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Biomedical subjects

E Martinka

Publications and source records attributed to E Martinka.

17 recordsLinked to original sources
PubMed1998

Endogenous digoxin-like immunoactivity in subjects with diabetes mellitus and hypertension.

The serum concentrations of digoxin-like immunoactivity (DLIA) were measured in 99 patients: 20 healthy volunteers (HV), 15 patients with insulin-dependent diabetes mellitus (IDDM), 14 patients with non-insulin-dependent diabetes mellitus without hypertension taking oral hypoglycemic (OHA) agents (NIDDM/-HT), 11 patients with NIDDM without hypertension taking insulin (NIDDM/-HT+INS), 12 NIDDM patients with hypertension taking OHA (NIDDM/+HT), nine NIDDM patients with hypertension taking insulin (NIDDM/+HT/+INS), 10 patients with essential hypertension with normal insulin levels (HT/-HI), and in eight patients with essential hypertension with hyperinsulinemia (HT/+HI). The numbers (%) of subjects with DLIA levels above the detection limit of the assay used (> 0.1 nmol/L) were, in the NIDDM/-HT group, 12/14 (85.7%) and in the NIDDM/+HT group, 9/12 (75%), significantly higher (P < .05) than in the HV (7/20; 35%), IDDM (3/15; 20%), and HT/-HI groups (2/10; 20%). The number and percentage of subjects with DLIA levels above the detection limit in the HT/+HI group was six of eight (75%), significantly (P < .05) higher than in the IDDM and HT/-HI groups, and tended to be higher than in the HV group (P < .055). Means and SD of serum DLIA levels (nmol/L) in the NIDDM/-EH (0.18/0.09) and NIDDM/+EH (0.19/0.15) groups were significantly higher (P < .05) than in the HV (0.09/0.07), IDDM (0.05/0.05), and EH/-HI (0.06/0.06) groups. DLIA levels in the HT/+HI group (0.15/0.12) were significantly higher (P < .05) than in the IDDM and HT/-HI groups. The percentage of DLIA levels above the detection limit, as well as the mean and SD of DLIA in the NIDDM group taking OHA, did not differ from those in subjects taking insulin. In all subjects studied (n = 99), DLIA correlated with C-peptide (r = 0.30; P < .01) and glomerular filtration (GF) (r = -0.21; P < .05). After exclusion of insulin-treated patients, DLIA correlated significantly with plasma glucose (PG; r = 0.25; P < .05), immunoreactive insulin (IRI; r = 0.41; P < .001), C-peptide (r = 0.27; P < .05), and GF (r = -0.26; P < .05) (n = 64). Correlation of DLIA with IRI (r = 0.33; P < .05; n = 38) also persisted after exclusion of patients taking insulin and those with DLIA levels below the detection limit. Similarly, DLIA also correlated with C-peptide (r = 0.64; P < .05) and IRI (r = 0.70; P < .05) in the subgroup of 10 patients with the highest levels of DLIA (> 0.25 nmol/L). None of the sera (n = 15) with different DLIA concentrations (0.0-0.38 nmol/L) exhibited K-pNPPase (Na+-K+-ATPase) inhibitory activity. In conclusion, this work demonstrated elevated serum DLIA in NIDDM and HT/+HI patients, and its correlation with IRI and GF. However, due to the fact that the chemical nature and biologic properties of DLIA are still a matter of debate, it is too early to speculate whether the elevation of DLIA is just a secondary result associated with HI and reduced GF, or whether it also has pathophysiologic consequences. Nevertheless, in both cases the elevated concentrations of substances with DLIA and their interference with antidigoxin antibodies may affect therapeutic monitoring of digitalization in NIDDM and HT/+HI patients. Also, the elevated DLIA could subclassify these patients. The significance of such subclassifications (pathophysiologic, therapeutic, or prognostic), however, will need further investigation.

Adult↗
PubMed1998

[Glutamic acid decarboxylase autoantibodies (antiGAD-Ab) in patients with non-insulin dependent diabetes mellitus (NIDDM)].

AIM OF STUDY: To assess the prevalence of markers of autoimmune destruction of pancreatic beta-cells in patients with non-insulin dependent diabetes mellitus (NIDDM). SUBJECTS: 127 hospitalized NIDDM patients subdivided to the following subgroups: non-obese with C-peptide < 0.3 nmol/l (NIDDM-(-)), non-obese with C-peptide > 0.3 nmol/l (NIDDM-(+)), obese with C-peptide < 0.3 nmol/l (NIDDM+(-)) and obese with C-peptide > 0.3 nmol/l (NIDDM2+). METHODS AND MEASURED PARAMETERS: Age, BMI, C-peptide, autoantibodies to glutamic acid decarboxylase (antiGAD-Ab), autoantibodies to islet cells (ICA), markers of specific cellular immunity CD4, CD8, CD19, CD4/CD8, CD4/CD45/RA+, CD4/CD45/RA-, NK (CD16+56), CD3/HLADR, organ specific/non-specific autoantibodies. RESULTS: AntiGAD-Ab were positive in 5/15 (33.3%) NIDDM-(-), 1/32 (3.1%) NIDDM-(+), 2/9 (22.2%) NIDDM+(-) and in 3/71 (4.2%) NIDDM2+. The positivity of antiGAD-Ab in NIDDM-(-) and NIDDM+(-) was significantly higher (p < 0.05) than in NIDDM-(+) and NIDDM2+. CONCLUSION: Some patients with manifestation of diabetes in older age initially classified and treated as having NIDDM may have in fact slowly evolving autoimmune insulin-dependent diabetes mellitus (LADA). These patients can be identified by measurement of antiGAD-Ab or other markers (ICA, IA-2) of autoimmune destruction of pancreatic beta-cells (AID). Moreover, in some patients both AID and insulin resistance may coexist in parallel.

Adult↗
PubMed1997

Endothelial markers in diabetes mellitus.

In this study we examined 22 NIDDM patients without vascular complications and 17 age-matched healthy blood donors. Von Willebrand factor (vWF) levels were significantly increased in NIDDM patients compared to healthy blood donors (1.33 +/- 0.39 vs 1.01 +/- 0.27 IU/ml p = 0.006), while thrombomodulin (TM) levels were similar in the both groups. vWF levels correlated with calcium dependent secretion parameters such as C-peptide (r = 0.680, p < 0.001) and PF4 (r = 0.613, p < 0.01) and did not correlate with calcium-independent markers of endothelial injury such as TM (r = 0.287, p = 0.196) and TFPI (r = 0.296, p = 0.181). Therefore it seems that increased levels of Cai-dependent endothelial and platelet activation markers may precede the signs of endothelial damage. This hypothesis requires further research.

Adult↗
PubMed1997

Endogenous digoxin-like immunoactivity and diabetes mellitus: facts and hypotheses.

Substances with digoxin- and ouabain-like immunoactivity (DLIA) are specific inhibitors of Na(+)-K(+)-ATPase which increase the total amount of intracellular stored calcium (Ca2+i). In diabetic patients, DLIA levels have been reported to be increased. Although this increase is probably secondary to sodium retention and volume expansion (included in diabetic subjects by hyperinsulinemia and/or diabetic nephropathy), the question arises of whether it has pathophysiological consequences: namely, whether substances with DLIA, via their effect on Na(+)-K(+)-ATPase activity and Ca2+i stores, could in diabetic subjects facilitate development of hypertension and/or modulate insulin sensitivity or insulin secretion. Clinical findings of correlations of DLIA to blood pressure, insulin levels and to degree of insulin resistance, together with experimental findings of decreased Na(+)-K(+)-ATPase activity, increased Ca2+i and decreased Mg2+i in both diabetic and hypertensive subjects, support these hypotheses. However, the issue of whether or not these relations are causative and whether or not defects in intracellular milieu are primary or secondary to non-insulin-dependent diabetes mellitus has not been resolved yet. Moreover, pathogenesis of both diabetes mellitus and hypertension is multifactorial and includes many other factors. Therefore, further efforts should be made to elucidate the exact role of substances with DLIA in diabetes mellitus.

Diabetes Mellitus↗
PubMed1997

[What does the relation of digoxin-like immunoactivity and serum insulin levels in pregnant women signify?].

BACKGROUND: Digoxin-like immunoactivity (DLIA) reflects the presence of endogenous substances which are close to cardiac glycosides. These substances via inhibition of Na(+)-K(+)-ATPase increase intracellular calcium stores (Ca2+i) and may modulate various Ca(2+)-dependent mechanisms. Although DLIA are known primarily as hypertension and natriuresis promoting factors, several recent works have suggested that DLIA relates also to diabetes mellitus. The main stimulus for DLIA secretion represents volume-expansion. AIM OF STUDY: To assess relation of DLIA to glucose tolerance and insulin levels in pregnant women (PW). SUBJECTS AND METHODS: 1) 67 PW (DLIA measured by RIA-kit HUMA-LAB Kosice), 2) 53 PW (DLIA measured by RIA-kit ORION). PW were subdivided according to the glucose tolerance and insulin concentrations. RESULTS: 1. DLIA in hyperinsulinemic PW were significantly higher than in those with normal insulin levels. 2. DLIA significantly correlated with insulin levels as well as with insulinogenic index. 3. The increase in plasma glucose and insulinemia during OGTT was accompanied by a decrease in DLIA. These findings were independent of other measured parameters (age, body mass index, pregnancy induced weight gain, blood pressure and steroid hormones). CONCLUSIONS: These findings suggest that DLIA does not respond only to changes regarding sodium-retention and volume-expansion, but also to changes in glucose and insulin metabolism. Thus, DLIA could represent one of the markers of "specific" neurohumoral activation. However, the question of whether an elevation in DLIA may consequently modulate mechanisms of insulin secretion, insulin sensitivity, vascular reactivity and other Ca2+i-dependent mechanisms remains speculative. (Tab. 4, Fig. 4, Ref. 41).

Blood Glucose↗
PubMed1997

[Plasminogen activator inhibitor (PAI-1) and markers of endothelial dysfunction in patients with diabetes mellitus].

The authors examined 25 patients with diabetes mellitus type 2 (NIDDM) without vascular complications, treated by sulphonyl urea preparations, 12 hyperinsulinaemic (HI) non-diabetic subjects and 11 normoinsulinaemic healthy subject s. Patients with NIDDM and HI non-diabetics had significantly elevated PAI-1 levels which correlated with the C-peptide level (r = 0.519, p < 0.001), triacylglycerols (TG) (r = 0.685, p < 0.001), BMI (r = 0.607, p < 0.001) and levels of endothelial markers such as von Willebrand s factor and thrombomodulin (TM). In the group of patients with NIDDM no relationship of PAI-1 and C-peptide was found and a significant correlation was found with TM levels (r = 0.609, p = 0.001) and TG levels (r = 0.476, p = 0.046). The results suggest that the endothelial department has an effect on the regulation of PAI-1 levels in patients with NIDDM.

Adult↗
PubMed1996

[Insulin resistance and pathogenesis of non-insulin-dependent diabetes mellitus (I)].

The authors present a review of current knowledge of insulin mechanism on cellular level and of the defects leading to diminished cellular insulin sensitivity and to development of insulin resistance (IR). Attention is focused primarily on IR in subjects with non-insulin dependent diabetes mellitus (NIDDM) with main stress on the postreceptor level of insulin effect which includes glucose transport, storage (glycogen-synthesis) and glycolysis. The defects of these mechanisms (namely the decrease in glycogen-synthase activity) are considered the main causes of IR in patients with NIDDM. Beside the above mentioned factors the authors discuss some of the less well-known mechanisms that can be found in the background of IR in patients with NIDDM (tissue blood flow, capillary density, transport of insulin across the endothelial barrier, glucose toxicity, role of intracellular calcium and others.

Diabetes Mellitus, Type 2↗
PubMed1996

[Insulin resistance and pathogenesis of non-insulin-dependent diabetes mellitus (part II)].

A review of the existing views is given, focused on the role of insulin resistance (IR), impaired insulin secretion and reduced suppression of hepatic glucose output and in the pathogenesis of noninsulin dependent diabetes mellitus (NIDDM). Currently, there are two basic theories on the sequence of these defects. Most of the authors suggest that NIDDM is caused primarily by insulin resistance (IR) (which is also considered an earliest detectable defect) with subsequent inability of the pancreas sufficiently compensate for IR. However, some authors suggest that NIDDM results from the abnormal pancreatic beta-cell function (disturbed pulsatility and first-phase of stimulated insulin secretion). These authors consider IR a secondary defect. It seems, that both these theories are well founded. Actually NIDDM is not a single disorder but is rather a syndrome of diverse etiology and pathogenesis. In case of NIDDM with obesity the primary etiopathogenetic role can be rather ascribed to IR. while in non-obese NIDDM subjects the secretory defect is more probable as a primary cause.

Diabetes Mellitus, Type 2↗
PubMed1996

[Hemostasis in patients with diabetes mellitus. I. Markers of endothelial dysfunction].

In the submitted pilot study the authors examined 47 diabetic patients without vascular complications and 15 healthy blood donors. In an aged-matched sub-group the authors confirmed significantly elevated levels of Willebrand factor (vWF) in patients with non-insulin dependent diabetes mellitus (NIDDM), as compared with healthy blood donors, while the thrombomodulin (TM) levels did not differ significantly. The mutual correlation of parameters with calcium-dependent release (vWF, platelet factor PF4 and C-peptide) was confirmed in the group of patients with NIDDM with normal TM values and in the group of blood donors. These findings could be explained by the hypothesis that raised intracellular calcium levels, described already in early stages of diabetes could in diabetic patients participate also in the activation of haemostasis.

Diabetes Mellitus↗
PubMed1996

[Hemostasis in patients with diabetes mellitus. II. Tissue factor and the extrinsic blood coagulation inhibitor].

In the submitted pilot study we examined 37 patients suffering from diabetes mellitus without vascular complications and 15 healthy blood donors. The diabetic patients had not, as compared with the blood donors, significantly elevated values of the tissue factor (TF) and tissue factor pathway inhibitor (TFPI). The TFPI levels correlated with other markers of endothelial dysfunction, in particular thrombomodulin (r = 0.452, p < 0.01) and with triacylglycerol and cholesterol levels. They did not correlate with age, the C-peptide level and BMI.

Adult↗
PubMed1995

[Endogenous digitalis-like substance. I. Basic characteristics].

Endogenous digitalis-like substances (EDLS) present endogenous products which structurally belong to cardiac glycosides (CG). According contemporary views these substances potentially present a newly discovered hormonal group produced by adrenal cortex. EDLS, similarly exogenous CG, bind to specific CG- receptor of Na(+)-K(+)-ATPase and inhibit activity of this enzyme. At the cellular level, EDLS lead to increase in intracellular calcium storing and such may play an important role in modulation of calcium-dependent processes and their response to characteristic stimuli (e.g. contractility of vascular smooth muscle cells, hormonal secretion etc.). First part is a review of present views to character and cellular effects of EDLS.

Animals↗
PubMed1995

[Endogenous digitalis-like substance. II. Relation to pathologic states and diseases].

Endogenous digitalis-like substances (EDLS) may play an active but differential role in numerous physiological and pathophysiological mechanisms. Reviewed are diseases, in which EDLS could be considered to play a causative role in their pathogenesis. Relations of EDLS were described mainly to cardiovascular, endocrine and metabolic diseases. Existence of EDLS, however, may have also another clinical implications which include possibility of influencing of digoxin monitoring as well as effects of digoxin therapy. Finally, methods of detection of EDLS are reviewed.

Blood Proteins↗
PubMed1994

[Renal excretion of calcium in healthy persons].

The authors examined the calcium excretion in a group of 100 healthy subjects (50 men and 50 women) aged 21-40 years. Urine was collected under ambulatory conditions. Calcium excretion was expressed as Ca excretion per minute, Nordin's index, calciuria/GF.1.73 m2 and the renal threshold for calcium. Calcium excretion per minute was significantly lower in women, as compared with men. This significant difference of mean values of calcium excretion per minute persists when the subjects are classified by sex and age groups. Women aged 31-40 years had a significantly lower calciuria/GF.1.73 m2 than men aged 21-30 years and a significantly higher renal threshold for calcium, as compared with men of equal age. If standard conditions of urine collection are respected, the mentioned examination method can be used during ambulatory examinations of patients with impaired calcium and phosphate metabolism. The assessed values of different indicators must be, however, compared with values of healthy subjects of the same age and sex.

Adult↗
PubMed1993

[Dynamics of digoxin-like immunoactivity during the oral glucose tolerance test in pregnant women].

The changes of serum digoxin-like immunoactivity (DLIA) during 75g oral glucose tolerance test (OGTT), were investigated in 25 pregnant women with various glucose tolerance. 13 women had a normal glucose tolerance (NGT), 12 women had an impaired glucose tolerance (IGT) or gestational diabetes mellitus (GDM). Test was performed after 25 week of pregnancy. The results were compared with 9 nonpregnant healthy volunteers (NHV). After an oral glucose challenge, there was observed a significant decrease in serum DLIA (p < 0.01 in 1st hour), in both groups of the pregnant women. In the group of NHV these findings were not found. Our findings suggest a possible relationships between DLIA and glucose tolerance in pregnant women. However, it needs further investigation. (Tab. 1, Fig. 1, Ref. 24.)

Adult↗
PubMed1993

[Lyme disease in internal medicine].

The authors present a review on the aetiology, clinical aspects, diagnosis and treatment of Lyme disease. They describe three patients who were treated in their department for Lyme disease. Although this disease has been followed up in Bohemia and Slovakia only for nine years, it is probable that it is more frequent than diagnosed. Lyme disease is a disease which affects different organs. Therefore it is important that specialists in internal medicine should more frequently consider the possible presence of this disease when making differential diagnoses.

Adult↗
PubMed1992

[Endogenous digitalis-like substance in relation to glycemia and insulinemia].

The digitalis-like substance (DLS), insulin resistance, and hyperglycemia are ascribed important roles in the pathogenesis of essential hypertension. The relationship between DLS and glycemia (insulinemia) was investigated in the present study. The levels of glycemia, insulinemia and DLS were measured during oral glucose load in a group of 18 subjects with various blood pressure values. Fasting levels of glycemia and insulinemia were in each subject within the physiological range and no correlation was found to exist between the fasting levels of DLS and glycemia (insulinemia). One hour after oral glucose load the increase of glycemia and insulinemia was significantly higher in the group of subjects with SBP > 140 and/or DBP > 90 mmHg than in normotensive subjects (p < 0.001). The increase in glycemia (insulinemia) was followed by a decrease of DLS. This contrary trend could be expressed as a significant inverse correlation between the change in plasma DLS and the change in glycemia (r = -0.660 p = 0.0039), and also between the change in plasma DLS and the change insulinemia (r = -0.687 p = 0.0023). These findings are assumed to suggest certain mechanisms involved in the pathophysiology of essential hypertension. (Tab. 3, Fig. 2, Ref. 20.)

Adult↗