AIM: Human exposure to organic pollutants (some of them also called endocrine disruptors) can be associated with adverse metabolic health outcomes including type 2 diabetes. The goal of this study was to compare the urine levels of bisphenol A and phthalate metabolites in subgroups of patients with metabolic syndrome composed of patients with and without three important components of metabolic syndrome (hypertension, dyslipidemia and diabetes). METHODS: We have investigated 24 hr urine samples of 168 patients with metabolic syndrome from the Metabolic Outpatient Department of General University Hospital in Prague. Using standard metabolic syndrome criteria, we classified patients as dyslipidemic (n=87), hypertensive (n=96), and type 2 diabetic (n=58). Bisphenol A and 15 metabolites of phthalates were evaluated in relation to creatinine excretion. Samples were analysed with enzymatic cleavage of glucuronide using ultra-high-performance liquid chromatography-electrospray ionization tandem mass spectrometry in one laboratory with external quality control. RESULTS: Four metabolites, mono-n-butyl phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl-5-oxohexyl) phthalate, and mono-(2-ethyl-5-carboxypentyl) phthalate showed significantly higher levels in diabetic compared to non-diabetic patients (p<0.001, p=0.002, p=0.002, and p=0.005, respectively). The differences remained significant after adjustment to hypertension, dyslipidemia, age, and BMI. No difference was found between either the hypertensive and non-hypertensive or dyslipidemic and non-dyslipidemic patients. There was no significant relation of bisphenol A level to diabetes, hypertension, dyslipidemia, age, and BMI. CONCLUSIONS: Urine levels of four phthalate metabolites were significantly higher in type 2 diabetics independently on specified predictors. Phthalate levels can be in relation to beta cell dysfunction in type 2 diabetic patients but this study is not able to show if the relation is causal.
- MeSH
- benzhydrylové sloučeniny moč MeSH
- biologické markery moč MeSH
- diabetes mellitus 2. typu moč MeSH
- dyslipidemie moč MeSH
- fenoly moč MeSH
- hypertenze moč MeSH
- kyseliny ftalové moč MeSH
- lidé středního věku MeSH
- lidé MeSH
- metabolický syndrom moč MeSH
- pilotní projekty MeSH
- vysokoúčinná kapalinová chromatografie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Proteinuria, that is, more than 200 mg/day of urinary albumin, is associated with the presence of kidney disease. Its increase over time is strongly correlated with progression of nephropathy. Retrospective analyses of nephropathy outcome trials show that proteinuria reduction of 30% or more after initiation of blood pressure (BP)-lowering therapy is associated with slower nephropathy progression than lowering BP without its reduction. RECENT FINDINGS: Retrospective analyses of five large nephropathy outcome trials demonstrate that nephropathy progression slowed by an additional 28-39% over the control or placebo group when proteinuria was reduced in concert with BP. Two separate trials demonstrate that nephropathy progression was slowed to a lesser degree when BP was reduced to a similar degree, but proteinuria reduced less than 30%. These associations do not hold for those with microalbuminuria, in which BP reduction is the key element to slowing nephropathy progression. Recent cardiovascular outcome trials fail to show a relationship between reductions in proteinuria and nephropathy outcomes. This large cardiovascular endpoint trial, however, was not only powered for nephropathy outcomes but also failed to show a benefit between proteinuria reduction and cardiovascular events, a previously established observation. SUMMARY: All patients with a history of hypertension and either kidney disease or diabetes should have an annual check for albuminuria. If albumin is present in amounts of more than 200 mg/day, strategies for BP-lowering therapy should also focus on a reduction of more than 30% of urinary protein.
- MeSH
- antihypertenziva terapeutické užití MeSH
- blokátory kalciových kanálů terapeutické užití MeSH
- blokátory receptoru 1 pro angiotenzin II terapeutické užití MeSH
- hypertenze farmakoterapie moč MeSH
- inhibitory ACE terapeutické užití MeSH
- klinické zkoušky jako téma MeSH
- kombinovaná farmakoterapie MeSH
- lidé MeSH
- nemoci ledvin farmakoterapie moč prevence a kontrola MeSH
- proteinurie farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Compression of the rostral ventrolateral medulla oblongata (RVLM) by an abnormally located artery is regarded as one possible cause of arterial hypertension. There exists a limited set of data suggesting that increased sympathetic activity in patients with RVLM compression may lead to arterial hypertension. Accordingly, we decided to assess the sympathetic activity in patients with severe arterial hypertension and to investigate any correlation with the presence of RVLM compression. Sixty-four patients with severe arterial hypertension were enrolled in our study. Sympathetic activity was evaluated using 24-hour urinary norepinephrine as measured by high-pressure liquid chromatography with electrochemical detection. The presence of RVLM compression was assessed with magnetic resonance imaging. Neurovascular compression of the RVLM was identified in 40 patients, 27 of whom presented left-sided compression. Twenty-four hour urinary norepinephrine averaged 263.6±135.9 nmol in patients with neurovascular compression - 255.6±137.3 nmol in those with left-sided compression and 251.6±138.5 nmol in patients without RVLM compression. We did not identify any increase in urinary norepinephrine in patients with severe arterial hypertension and neurovascular compression of the RVLM. Our results do not support the hypothesis that neurovascular compression of RVLM may exhibit a sympathetically mediated increase in blood pressure.
- MeSH
- časové faktory MeSH
- dospělí MeSH
- elektrochemické techniky MeSH
- financování organizované MeSH
- hypertenze moč patofyziologie patologie MeSH
- krevní tlak MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- medulla oblongata patofyziologie patologie MeSH
- noradrenalin moč MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- sympatický nervový systém metabolismus patofyziologie MeSH
- úžinové syndromy moč patofyziologie patologie MeSH
- vysokoúčinná kapalinová chromatografie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- MeSH
- dieta s nízkým obsahem soli MeSH
- dieta MeSH
- dítě MeSH
- dospělí MeSH
- genetické markery MeSH
- hydrokortison moč MeSH
- hypertenze klasifikace moč patofyziologie MeSH
- kohortové studie MeSH
- krevní tlak MeSH
- lidé středního věku MeSH
- lidé MeSH
- sodík dietní MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- souhrny MeSH
- MeSH
- dospělí MeSH
- estriol moč MeSH
- hypertenze moč MeSH
- komplikace těhotenství moč MeSH
- lidé MeSH
- rizikové faktory MeSH
- těhotenství při diabetu moč MeSH
- těhotenství MeSH
- třetí trimestr těhotenství metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- srovnávací studie MeSH
