BACKGROUND: Maternal characteristics may be associated with human milk macronutrients but no definite conclusions have been made to date. AIM: This study aimed to determine the relationship of maternal-associated factors on the content of macronutrients in human milk for the first six weeks after preterm delivery. STUDY DESIGN: Prospective observational cohort study. SUBJECTS: Milk samples were collected from mothers after premature birth between 24 + 0-35 + 6 weeks. OUTCOME MEASURES: Macronutrients and energy content were analyzed by mid-infrared transmission spectroscopy. Demographic and anthropometric data from mothers were systematically recorded. RESULTS: A total 1.558 human milk samples from 192 mothers were analyzed. Colostrum: higher protein (p = 0.001) and lower carbohydrate content (p = 0.003) were present in primiparous compared to multiparous milk. Vaginal birth was associated with increased carbohydrate content (p = 0.021). Fat and energy content in colostrum was not related to any maternal characteristics. Mature human milk: similarly to colostrum, higher protein content (p = 0.001) and lower carbohydrates content (p = 0.022) were observed in primiparous compared to multiparous milk. The mode of delivery was found to be another factor possibly influencing protein and carbohydrate levels (p = 0.036, p = 0.003, respectively). Pre-pregnancy obesity was associated with increased fat (p = 0.030) and energy content (p = 0.020) in human milk. On the contrary, smoking had a negative relationship to fat and energy content (p = 0.026, p = 0.007, respectively). CONCLUSION: Human milk macronutrient concentration after preterm delivery is associated with pre-pregnancy obesity, parity, mode of delivery and smoking. The impact of maternal factors on human milk composition should be taken into account in a strategy of feeding in premature infants.

• Klíčová slova
• Breast milk, Human milk composition, Nutrition, Premature delivery, Prematurity,
• MeSH
• dospělí MeSH
• index tělesné hmotnosti * MeSH
• kouření škodlivé účinky   epidemiologie   MeSH
• lidé MeSH
• mateřské mléko chemie   metabolismus   MeSH
• parita * MeSH
• předčasný porod epidemiologie   metabolismus   MeSH
• těhotenství MeSH
• živiny analýza   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Sustainable development emphasizes the sustainability of natural resources and the environment as well as the development of social welfare. Under the background of resource scarcity and environmental constraints, maximizing social welfare is an inevitable choice to achieve sustainable development. Ecological Wellbeing Performance (EWP) can comprehensively reflect the efficiency of natural capital conversion into social welfare, and improving EWP is a feasible measure to achieve sustainable development. Moreover, island areas are the extremely complicated ecological-social-economic systems due to the traits that are geographical isolation, scarce resources, and frequent natural disasters, so that emphasizing the sustainability of island systems is a key step for achieving sustainable development goals. This study developed the EWP model based on the improved Three-dimensional Ecological Footprint (EF) and urban-scale Human Development Index (HDI), to synthetically evaluate and analyze the sustainable development of four major island regions in China with the data in 2017. Results found that: (1) The four regions are all in ecological deficits, being in exchange for overdraft natural capital for economic development. The EFdepth is greater than the original length 1 indicating the excessive consumption of the natural capital stock. The EFsize reflects the abundance and liquidity of regional natural capital, all the four regions are with the generally low level of flow capital utilization. Hainan with highest EFsize 0.428 is due to its comparatively sparse population density, abundant resources, and strong ecological capacity, while the relatively large population density and more restricted natural capital flows make Taiwan in the lowest value. (2) Judging from the evaluation results of the HDI, Chongming (0.796) and Hainan (0.773) high development level are relatively behind Taiwan (0.912) and Zhoushan (0.827) very high development level, for the impact of income is greater, that is, economic development in Hainan and Chongming is slightly weak. (3) Taiwan, with the highest EWP 3.646, shows the excellent natural resource utilization efficiency and sustainability, followed by Zhoushan, Chongming, and Hainan. In general, increasing HDI while reducing EF can be an ideal way to improve the efficiency of ecological resources and achieve sustainable urban development.

• Klíčová slova
• Ecological well-being performance, Human Development Index, Human welfare, Natural capital, Sustainability evaluation, Three-dimensional Ecological Footprint,
• MeSH
• ekosystém * MeSH
• lidé MeSH
• ostrovy MeSH
• zachování přírodních zdrojů * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Čína MeSH
• ostrovy MeSH
• Taiwan MeSH

BACKGROUND: Ghrelin is an endogenous hormone expressed predominantly in the stomach. Ghrelin controls growth hormone secretion and also affects the body's energy balance. We analyzed the association of ghrelin variants with body mass index (BMI), albumin as a marker of malnutrition and plasma lipids as risk factors for atherosclerosis in hemodialyzed patients, in whom malnutrition and accelerated atherosclerosis are common complications. METHODS: Ghrelin variants Arg51>Gln and Leu72> Met were analyzed by PCR-RFLP in 210 hemodialyzed patients, prospectively followed up for 15 months. Changes in body mass index, triglycerides, total cholesterol and albumin over time (after 3, 6, 9, 12 and 15 months of dialysis) were analyzed in subgroups divided according to ghrelin genotypes. RESULTS: Carriers of at least one of the Gln51 and Met72 alleles lost body weight more quickly than Arg51Arg/Leu72Leu homozygotes (p<0.01). Carriers of the Gln51 allele were at higher risk of developing high cholesterol levels (p<0.01). CONCLUSIONS: Common ghrelin variants may have an effect on changes in biochemical and anthropometric parameters in hemodialyzed patients over time and could be used in the future to plan individualized therapy.

• MeSH
• alely MeSH
• arginin chemie   MeSH
• cholesterol krev   MeSH
• dialýza ledvin MeSH
• dialýza MeSH
• genetická variace * MeSH
• ghrelin biosyntéza   genetika   metabolismus   MeSH
• glutamin chemie   MeSH
• heterozygot MeSH
• index tělesné hmotnosti MeSH
• leucin chemie   MeSH
• lidé MeSH
• methionin chemie   MeSH
• renální insuficience genetika   terapie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• arginin MeSH
• cholesterol MeSH
• ghrelin MeSH
• glutamin MeSH
• leucin MeSH
• methionin MeSH

OBJECTIVES: Autoinflammatory diseases cause systemic inflammation that can result in damage to multiple organs. A validated instrument is essential to quantify damage in individual patients and to compare disease outcomes in clinical studies. Currently, there is no such tool. Our objective was to develop a common autoinflammatory disease damage index (ADDI) for familial Mediterranean fever, cryopyrin-associated periodic syndromes, tumour necrosis factor receptor-associated periodic fever syndrome and mevalonate kinase deficiency. METHODS: We developed the ADDI by consensus building. The top 40 enrollers of patients in the Eurofever Registry and 9 experts from the Americas participated in multiple rounds of online surveys to select items and definitions. Further, 22 (parents of) patients rated damage items and suggested new items. A consensus meeting was held to refine the items and definitions, which were then formally weighted in a scoring system derived using decision-making software, known as 1000minds. RESULTS: More than 80% of the experts and patients completed the online surveys. The preliminary ADDI contains 18 items, categorised in the following eight organ systems: reproductive, renal/amyloidosis, developmental, serosal, neurological, ears, ocular and musculoskeletal damage. The categories renal/amyloidosis and neurological damage were assigned the highest number of points, serosal damage the lowest number of points. The involvement of (parents of) patients resulted in the inclusion of, for example, chronic musculoskeletal pain. CONCLUSIONS: An instrument to measure damage caused by autoinflammatory diseases is developed based on consensus building. Patients fulfilled a significant role in this process.

• Klíčová slova
• Familial Mediterranean Fever, Fever Syndromes, Outcomes research, Patient perspective,
• MeSH
• dědičné zánětlivé autoimunitní nemoci komplikace   MeSH
• dítě MeSH
• dospělí MeSH
• horečka komplikace   MeSH
• konsensus MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• předškolní dítě MeSH
• přehledová literatura jako téma MeSH
• průzkumy a dotazníky MeSH
• senioři MeSH
• stupeň závažnosti nemoci * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• předškolní dítě MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• konsensus - konference MeSH

The paper presents the results of a primary medical examination and of a prospective, on the average 14-year follow-up study of the male population of Kaunas aged 45-59 years (n = 2452). The prevalence of overweight, according to the WHO criteria, was 48.7%, that of obesity 20.5%. With increasing body mass index (BMI) there occurred a statistically significant increase of main risk factors of ischaemic heart disease (IHD) and of IHD itself. The results of the prospective study showed a U-shaped relationship between BMI and mortality from all cardiovascular diseases, and a J-shaped relationship between BMI and mortality from IHD and morbidity of acute myocardial infarction, respectively. The same relationship held true even after standardization of the level of all other risk factors using the multiple logistic function. Thus, the overweight was confirmed as an independent IHD risk factor in the given population.

• MeSH
• dospělí MeSH
• index tělesné hmotnosti * MeSH
• infarkt myokardu epidemiologie   MeSH
• ischemická choroba srdeční diagnóza   etiologie   MeSH
• kardiovaskulární nemoci diagnóza   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• obezita komplikace   MeSH
• prevalence MeSH
• prognóza MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Litva epidemiologie   MeSH

Obesity represents a growing problem due to its impacts on human health and reproduction. In this study, we analysed semen quality, sperm DNA integrity and gene-specific CpG methylation in 116 healthy men from normal population. The men were divided into three groups according to their body mass index (BMI), and their ejaculates were analysed using standard methods, sperm chromatin structure assay (SCSA), methylation next generation sequencing (NGS) and amplicon sequencing. The sperm methylation NGS revealed six significantly differentially methylated regions (DMRs). Using subsequent targeted amplicon sequencing in 116 men, two of the DMRs were proved as differentially methylated in sperm of men with normal BMI vs. BMI ≥ 25. The DMRs were located in the EPHA8 and ANKRD11 gene. Also, we detected a significant decline in the EPHA8, ANKRD11 and CFAP46 gene methylation in association with increasing BMI values. The genes EPHA8 and ANKRD11 are involved in the nervous system and brain development; the CFAP46 gene plays a role in a flagellar assembly and is associated with sperm motility. Significantly lower rates of motile and progressive motile sperm were observed in men with BMI ≥ 30. Our results show that excess body weight can modify CpG methylation of specific genes, affect sperm motility, and compromise sperm chromatin integrity. These factors can stand behind the observed reduced fertility in men with obesity. The methylation changes might be transmitted to their offspring through sperm, and become a basis for possible developmental and reproductive issues in the next generation.

• Klíčová slova
• BMI, Body mass index, DNA fragmentation, DNA methylation, Obesity, Semen, Sperm,
• MeSH
• analýza spermatu * MeSH
• chromatin * metabolismus   MeSH
• CpG ostrůvky MeSH
• dospělí MeSH
• index tělesné hmotnosti * MeSH
• lidé MeSH
• metylace DNA * MeSH
• mladý dospělý MeSH
• motilita spermií genetika   MeSH
• obezita genetika   MeSH
• spermie * metabolismus   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• chromatin * MeSH

Studies show that metabolic syndrome is a factor for developing renal cell cancer (RCC) and tumour aggressiveness. In our study, we evaluated the association between renal cell cancer and cardiometabolic index (CMI) which meets the main components of the metabolic syndrome. We retrospectively reviewed the records of 310 consecutive patients with RCC who underwent radical nephrectomy at our institution. We evaluated the tumour size, histologic subtype, Fuhrman nuclear grade. CMI was calculated as the product of waist circumference (WC) to waist-to-height ratio (WHtR) and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c). CMI were statistically higher in patients with tumour size ≥ 7 cm than those < 7 cm (p<0.05). Mean CMI level was 2.34 ± 0.84 in patients with high tumour size; and 1.18 ± 0.74 in the other group. The patients with high tumour size had higher TG levels, higher WC and lower HDL-c levels. Similarly, CMI levels were statistically higher in patients with Fuhrman grade 3 and 4 than patients with Fuhrman grade 1 and 2 (p<0.001). The patients with high Fuhrman grade had higher TG levels, higher WC and lower HDL-c levels. The simplicity of WC and height measurement and TG and HDL assessment make CMI an easily applicable index for the evaluation of cardiovascular dysfunction. The components of CMI may have effect on tumour carcinogenesis in similar pathways. In this context, CMI which meets the main components of the metabolic syndrome, can be a useful index for the evaluation and calculation of renal cell cancer aggressiveness.

• Klíčová slova
• Cardiometabolic index, Fuhrman grade, Metabolic syndrome, Renal cell cancer,
• MeSH
• index tělesné hmotnosti MeSH
• karcinom z renálních buněk * diagnóza   patologie   MeSH
• kardiovaskulární nemoci * MeSH
• lidé MeSH
• metabolický syndrom * MeSH
• nádory ledvin * diagnóza   patologie   MeSH
• průřezové studie MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• staging nádorů MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Insulin resistance (IR), a key pathogenesis mechanism of metabolic disorders, can be tested using homeostatic model assessment (HOMA). HOMA-IR quantifies peripheral tissue IR, whereas HOMA-β determines insulin secretion. The cross-sectional study aimed to examine non-linear associations of HOMA indices with age when adjusting for body mass index (BMI), and thus to investigate the indices' ability to reflect the real development of glucose metabolism disorders over time. MATERIAL AND METHODS: The sample comprised 3406 individuals without diabetes mellitus (DM) divided into those with normal glucose metabolism (NGT, n = 1947) and prediabetes (n = 1459) after undergoing biochemical analyses. Polynomial multiple multivariate regression was applied to objectify associations of HOMA with both age and BMI. RESULTS: Mean values of HOMA-IR and HOMA-β in individuals with NGT were 1.5 and 82.8, respectively, while in prediabetics they were 2.2 and 74.3, respectively. The regression proved an inverse non-linear dependence of pancreatic b dysfunction, expressed by HOMA-β, on age, but did not prove a dependence on age for HOMA-IR. Both indices were positively, statistically significantly related to BMI, with a unit increase in BMI representing an increase in HOMA-IR by 0.1 and in HOMA-β by 3.2. CONCLUSIONS: The mean values of HOMA indices showed that, compared with NGT, prediabetes is associated with more developed IR but lower insulin secretion. Both HOMA-IR and HOMA-b are predicted by BMI, but only HOMA-β is predicted by age. HOMA indices can reflect non-linear, closer-to-reality dependencies on age, which in many epidemiological studies are simplified to linear ones. The assessment of glucose metabolism using HOMA indices is beneficial for the primary prevention of IR and thus DM.

• Klíčová slova
• diabetes mellitus, homeostasis model assessment, insulin resistance, prediabetes,
• MeSH
• glukosa MeSH
• homeostáza MeSH
• index tělesné hmotnosti MeSH
• inzulinová rezistence * MeSH
• lidé MeSH
• prediabetes * metabolismus   MeSH
• průřezové studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• glukosa MeSH

OBJECTIVES: Previous studies have observed notable unexplained geographic differences in incidence of kidney cancer in Europe. Lithuania is among the countries with the highest incidence and mortality. Our objective was to investigate the effect of different lifestyle, anthropometric and biological factors on the risk of kidney cancer in Lithuanian men. METHODS: This population-based cohort study included 6,849 men initially free from cancer. During the follow-up (1978-2008), 79 incident cases of kidney cancer were identified. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and corresponding 95% confidence intervals (95% CI). RESULTS: Risk of kidney cancer was significantly associated with increasing body mass index (BMI), the adjusted HR for ≥ 35 vs. < 25 kg/m2 was 3.00, 95% CI 1.10-8.19 and the HR per 1 unit increment of BMI was 1.07, 95% CI 1.01-1.14. In overweight men (BMI ≥ 25 kg/m2), the HRs for kidney cancer per 10 mmHg increment of systolic or diastolic blood pressure were 1.10, 95% CI 0.96-1.25 and 1.26, 95% CI 1.01-1.56, respectively. We found no significant association between smoking, alcohol consumption or total serum cholesterol level and kidney cancer risk. CONCLUSIONS: This study supports a link between increased BMI and the development of kidney cancer among men in Lithuania. Hypertension appears to be associated with risk of kidney cancer in overweight men, although the assessment was limited by the lack of statistical power.

• Klíčová slova
• body mass index, cohort study, hypertension, kidney cancer, risk factors,
• MeSH
• incidence MeSH
• index tělesné hmotnosti * MeSH
• kohortové studie MeSH
• lidé MeSH
• nádory ledvin epidemiologie   MeSH
• proporcionální rizikové modely MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Litva epidemiologie   MeSH

The authors examined 126 medical students of the Stomatological branch, Palacký University, Olomouc--Czech and Slovaks--and 32 foreign students from developing countries. The examination under standard conditions assessed the state of the periodontium and the need of periodontological treatment. Despite the fact that in dental students we must foresee a professional attitude and knowledge of the problem, the need of periodontological cases is increasing with the extent of professional training. 10% of the 5th year dental students require a surgical operation of the periodontium. The final conclusions will be made after evaluation of the whole longitudinal study.

• MeSH
• dospělí MeSH
• lidé MeSH
• nemoci parodontu epidemiologie   MeSH
• parodontální index MeSH
• rozvojové země MeSH
• studenti lékařství MeSH
• zdravotnické služby - potřeby a požadavky MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Geografické názvy
• Československo epidemiologie   MeSH