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Biomedical subjects

Andreja Kocijancic

Publications and source records attributed to Andreja Kocijancic.

9 recordsLinked to original sources

Association of TNFSF11 gene promoter polymorphisms with bone mineral density in postmenopausal women.

OBJECTIVES: The receptor activator of nuclear factor-kappaB ligand (RANKL) is recognized as one of the important regulators of osteoclastogenesis. The expression of the tumour necrosis factor superfamily, member 11 (TNFSF11) gene, which encodes for RANKL protein, is increased relative to the expression of osteoprotegrin in cases of senile osteoporosis with hip bone fracture. Our aim was to find polymorphisms in the TNFSF11 gene promoter and to investigate their possible association with bone mineral density (BMD). METHODS: The TNFSF11 gene promoter region was screened for the presence of new sequence variations by direct sequencing. DNA sequencing revealed the presence of four sequence variations: -290C>T, -643C>T, -693G>C and -1594G>A. Association of the discovered polymorphisms with BMD was investigated in 115 Slovenian postmenopausal women, using restriction fragment length polymorphism analysis. After a year, bone loss in the association with the identified sequence variations was evaluated in 43 postmenopausal women. RESULTS: Three of the discovered sequence variations (-290C>T, -643C>T, -693G>C) proved to be polymorphic, whereas variation -1594G>A was only found in one patient. The frequencies of genotypes were as follows: CC (27.8%), CT (43.5%), TT (28.7%) for -290C>T polymorphism; CC (23.5%), CT (47.8%), TT (28.7%) for -643C>T polymorphism; and GG (22.6%), GC (51.3%), CC (26.1%) for -693G>C polymorphism. A statistically significant association of genotype with BMD at the femoral neck was observed only in the -290C>T polymorphism. Genotype CC was associated with lower BMD than the TT genotype (P = 0.022). In polymorphism -693G>C, a significant difference in bone loss rate was observed in total hip (P = 0.011) and femoral neck BMD (P = 0.037). CONCLUSIONS: Four sequence variations were identified in the studied region of TNFSF11 gene promoter. Our results of preliminary clinical evaluation suggest that the -290C>T polymorphism in the TNFSF11 gene promoter could contribute to the genetic regulation of BMD.

Aged↗

Macro- and microcirculation in the lower extremities--possible relationship.

AIMS: Impaired blood supply is a significant risk factor for diabetic foot ulceration and gangrene. A possible relationship between peripheral macroangiopathy and the spectral components of microvascular skin blood flow in the lower extremities was tested in diabetic patients (DP) and non-diabetic subjects (C). PATIENTS AND METHODS: Basal skin blood flow (BSBF) was recorded for 30min at the right and left medial malleolus (predominantly nutritive capillary circulation) by laser Doppler flowmetry in 64 DP and 31 C. Its oscillatory components were analyzed using wavelet transform. Peripheral arterial obliterative disease (PAOD) was defined according to ankle/brachial index (ABI): PAOD+ (ABI<0.9: 21 DP, 12 C), PAOD- (ABI 0.91-1.3: 43 DP, 19 C). RESULTS: No statistically significant differences in BSBF and its oscillatory components were observed between PAOD+ and PAOD-, neither in DP nor in C. In DP, the spectral component of microvascular flow associated with endothelial activity was in significant positive correlation with systolic pressures on brachial and dorsal pedal artery (p=0.001 and 0.010, respectively). CONCLUSIONS: These results indicate that mean BSBF and its oscillatory components do not change with diabetic PAOD; however there is a strong correlation between systolic pressure and the oscillatory components of BSBF related to endothelial activity manifested in the frequency interval 0.0095-0.02Hz.

Aged↗

Association of the osteoprotegerin gene polymorphisms with bone mineral density in postmenopausal women.

OBJECTIVES: Osteoprotegerin (OPG) is a recently discovered member of the tumour necrosis factor receptor superfamily. It plays a crucial role in the control of bone resorption and its gene could therefore be a good candidate gene for osteoporosis. The aim of our work was to find polymorphisms in the OPG gene and to investigate their possible contribution to the genetic susceptibility to osteoporosis by testing for their association with bone mineral density (BMD). METHODS: The whole OPG gene coding region was screened for the presence of polymorphisms in a group of 60 osteoporotic women by single-strand conformation polymorphism analysis (SSCP) approach. Association of the discovered polymorphisms with bone mineral density was investigated in 136 Slovenian postmenopausal women. RESULTS: We detected eight OPG gene polymorphisms that were confirmed by direct DNA sequencing, deletion 4752_4753delCT and nucleotide substitutions 1181G>C, 1217C>T, 1284G>A, 4501C>T, 6893A>G, 6950A>C and 8738T>A. Nucleotide substitutions 1284G>A and 8738T>A have not been previously described. Polymorphisms 4752_4753delCT, 6893A>G and 6950A>C were in complete linkage and the same was true for 1217C>T and 4501C>T. The association with BMD was found only for polymorphism 1181G>C. Subjects with genotype 1181GG had significantly lower lumbar spine BMD than subjects displaying 1181GC. CONCLUSIONS: By our approach we detected eight polymorphisms in the OPG gene. According to our analysis polymorphism 1181G>C is associated with BMD and could therefore be considered as an element of genetic susceptibility to osteoporosis.

Aged↗

Chromium supplementation shortens QTc interval duration in patients with type 2 diabetes mellitus.

BACKGROUND: We investigated the potential effects of chromium supplementation on QTc interval duration in type 2 diabetic patients. METHODS: Of 60 patients with type 2 diabetes mellitus, 30 were randomly assigned to group A, and 30 to group B. Group A received 1000 microg of chromium picolinate (CrPic) daily for 3 months, followed by placebo in the next 3 months; group B was treated with placebo for the first 3 months and CrPic in the next 3 months. At each visit, QT interval was measured on a standard electrocardiogram by averaging 3 consecutive beats in leads II and V4 and corrected for heart rate with Bazett formula. RESULTS: Although baseline QTc interval was similar in both groups (422 +/- 34 milliseconds in group A vs 425 +/- 24 milliseconds in group B, P = .77), QTc interval at 3 months was shorter in group A (406 +/- 35 milliseconds) than in group B (431 +/- 26 milliseconds, P = .01). In the following 3 months, QTc interval shortened in group B but not in group A, which resulted in a comparable QTc interval duration of both groups at the end of the study (414 +/- 28 milliseconds in group A vs 409 +/- 22 milliseconds in group B, P = .50). Apart from body mass index (31.4 +/- 4.2 kg/m2 in patients with QTc shortening vs 28.7 +/- 4.2 kg/m2 in patients without QTc shortening, P = .03), none of the clinical and laboratory variables predicted QTc interval shortening in our patient cohort. CONCLUSIONS: Short-term chromium supplementation shortens QTc interval in patients with type 2 diabetes mellitus.

Chromium↗

Quantitative ultrasound of the calcaneus in children and young adults with severe cerebral palsy.

Osteopenia is common in children, adolescents, and young adults with severe cerebral palsy (CP; spastic quadriplegia) living in residential care, and frequently results in atraumatic fractures. On clinical grounds 67 patients (34 males, 33 females) with severe CP (gross motor function classification system [GMFCS] levels IV or V) aged 5 to 25 years (median 20 y) were divided into three groups with increasing likelihood of severe impairment of bone quality: (1) patients without fractures and without anticonvulsant medication (n=13); (2) patients without fractures and with anticonvulsant medication (n=45); (3) patients with fractures and with anticonvulsant medication (n=9). Evaluation included measurements of quantitative ultrasound (QUS) of the calcaneus, multiple serum analyses, and determination of urinary bone-resorption markers. Values of the quantitative ultrasound index (QUI) were significantly different (p=0.001): group 1 (median 56.9; interquartile range 43.8-75.3); group 2 (49.9; 40.0-60.0); group 3 (35.6; 30.5-38.5). when comparing values of laboratory serum and urine in the three groups, we found significant differences in values of serum bone alkaline phosphatase (p=0.001), serum parathyroid hormone (PTH; p=0.002), serum albumin (p=0.020), and urinary deoxypyridinoline/creatinine ratio (p=0.004). In multiple regression analysis, no laboratory variable was found to be an independent predictor of QUI. QUS of the calcaneus may be a useful method to assess bone quality and fracture risk in children and young adults with severe cp living in residential care, independent of information from laboratory data.

Adolescent↗

Renal functional reserve in patients with Type 1 diabetes mellitus.

AIM: Decreased renal functional reserve might precede incipient diabetic nephropathy in patients with Type 1 diabetes. The aim of this study was to assess the relationship between renal functional reserve and easily assessable estimates of systemic endothelial dysfunction in normoalbuminuric patients with Type 1 diabetes and diabetic retinopathy. METHODS: Renal functional reserve was calculated as the relative change in glomerular filtration rate after protein ingestion. Glomerular filtration rate was measured using pharmacokinetic compartmental analysis of single-shot plasma sinistrin clearance. We measured the activity of von Willebrand factor and concentrations of C-reactive protein and apolipoprotein B, as easily assessable estimates of systemic endothelial dysfunction. RESULTS: Twenty-two patients were studied. Renal functional reserve was inversely associated with activity of von Willebrand factor (R=-0.431, p=0.045) and, in a multivariate model, with concentration of C-reactive protein (R=0.652, p=0.031). CONCLUSION: Renal functional reserve is inversely associated with concentration of C-reactive protein in normoalbuminuric patients with Type 1 diabetes and diabetic retinopathy. This finding provides evidence that decreased renal functional reserve might reflect endothelial dysfunction. We speculate that decreased renal functional reserve might possibly show as an early marker of diabetic nephropathy.

Adult↗

Vitamin D receptor gene polymorphism and bone metabolism during low-dose oral contraceptive use in young women.

With the aim to determine whether bone metabolism in young women using low-dose oral contraception is influenced by vitamin D receptor (VDR) genotype, we designed the prospective clinical study of 41 healthy women aged 20-27 years. Twenty-one women of the study group were prescribed an oral contraceptive (30 microg ethynyl estradiol and 150 microg levonorgestrel) and 20 women of the control group a nonhormonal contraceptive or none. Biochemical markers of bone metabolism (bone-specific alkaline phosphatase, osteocalcin, deoxypyridinoline) and VDR genotype, using BsmI endonuclease, were determined. After 3 months in the study group, the BB genotype subgroup showed significantly decreased osteocalcin (p = 0.010), in the Bb genotype subgroup bone-specific alkaline phosphatase (p = 0.043) and osteocalcin (p = 0.006) decreased, and in the bb genotype subgroup no changes were observed. In the control group, there were no significant changes in markers of bone metabolism regarding VDR genotype. In conclusion, our study shows that in young women VDR gene polymorphism could influence bone metabolism during low-dose oral contraceptive use.

Adult↗

Basal glucose level as an independent predictor of fertilization rate in patients without polycystic ovary syndrome included in an in-vitro fertilization program.

Insulin resistance is a common characteristic of women with polycystic ovary syndrome (PCOS) who are known to differ in their in-vitro fertilization outcomes compared to non-PCOS patients. As insulin resistance can be found in a considerable proportion of normal individuals, we assessed its contribution to ovarian responsiveness and fertilization rate. 26 non-PCOS patients undergoing IVF for the first time were investigated. Insulin resistance was evaluated by using a euglycemic hyperinsulinemic clamp technique. According to multiple regression analysis insulin sensitivity, expressed as insulin stimulated glucose disposal rate, during euglycemic clamp (r = -0.81, p < 0.05 and r = -0.89; p < 0.01) and basal estradiol level (r = -0.54; p < 0.05 and r = -0.56; p < 0.05) appeared significant negative predictors of the number of fertilized oocytes and embryos, respectively. Furthermore, basal glucose level appeared independently as a significant positive predictor of the number of fertilized oocytes and the number of embryos. (r = 0.90; p < 0.01 and r = 0.96; p < 0.01 respectively). We conclude that blood glucose concentration and insulin resistance respectively are independent predictors of IVF outcome.

Adult↗

No major effect of estrogen receptor beta gene RsaI polymorphism on bone mineral density and response to alendronate therapy in postmenopausal osteoporosis.

Genetic factors play an important role in the pathogenesis of osteoporosis. The genes involved are, however, still largely unknown. In the present study, we have investigated whether sequence variations in the estrogen receptor beta (ERbeta) gene are associated with bone mineral density (BMD) and biochemical markers of bone turnover in 79 Slovenian postmenopausal women with osteoporosis. We also assessed the response by BMD and bone markers to antiresorptive therapy with bisphosphonate alendronate. All eight exons of ERbeta gene were amplified by polymerase chain reaction and screened for mutations by single-strand conformation polymorphism analysis. Potentially mutated samples were found only in exon 5 and sequence analysis identified the presence of a silent mutation in codon 328 with a nucleotide substitution GTG to GTA. For easier detection of this silent mutation, the RsaI restriction fragment length polymorphism analysis was developed. The frequencies of genotypes were as follows: Rr 5.1% and RR 94.9%. Between both genotypes, no significant differences in baseline lumbar spine and femoral neck BMD or in bone markers osteocalcin and deoxypyridinoline were observed. Similarly, no significant difference between RR and Rr genotypes in BMD or bone markers after 1 year of therapy was found. The increase in lumbar spine BMD after therapy was the only parameter that approached statistical significance (P=0.099). Patients with genotype Rr showed a smaller increase compared to those with RR. Our results suggest that RsaI polymorphism of ERbeta gene is probably not an important genetic determinant of BMD and does not significantly influence the responsiveness to alendronate therapy.

Adult↗