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Biomedical subjects

H Papezová

Publications and source records attributed to H Papezová.

At least 19 recordsLinked to original sources
PubMed2006

[New questions and their solution in eating disorders].

Eating disorders represent a continuum in the pathological feeding behaviour with anorexia and severe malnutrition as one extreme and with psychogenic overeating and atypical forms of Eating disorders accompanied with obesity as the second extreme. World-wide epidemical spread of obesity and consequences of obesity frequently results in neglection of eating disorders problems and in apprehension of obesitologists that the Eating disorders prevention could challenge their efforts in the prevention of obesity. Because the scientific approach can enrich both fields, possibilities to improve cooperation between them in the fields of clinical and preventive care are studied. They are based on the recognition of common risk factors and in the more effective and aimed prevention and therapy. Some new discoveries in this field are discussed.

Feeding and Eating Disorders↗
PubMed2006

[Polymorphisms of adiponectin and resistin genes in patients with obesity and anorexia nervosa].

BACKGROUND: Adiponectin and resistin are hormones that may represent a link between obesity and insulin resistance. Genes for these hormones are new candidate genes of insulin resistance and type 2 diabetes mellitus. The aim of our study was to determine the frequency of single nucleotide polymorphisms 45T > G and 276T > G of adiponectin gene and 62G > A and -180C > G of resistin gene in patients with obesity, anorexia nervosa and in lean women and to study the influence of particular genotypes on serum concentrations of these hormones. METHODS AND RESULTS: Serum adiponectin, resistin, TNF-alfa and insulin levels were measured in 51 patients with obesity, 17 with anorexia nervosa and 17 lean women. DNA analysis was carried out by means of polymerase chain reaction (PCR) with restriction analysis of PCR product (RFLP). Adiponectin levels were lowest in obese women and highest in anorexia nervosa patients. Resistin concentrations were lowest in anorexia nervosa and highest in obese patients. Genotype analysis within respective groups showed no differences in assessed parameters when comparing different adiponectin and resistin polymorphisms. The only difference detected was significantly higher BMI in G/G genotype relative to T allele carries in 276 position of ADP gene in control group (23.48 +/- 0.85 vs. 19,7 +/- 0.95, p < 0.05). In anorexia nervosa patients, frequency of G allele in RETN -180 polymorphism was significantly higher relative to control group (p < 0.05). CONCLUSIONS: Polymorphisms 45T > G a 276T > G of ADP gene and 62G>A and -180C > G RETN gene did not influence serum ADP and RETN concentrations. BMI was influenced by T allele presence in 276 position of ADP gene in control group only. Anorexia nervosa patients had higher frequency of G allele of RETN -180 polymorphism compared to healthy women.

Adiponectin↗
PubMed2006

[Assisted reproduction in patients with food intake disorders--clinical and ethical aspects].

Fertilization treatment is established therapy of infertility in the cases, where other approaches have failed or were impossible. In eating disorders, majority of fertility problems has been secondary and so fully reversible if appropriately treated. Fertilization treatment should not be used in patients refusing the psychological treatment of the illness. In patients in active phase of the illness fertility treatment at fertility are contra-indicated. Two cases of negative impact of fertility treatment in patients with anorexia nervosa are presented.

Adult↗
PubMed2006

[The role of adiponectin in increased insulin sensitivity of patients with anorexia nervosa].

The aim of the present study was to determine the relationship between plasma levels of adipocytokine adiponectin and the degree of insulin sensitivity in patients with anorexia nervosa (AN). AN is a psychiatric disorder characterized mainly by severe malnutrition and loss of body fat. We measured fasting plasma adiponectin, insulin and glucose levels in ten women with a restrictive type of AN and in twelve healthy normal-weight women. Plasma adiponectin levels were significantly increased in patients with AN compared to healthy women (p < 0.01) and were negatively related to body mass index and percent body fat in both groups. Plasma adiponectin levels were negatively related to plasma insulin levels in the AN group only. Using homeostasis model assessment of insulin resistance (HOMA-IR), we found significantly increased insulin sensitivity in patients with AN compared to control women (p < 0.05). In conclusion, hyperadiponectinemia in patients with AN might contribute to increased insulin sensitivity in these patients.

Adiponectin↗
PubMed2005

Elevated pain threshold in eating disorders: physiological and psychological factors.

Several studies have found decreased pain sensitivity in patients with eating disorders but it is unclear what physiological and psychological factors are associated with this abnormality. In the present investigation, thermal pain threshold latency, somatoform dissociation, body image disturbance and physiological indices of autonomic neural system activity were measured in 39 female patients with eating disorders (21 with anorexia nervosa and 18 with bulimia nervosa) and 17 healthy women. Pain threshold was elevated in patients with eating disorders, especially those with binge-purging symptomatology. A regression analysis indicated that increased pain threshold is moderately associated with decreased peripheral skin temperature and weakly associated with lack of familiarity with one's own body. However, the between group differences in pain perception remained significant after controlling for peripheral skin temperature. Hence, elevation of pain threshold in eating disorders is a replicable finding, which is not explicable by peripheral indices of autonomic system activity or by somatoform dissociation. In future research it may be evaluated as a potential marker of broader phenotype of decreased interoceptive awareness, which may be associated with vulnerability to the development of eating disorders.

Adult↗
PubMed2005

[Serum concentrations of adiponectin in patients with restrictive and purgative subtype of mental anorexia].

BACKGROUND: The aim of our study was to compare serum concentrations of adiponectin, leptin and other selected parameters in female patients with restrictive subtype of anorexia nervosa (n=15), (RMA), binge/purge subtype of anorexia nervosa (n=11) (PMA) with age-matched healthy females, (C, n=14). METHODS AND RESULTS: RMA patients had the most severely decreased body mass index (BMI) and serum leptin levels of the three groups studied. These parameters were also significantly lower in PMA relative to C group. (BMI: RMA 14.61 +/- 0.49 kg/m2, PMA 17.30 +/- 0.25 kg/m2, C 23.21 +/- 0.96 kg/m2; leptin: RMA 1.39 +/- 0.31 ng/ml, PMA 3.72 +/- 0.77 ng/ml, C 9.17 +/- 1.53 ng/ml). In contrast, serum adiponectin levels were markedly increased in RMA patients (57.28 +/- 4.86 ug/ml) relative to other groups (PMA 40,25 +/- 2.18 microg/ml, K 26.84 +/- 2.40 microg/ml). Serum leptin levels positively correlated with BMI in all groups studied (r = 0.56, p = 0.002), while the inverse relationship was found for adiponectin levels and BMI (r = -0.72, p = 0.000003). The hormonal concentrations were measured by commercially available RIA and ELISA kits. CONCLUSIONS: The most significant changes of serum adiponectin and leptin levels were found in the RMA group with most severely decreased BMI and body fat content relative to rest of the groups. Possible role of increased adiponectin levels in the etiopathogenesis and/or metabolic changes in patients with anorexia nervosa is under the scope of our current investigations.

Adiponectin↗
PubMed2004

Composition of plasma fatty acids and non-cholesterol sterols in anorexia nervosa.

Anorexia nervosa is a model of simple starvation accompanied by secondary hyperlipoproteinemia. The pattern of plasma fatty acids influences the levels of plasma lipids and lipoproteins. The concentration of plasma lathosterol is a surrogate marker of cholesterol synthesis de novo, concentrations of campesterol and beta-sitosterol reflect resorption of exogenous cholesterol. The aim of the study was to evaluate fatty acids in plasma lipid classes and their relationship to plasma lipids, lipoproteins, cholesterol precursors and plant sterols. We examined 16 women with anorexia nervosa and 25 healthy ones. Patients with anorexia nervosa revealed increased concentrations of total cholesterol, triglycerides, HDL-cholesterol, campesterol and beta-sitosterol. Moreover, a decreased content of n-6 polyunsaturated fatty acids was found in all lipid classes. These changes were compensated by an increased content of monounsaturated fatty acids in cholesteryl esters, saturated fatty acids in triglycerides and both monounsaturated and saturated fatty acids in phosphatidylcholine. The most consistent finding in the fatty acid pattern concerned a decreased content of linoleic acid and a raised content of palmitoleic acid in all lipid classes. The changes of plasma lipids and lipoproteins in anorexia nervosa are the result of complex mechanisms including decreased catabolism of triglyceride-rich lipoproteins, normal rate of cholesterol synthesis and increased resorption of exogenous cholesterol.

Adult↗
PubMed2003

Plasma ghrelin levels and malnutrition: a comparison of two etiologies.

Ghrelin is a peptide hormone that is involved in regulating growth hormone secretion as well as food intake and energy homeostasis. The aim of this study was to compare changes in plasma ghrelin levels in patients with malnutrition due to anorexia nervosa (AN) or short bowel syndrome (SBS). Blood samples for laboratory analyses were taken from 16 AN patients (plus 13 comparable healthy controls) and 27 SBS patients (plus 13 comparable healthy controls) after an overnight fast. In comparison with their respective control groups, plasma ghrelin levels were increased in the AN patients (p < 0.05) and significantly decreased in the patients with SBS (p < 0.01). These results suggest that quantitative ghrelin secretion in the gut wall is important in determining ghrelin concentrations in the systemic circulation.

Adipose Tissue↗
PubMed2003

Cholesterol concentrations in violent and non-violent women suicide attempters.

The aim of this study was to evaluate whether women with a history of violent suicide attempts have lower serum cholesterol concentrations than those who attempted suicide by non-violent methods. Our retrospective study used a case-control design to compare serum total cholesterol concentration, hematocrit, red blood cell count and body mass index (BMI) in women with a history of violent (n = 19) or non-violent (n = 51) suicide attempts and of non-suicidal controls (n = 70) matched by diagnosis and age. Analysis of covariance (ANCOVA) with age as the covariate was used to analyze differences in cholesterol levels in groups according to violence. Violence was found to be a significant factor (P = 0.016). Using the Scheffé test, a significant difference (P = 0.011) was revealed between the group of violent and non-violent suicide attempters and between the violent suicide attempters and the control group. Patients with a violent suicidal attempt have significantly lower cholesterol levels than patients with non-violent attempts and the control subjects. Our findings suggest that suicide attempts should not be considered a homogeneous group. They are consistent with the theory that low levels of cholesterol are associated with increased tendency for impulsive behavior and aggression and contribute to a more violent pattern of suicidal behavior.

Adult↗
PubMed2003

[Lipid metabolism in anorexia nervosa].

BACKGROUND: Anorexia nervosa is a model of simple starvation accompanied by secondary hyperlipoproteinemia. Plasma fatty acid pattern influences levels of plasma lipids and lipoproteins. Level of plasma lathosterol represents a marker of cholesterol synthesis de novo; levels of plant sterols reflect resorption of exogenous cholesterol. The aim of the study was to evaluate fatty acids in plasma lipid classes and their relationships to plasma lipids, lipoproteins, lathosterol, campesterol and beta-sitosterol. METHODS AND RESULTS: We examined 16 women with anorexia nervosa and 25 matched controls. Main lipid classes were separated by thin-layer chromatography, fatty acids and non-cholesterol sterols were evaluated by capillary gas chromatography. Patients with anorexia nervosa revealed increased concentrations of total cholesterol, triglycerides, HDL-cholesterol, campesterol and beta-sitosterol; changes in plasma levels of lathosterol did not reach statistical significance. The most consistent finding in fatty acid composition was a decreased content of linoleic acid and raised content of palmitoleic acid in all lipid classes. CONCLUSIONS: Changes of plasma lipids and lipoproteins in anorexia nervosa result from complex mechanisms including increased synthesis of triglyceride-rich lipoproteins along with unchanged cholesterol synthesis rate. Hypercholesterolemia in anorexia nervosa may also result from increased resorption of exogenous cholesterol.

Adult↗
PubMed2003

[Leptin levels in female patients with restrictive and purgative types of anorexia nervosa].

BACKGROUND: Anorexia nervosa is an eating disorder with typically chronic course. Two subtypes of anorexia nervosa have been described based on the pattern of eating behavior. Restrictive form of anorexia nervosa is characterized by chronically decreased food intake, while the purgative subtype typically consists of alternating episodes of fasting and overnutrition with factitious vomiting. METHODS AND RESULTS: The aim of this study was to compare anthropometric parameters, serum levels of fat-derived hormone leptin, cholesterol, triacylglycerols and serum leptin/body mass index ratio in patients with restrictive and purgative subtypes of anorexia nervosa respectively. Significantly lower body weight (37.79 +/- 3.93 vs. 49.63 +/- 9.84 kg, p < 0.05), body mass index (13.51 +/- 1.43 vs. 17.75 +/- 2.64 kg/m2, p < 0.05),), body fat percentage (13.28 +/- 2.83 vs. 18.9 +/- 5.65%, p < 0.05), serum leptin (1.117 +/- 0.95 vs. 5.88 +/- 4.7 ng/ml, p < 0.05) and cholesterol levels (4.14 +/- 1.78 vs. 6.31 +/- 1.27 mmol/l, p < 0.05) were found in patient with restrictive relative to purgative subtype of anorexia nervosa. In contrast, no difference in triglyceride levels between both groups was found. Serum leptin levels positively correlated with body mass index and body fat percentage only in patients with purgative subtype of anorexia nervosa (body mass index r = 0.95, p < 0.001, body fat percentage r = 0.64, p < 0.05) but not in those with restrictive subtype. CONCLUSIONS: In conclusion, we demonstrated that serum leptin levels were significantly lower in restrictive relative to purgative subtype of anorexia nervosa. We suggest that this difference is primarily due to distinctions in body fat content.

Adult↗
PubMed2002

[The changes in serum ghrelin levels and their relationship to IGF-I, its binding proteins and leptin in women patients with anorexia nervosa].

Ghrelin is recently discovered peptide hormone involved in the regulation of growth hormone secretion as well as in the regulation of food intake and energetic homeostasis. The study was aimed to describe the changes in ghrelin serum levels in patients with anorexia nervosa and its relationship to some other studied parameters. Sixteen women patients with anorexia nervosa and thirteen healthy women of comparable age were examined clinically and blood samples were taken for estimation of serum levels of ghrelin, leptin, soluble leptin receptor, IGF-I, IGFBP-1 and IGFBP-3. Ghrelin serum levels were significantly increased in the group of patients with anorexia nervosa (p < 0,05). In contrary, serum leptin levels were decreased in the group of patients with anorexia nervosa (p < 0,01). Serum ghrelin levels did not correlate with any other of studied parameters with exception of BMI. We can conclude that serum ghrelin levels are increased in patients with anorexia nervosa and their increase fails to significantly stimulate food intake in this group of patients.

Adult↗
PubMed2001

Pain modulation role of melatonin in eating disorders.

The objective of this study was to test the effect of melatonin on thermal pain threshold in female patients with eating disorders. Fourteen patients were included in the study. We found a parabolic relation between pain threshold and the content of urine sulfatoxymelatonin (r = 0.6299, P < 0.05). We can speculate that increase in severity of eating disorder pathology may decrease both the melatonin level and pain sensitivity. In contrast with expected melatonin analgesic effect, our results showed its possible normalizing influence as well on pathologically decreased pain sensitivity.

Adult↗
PubMed2000

Interaction between serum leptin levels and hypothalamo-hypophyseal-thyroid axis in patients with anorexia nervosa.

The main objective of the study was to evaluate the endocrinological picture of anorexia. Serum leptin levels are low in untreated anorexia nervosa (AN), but studies of the exact relationship between leptin, body weight and hormones of hypothalamo-hypophyseal-thyroid axis and the impact of refeeding in anorectics are limited. The sample consistent of 15 patients with anorexia nervosa before and 1 month after partial weight recovery, and 15 age-matched control subjects. The body mass index (BMI), leptin, plasma neuropeptide Y (NPY), serotonin, thyroxine (T4), triiodothyronine (T3) and reverse triiodothyronine (rT3) in serum were evaluated for each subject. The mean serum levels of leptin, T4, and T3 were significantly lower before weight recovery in 15 patients with AN than they were in control subjects. After partial weight recovery, basal T3 levels were unchanged and significantly lower than in controls. Basal T4 was even still more reduced, but we observed significantly elevated ratio of T3/T4 and reduced ratio rT3/T4 of in AN patients after gain recovery, indicating increased conversion of T4 to T3 than to rT3. The levels of serum leptin were low in AN, but after partial weight recovery slightly increased, and correlated with BMI. No differences were observed in serum NPY. Serum levels of IGF-1 and serotonin were lower in AN than in controls before and after partial weight gain. IGF-1 was slightly increased after partial weight gain. We did not find correlation between serum levels of leptin and serum T4. The low serum levels of T3 associated with chronic starvation were thought to be the result of impaired peripheral conversion of T4 to T3. However, decreased levels of T3 were still apparent even after a partial weight gain, and the concentration of T4 was even lower. The diminished serum level of TSH in AN, however, appeared to return to the level of controls. On the basis of these results, we assume that low serum levels of thyroid hormones in AN reflect a dysfunction of the HPT axis in AN patients. It is known that in man serum serotonin levels correlate positively with T3 levels. It is possible that the low serum levels of thyroid hormones in AN subjects result in low serum serotonin and its product, melatonin. While IGF-1 reflects the energy intake of the previous few weeks, the serum leptin concentration reflects the true status of the adipose stores, a fact that has useful clinical implications.

Anorexia Nervosa↗
PubMed1999

[The effect of partial refeeding on serum levels of leptin and resting energy expenditure in female patients with anorexia nervosa].

BACKGROUND: Serum leptin levels and resting energy expenditure are significantly decreased in patients with anorexia nervosa compared to healthy subjects. Partial realimentation of patients with anorexia nervosa increases both these parameters. However, there so far are no data concerning the relationship of serum leptin levels and resting energy expenditure in patients with anorexia nervosa. The aim of our study was to follow the relationship of serum leptin levels and resting energy expenditure in patients with anorexia nervosa before and after refeeding. METHODS AND RESULTS: It was found that serum leptin levels in patients with anorexia nervosa both before and after partial realimentation were significantly lower compared to healthy subjects (0.86 +/- 0.9 ng.ml-1 and 1.77 +/- 1.9 ng.ml-1 vs 6.85 +/- 3.0 ng.ml-1, p < 0.05). The total resting energy expenditure in patients with anorexia nervosa both before and after realimentation were significantly lower than in the control group (4973 +/- 979 and 5263 +/- 899 vs 6401 +/- 827 kJ/day, p < 0.05). When expressed per body weight the resting energy expenditure in patients with anorexia nervosa was significantly higher in comparison with the control group (122.3 +/- 20.6 and 121.5 +/- 14.2 vs 104.2 +/- 14.6 kJ/day, p < 0.05). The differences in resting energy expenditure in patients with anorexia nervosa before and after refeeding did not reach statistical significance. The body mass and the body fat content increased significantly after realimentation index (14.5 +/- 1.4 vs 15.6 +/- 1.5 kg.(m2)-1 and 14.9 +/- 3.4 vs 16.6 +/- 3.7, p < 0.05) but remained still below of those of control group (BMI 22.3 +/- 2.7, body fat content 26.9 +/- 4.2). CONCLUSIONS: Our study confirmed the reduced serum leptin levels and the total resting energy expenditure in patients with anorexia nervosa compared to healthy age-matched subjects. No statistically significant relationships were found between serum leptin levels and resting energy expenditure either in healthy subjects or in patients with anorexia nervosa before or after partial realimentation respectively.

Adolescent↗
PubMed1995

[Phospholipase A2 in schizophrenia].

The objective of the present work was to evaluate on the basis of the authors' data and data in the literature the role of phospholipase A2 in the pathogenesis of schizophrenia. The authors submit available literature pertaining to the problem as well as their own experimental findings. Based on the submitted facts, it cannot be states that phospholipase A2 is a specific marker of schizophrenia.

Adult↗
PubMed1992

[Intensive psychiatric care of patients with psychogenic eating disorders].

The authors summarize their therapeutic results in anorexia nervosa achieved at the unit of specialized care for eating disorders at the Psychiatric Clinic of the First Medical Faculty, Charles University, Prague. They find that applications for hospitalization of these patients have a rising trend and that in recent years in the unit mainly patients with severe forms of these diseases are admitted. During the past 7 years in the unit a total of 147 patients were hospitalized. By comprehensive regime treatment 84% of the patients with bulimia nervosa. As to basic symptoms, in bulimia nervosa the results were achieved in vomiting and bulimic attacks and in anorexia nervosa as regards appetite, hunger and general attitude to food. Finally the authors summarize the advantages of the unit specialized care for psychogenic eating disorders.

Adolescent↗