No significant differences were found in plasma Ca, P, AP, BAP between both groups. A statistically significant positive correlation (p < 0.001) was found between duration of GFD and AP-spine BMD and total body BMD, respectively. A statistically significant positive correlation (p < 0.05) was also found between duration of GFD and BMI. CONCLUSION: Long-term GFD significantly improves BMD and BMI in children with CD.

Absorptiometry, Photon↗
PubMed1999

Pathophysiological role of leptin in patients with chronic renal failure, in kidney transplant patients, in patients with essential hypertension, and in pregnant women with preeclampsia.

This paper is a summary of results obtained in our studies on leptinemia in patients with chronic renal failure treated with recombinant human erythropoietin (rHuEPO), in kidney transplant patients, in patients with essential hypertension, and in pregnant women with preeclampsia. In this study, we found that rHuEPO treatment has a suppressive effect on leptinemia in patients with endstage renal failure. These results suggest that the appetite stimulating effect of rHuEPO may be mediated by a reduction of leptin synthesis and release. At the early stage of successful kidney transplantation, a significant decline of leptinemia was noticed, which was not related either to the excretory function of the graft or the kind and dose of immunosuppressants. In kidney transplant patients with grafts functioning well for 2.5 years, significantly elevated leptinemia was found. From these results, we may conclude that factors other than the excretory function of the graft and the kind and dosage of immunosuppressants may be involved in the pathogenesis of abnormal leptinemia in these patients. Both in normotensive subjects and patients with essential hypertension, a positive correlation was found between leptinemia and mean blood pressure, suggesting that leptin may be involved in the regulation of blood pressure. Both healthy and preeclamptic pregnant women show higher leptinemia than nonpregnant women. In preeclamptic women, leptin levels in maternal vein blood, umbilical cord blood, and amniotic fluid were significantly higher than respective values found in healthy pregnant women. In contrast to healthy pregnant and nonpregnant women, in women with preeclampsia, no correlation was found between the body mass index (BMI) and leptinemia. In preeclamptic women the abnormally elevated leptinemia was not related to blood pressure. Finally, no correlation was found between leptinemia in maternal and umbilical cord blood. From these studies, it follows that the elucidation of abnormal leptin secretion in the pathogenesis of preeclampsia needs further study.

Adipose Tissue↗
PubMed1999

Does leptin play a role in the pathogenesis of essential hypertension?

BACKGROUND: Leptin is produced and released by adipocytes in proportion to fat stores. Leptin as an anorectic hormone plays an important role in the regulation of food intake, energy expenditure, and insulin secretion. In contrast, neuropeptide Y, insulin, cortisol, and growth hormone are presumed to be appetite modulators. Leptin and neuropeptide Y are both involved in the activation of sympathetic tone. Increased body fat stores in obese patients are involved in the pathogenesis of some metabolic disorders (e.g., hyperinsulinaemia, glucose intolerance) and arterial hypertension. METHODS AND RESULTS: Based on this pathophysiological background, we tried to assess the relationship between plasma leptin and blood pressure in 41 patients with essential hypertension (EHP; 20 females, 21 males, mean age 38.7+/-1.9 years, mean body mass index - BMI - 25.8+/-0.5 kg/m2) and in an appropriately sex- and BMI-matched control group of 27 normotensive healthy subjects (NHS; 11 females, 16 males, mean age 39.7+/-2.5 years, mean BMI 24.8+/-0.6 kg/m2). The plasma leptin concentration did not differ significantly between EHP and NHS (13.0+/-1.9 vs. 8.1+/-1.0 ng/ml, respectively). In both groups a significant positive correlation was found between BMI and plasma leptin concentration (p<0.0001). A significant positive correlation (p<0.02) was found between leptinaemia and mean (MAP), systolic and diastolic blood pressures, if data were analyzed for all examined subjects or separately only for women. Such a correlation could not be confirmed for male NHS and EHP subjects. The plasma neuropeptide Y concentration was higher in EHP than in NHS (77.1+/-23.0 vs. 63.6+/-9.8pg/ml, p = 0.05). In contrast to neuropeptide Y plasma insulin, cortisol, and growth hormone concentrations were similar in EHP and in NHS. CONCLUSION: Both EHP and NHS are characterized by a positive correlation between BMI and leptinaemia. Leptin may be indirectly involved in blood pressure regulation, especially in women of both NHS and EHP.

Adult↗
PubMed1999

[Hemodialysis--is it a method of acute intermittent porphyria treatment? Case report].

In this paper a female patient with severe acute intermittent porphyria is presented in whom routine pharmacological treatment was unsuccessful. After five haemodialysis sessions a dramatic improvement of the clinical status was observed in spite of markedly elevated urinary excretion of porphyrin metabolites. Further studies are mandatory in order to evaluate the effectiveness of acute intermittent porphyria treatment.

Adult↗
PubMed1999

[Do leptin and neuropeptide Y influence blood pressure regulation in healthy pregnant women and women with preeclampsia?].

UNLABELLED: Leptin (LP) and neuropeptide Y (NPY) are involved in the regulation of appetite and energy expenditure. As was shown in our previous studies healthy non pregnant and pregnant women are characterized by a significant positive correlation between maternal body mass index (BMI) and plasma leptin concentration. On the other side participation of both leptin and obesity in the pathogenesis of essential hypertension is presumed. The present study aimed to answer the following question: to what extend LP and NPY are involved in the pathogenesis of arterial hypertension in pregnant women with EPH gestosis. One to 2 days before delivery plasma LP and NPY concentration were estimated in 43 healthy pregnant women, in 18 pregnant women with EPH gestosis and in 26 healthy non pregnant women. In pregnant women with EPH gestosis, mean arterial blood pressure (MAP) (114.6 +/- 1.3 mm Hg) and mean leptinaemia (21.9 +/- 8.5 ng/ml) were significantly higher than in healthy pregnant women (89.1 +/- 0.9 mm Hg and 15.0 +/- 1.3 ng/ml respectively) and in non pregnant women (MAP--91.56 +/- 1.4 mm HG i LP--10.9 +/- 1.7 ng/ml). In healthy pregnant women, in women with EPH gestosis and in healthy nonpregnant women plasma NPY concentrations were of similar magnitude (42.3 +/- 4.1 vs 43.7 +/- 8.5 vs 50.7 +/- 6.1 pg/ml respectively). In pregnant women with EPH gestosis a significant positive correlation was found between diastolic blood pressure or MAP and plasma NPY concentration. Leptinaemia was significantly correlated with systolic, diastolic and MAP respectively only when results obtained in both groups of pregnant women were analyzed together. CONCLUSIONS: 1) leptin seems to be involved in the regulation of blood pressure both in healthy and preeclamptic pregnant women, 2) participation of NPY in the pathogenesis of hypertension in preeclamptic women is likely.

Adult↗
PubMed1998

Atrial natriuretic peptide and arginine-vasopressin secretion in patients with active renal stone disease.

The pathogenesis of active renal stone disease (ARSD) is still not fully elucidated. In the present study the role of atrial natriuretic peptide (ANP) and arginine-vasopressin (AVP) as potential pathogenetic factors in ARSD were examined. Thirty patients with ARSD and 21 healthy subjects (HS) were examined both under bed rest (BR) and head-out water immersion (WI) conditions. Serum concentrations of electrolytes (Na, Ca, Mg), ANP and AVP were assessed before (0'), and after 60 and 120 minutes of BR or WI, respectively. Urinary excretions of Na, Ca, Mg, and oxalates were also estimated during BR and WI. Patients with ARSD showed higher basal plasma levels of ANP and a greater response of ANP secretion, but a lower suppression of plasma AVP to WI induced hypervolaemia as compared with the controls. In addition, in patients with ARSD the physiological relationship between plasma AVP concentration and urinary excretion of Ca and Mg (positive correlation), between plasma ANP level and urinary excretion of Ca and Mg (negative correlation), and between plasma ANP and AVP concentration (negative correlation), respectively, were absent. In addition, patients with ARSD showed a positive correlation between plasma ANP and urinary oxalate excretion. From the results obtained in this study we conclude that both AVP and ANP may be involved in the pathogenesis of ARSD.

Adult↗
PubMed1998

Influence of long-term recombinant human erythropoietin (rHuEpo) therapy on plasma leptin and neuropeptide Y concentration in haemodialysed uraemic patients.

BACKGROUND: In patients with chronic renal failure, rHuEpo therapy ameliorates anaemia and improves wellbeing, exercise tolerance, and appetite. Both leptin and neuropeptide Y play an important role in regulation of appetite and energy balance in humans. METHODS: The present study aimed to assess the influence of 12 months rHuEpo therapy on plasma leptin and neuropeptide Y concentrations in 15 haemodialysed patients (HDP) (6F, 9M; mean age 40.8+/-2.9 years; mean BMI 23.6+/-1.1 kg/m2; mean duration of HD 3.3+/-0.6 months) (Epo group). A second group (No-Epo group) consisted of 17 HDP (9F, 8M; mean age 44+/-3.2 years; mean BMI 24.3+/-1.0 kg/m2; mean duration of HD 2.5+/-0.4 months) not treated with rHuEpo for 12 months. Basal plasma leptin and neuropeptide Y concentrations were estimated by RIA at the beginning and after 3, 6, 9 and 12 months of rHuEpo therapy (Epo group) or clinical observation (No-Epo group). The control group consisted of 30 healthy subjects (15 females, 15 males, mean age=38.2+/-1.7 years, mean BMI 24.5+/-0.7 kg/m2). RESULTS: Baseline plasma leptin concentrations in HDP were higher, although statistically not significant than leptinaemia in healthy subjects. After 3, 6, and 12 months of rHuEpo therapy plasma leptin concentrations were significantly lower than at the beginning of the study. Baseline plasma neuropeptide Y concentrations in HDP did not differ significantly from controls. After 3 and 6 months of the study period plasma neuropeptide Y concentrations increased significantly in patients of both the Epo and No-Epo group. This increase was, however, significantly higher in rHuEpo-treated than in untreated patients. CONCLUSIONS: (1) rHuEpo treatment in haemodialysed patients with chronic renal failure is followed by a significant decline of leptinaemia and disappearance of the physiological positive BMI/leptinaemia relationship. (2) Suppression of leptinaemia induced by rHuEpo may be of clinical relevance in haemodialysed patients with chronic renal failure.

Adult↗
PubMed1998

Does the vitamin D receptor genotype predict bone mineral loss in haemodialysed patients?

BACKGROUND: It has been suggested that the vitamin D receptor (VDR) gene BsmI-polymorphism is a genetic determinant of bone metabolism. DESIGN: To test this hypothesis, the relationship between VDR genotypes, bone mineral density (baseline and after 18 months) and parameters of calcium metabolism and bone turnover were investigated prospectively in 88 haemodialysed patients not receiving active vitamin D metabolites. METHODS: Whole body, lumbar spine and femoral neck bone mineral density (BMD) were assessed by dual energy X-ray absorptiometry (DEXA). In addition calcium, phosphorus, 25(OH)D3, 1,25(OH)2D3, osteocalcin serum concentrations, alkaline phosphatase activity and intact 1,84 PTH levels were measured. RESULTS: VDR genotype BB, Bb and bb were found in 27, 49 and 24% of patients. Initial BMD (g/cm2) of whole body, lumbar spine and femoral neck did not differ between genotypes (whole body: BB 1.055 +/- 0.120, Bb 1.082 +/- 0.102, bb 1.128 +/- 0.120; lumbar spine: BB 1.075 +/- 0.199, Bb 1.079 +/- 0.185, bb 1.099 +/- 0.170; femoral neck: BB 0.808 +/- 0.160, Bb 0.862 +/- 0.127, bb 0.842 +/- 0.125; mean +/- SD), but the decrease of whole body and femoral neck BMD during 18 months was significantly (P < 0.02) different between the genotype groups (whole body: BB -0.048 +/- 0.028, Bb -0.031 +/- 0.029, bb -0.024 +/- 0.023; femoral neck BB -0.044 +/- 0.069, Bb -0.032 +/- 0.081, bb -0.012 +/- 0.029 g/cm2). CONCLUSION: This preliminary study suggests faster mineral loss in BB genotype of VDR in haemodialysed patients.

Adolescent↗
PubMed1998

Plasma leptin concentration in kidney transplant patients during the early post-transplant period.

BACKGROUND: Leptin, is produced by adipose tissue and is presumed to be involved in the regulation of appetite and energy balance. The kidneys are involved in the inactivation of circulating leptin, and elevated plasma leptin concentrations were reported in uraemic patients. Finally, glucocorticosteroids as used in transplanted patients stimulate leptin secretion. METHODS: The present study aimed to asses the relationship between plasma leptin concentration and kidney graft function in the early post-transplant period. We studied 40 successfully transplanted haemodialysed uraemic patients (27 males, 13 females, mean age 34.3 +/- 1.6 years, mean body mass index 22.5 +/- 0.5 kg/m2). The circadian rhythm of leptinaemia and insulinaemia was assessed twice: 2-4 days after kidney transplantation and 1 day before discharge from the hospital when graft function was good. Plasma leptin concentration was measured at 8 am, 4 pm, and 12 pm. The control group consisted of 21 healthy subjects (13 males, 8 females, mean age 39.4+/-2.5 years, mean body mass index 24.1 +/-0.7 kg/m2). RESULTS: Before kidney transplantation, patients had elevated plasma leptin and insulin levels. A positive correlation was found between BMI and leptinaemia and BMI and insulinaemia, respectively. An inverse relationship was found between leptinaemia and age. Successful kidney transplantation was followed by a significant decline of leptinaemia i.e. from 21.5 +/- 0.1 vs 7.1 +/- 1.3 ng/ml. Kidney transplantation did not influence the circadian rhythm of leptinaemia. CONCLUSION: Leptinaemia was not related to the excretory graft function or immunosuppression. In addition to renal excretory function, other factors must be involved in the post-transplant decline of leptinaemia.

Adult↗
PubMed1998

[Vitamin D receptor gene polymorphism and the rate of bone loss of the femur neck and lumbar spine in hemodialized patients with chronic renal failure].

It has been suggested that the vitamin D receptor (VDR) gene Bsml-polymorphism is a genetic determinant of bone metabolism. To test this hypothesis, the relationship between VDR genotypes, bone mineral density (baseline and after 18 months) and parameters of calcium metabolism and bone turnover were investigated prospectively in 136 haemodialyzed patients. Lumbar spine and femoral neck bone mineral density (BMD) were assessed by dual energy X-ray absorptiometry (DEXA). In addition calcium, phosphorus, 25(OH)D3, 1.25(OH)2D3, osteocalcin serum concentrations, bone alkaline phosphatase activity and intact 1, 84-PTH levels were measured. VDR genotype BB, Bb and bb were found in 24%, 46% and 30% of patients respectively. Initial BMD (g/cm2) of lumbar spine and femoral neck did not differ between genotypes, however the decrease of femoral neck BMD during 18 months of observation differ significantly (p < 0.02) between the particular genotype groups (femoral neck: BB -0.031 +/- 0.029; Bb -0.027 +/- 0.017; bb -0.017 +/- 0.019 g/cm2). Significantly lower serum level of 25OHD3 was found in patients with the BB genotype before and after 18 months of observation in comparison to the respective values obtained in bb genotype patients, (respectively, 21.0 +/- 16.8 ng/ml vs 30.8 +/- 17.9 ng/ml; p < 0.01 and 24.0 +/- 10.8 ng/ml vs 32.4 +/- 16.0 ng/ml; p < 0.02). BB genotype patients were also characterised by significantly lower serum level of 1.25(OH)2D3 both initially and after 18 month of the study (respectively in BB and bb patients 25.9 +/- 9.7 pg/ml vs 30.7 +/- 10.0 pg/ml; p < 0.02 and 18.4 +/- 12.3 pg/ml vs 24.3 +/- 13.0 pg/ml; p < 0.01). No significant differences were found in Ca, P, osteocalcin, iPTH serum concentrations and bone fraction of alkaline phosphatase activity between particular genotypes. Results from this study suggest that faster bone mineral loss and more exaggerated disturbances of vitamin D metabolism are present in haemodialyzed uraemic patients with BB than bb genotype of VDR.

Adult↗
PubMed1998

Partial regression of advanced cyclosporin-induced gingival hyperplasia after treatment with azithromycin. A case report.

Gingival hyperplasia is a well recognised complication of cyclosporin A therapy. Although its pathogenesis is still debated in several recent reports a second generation macrolide antibiotic-azithromycin induced partial or even complete regression of hyperplasia. We present a patient after kidney transplantation treated with cyclosporin who developed very advanced gigival overgrowth (stage 3+). The patient received a 3-day treatment with azithromycin which was repeated after 3 months. The first course of the drug caused a partial regression of gingival hyperplasia during following months but the repeated treatment did not provide a further regression of the changes.

Adult↗