Lege Artis Medicinae

[THE ROLE OF INTRA-ABDOMINAL OBESITY IN THE DEVELOPMENT OF CARDIOVASCULAR DISEASE]

ZÁMOLYI Károly

SEPTEMBER 15, 2006

Lege Artis Medicinae - 2006;16(08-09)

[Obesity, particularly intra-abdominal (visceral) obesity, is a leading cause of cardiovascular disease, insulin resistance, type 2 diabetes, dyslipidaemia, and thrombosis. There is a growing consensus that abdominal obesity, measured by wait circumference, is a better predictor of coronary artery disease, diabetes and metabolic syndrome than body mass index. Although the primary function of adipocytes is storage and release of energy, several factors secreted by adipocytes have regulatory roles in metabolism and exert vascular effects. The pro-inflammatory adipokines, for example, play a causal role in the development of insulin resistance, type 2 diabetes and cardiovascular disease. Clinical studies provide growing evidence that adipous tissue is biologically highly active and possesses a range of metabolic and endocrine functions. The aim of this review is to explore the pathophysiological connections between abdominal obesity and the development of cardiovascular diseases.]

COMMENTS

0 comments

Further articles in this publication

Lege Artis Medicinae

[A new simple tool for tonometric determination of the pCO2 in the gastrointestinal tract]

BODA Domokos, TÁLOSI Gyula, KASZAKI József

Lege Artis Medicinae

[Clinical Evidence György Jermendy: Evidence-Based Diabetic Care]

dr. KAUTZKY László

Lege Artis Medicinae

[THE PRACTICE AND RESULTS OF OSTEOPOROSIS MANAGEMENT IN HUNGARY]

POÓR Gyula

[Osteoporosis poses a major public health problem worldwide due to the extreme number of patients and to the deterioration of quality of life, disability, excess mortality and costs associated with consequent fractures. Representative studies of the author’s group have previously shown that the average bone mineral density values of the Hungarian population are among the lowest in Europe while the prevalence of vertebral fractures is among the highest in international comparison. This revelation has led to the development of a National Osteoporosis Programme, the key element of which being the setting up of a network of osteoporosis centres that are based on the collaboration of various medical specialists, the availability of advanced diagnostic tools and outstanding therapeutic opportunities. On describing the 10-year activity of the centres, the main diagnostic, prevention and management approaches of osteoporosis are discussed. According to the WHO classification the diagnosis of osteoporosis is based on a low bone mineral density finding supported by the laboratory and radiological exclusion of other metabolic bone diseases and secondary forms of osteoporosis. According to the up-to-date treatment guidelines of osteoporosis, when considering medical treatment, preference should be given to patients with high fracture risk in giving drugs with extensive antifracture efficacy that has been confirmed by studies of evidencebased medicine. Among these drugs the most important are the antiresorptive bisphosphonates that have widely been used in Hungary and the bone forming teriparatide that is expected to gain wider use in the near future with the introduction of public health insurance financing. The efficacy of these specific antiosteoporotics is increased by supplementation with calcium and vitamin D. The internationally acknowledged Hungarian osteoporosis management system offers to Hungarian patients outstanding standards for the prevention and management of osteoporosis.]

Lege Artis Medicinae

[So That’s What it is About!?]

GRÉTSY Zsombor

Lege Artis Medicinae

[BRONCHUS ASSOCIATED LYMPHOID TISSUE LYMPHOMA]

HERTEL Katalin, ZSIRAY Miklós, SOLTÉSZ Ibolya

[INTRODUCTION - Primary lymphomas rarely occur in the lung. CASE REPORT - The authors present the case of an asymptomatic 61-year-old man. The patient was identified on routine chest X-ray having a streak infiltrate in the upper lobe of the right lung, which did not respond to antibiotics. On histological examination of the bronchoscopic specimen BALT- (bronchus associated lymphoid tissue) lymphoma was presumed. Since staging showed the disease to be localized, lobectomy was performed. The patient is symptom-free 16 months after surgery and there is no relapse. CONCLUSION - Although BALT-lymphomas are of low-grade malignancy in most of the cases, relapses can develop in the original organ or in other extra-nodal locations years later and BALTlymphomas may also transform into large-cell lymphomas of more aggressive behaviour.]

All articles in the issue

Related contents

Lege Artis Medicinae

[LATE EFFECTS OF TREATMENT FOR DECREASING CARDIOVASCULAR RISK “CARDIOMETABOLIC THERAPEUTIC MEMORY” - A HYPOTHESIS]

JERMENDY György

[In several randomised, controlled clinical studies conducted to decrease cardiovascular morbidity and mortality, there was long-term observational follow-up after the termination of the double-blind phase. There is evidence that the beneficial effect of the therapeutic intervention in the active study phase was maintained in the follow-up period. This phenomenon was observed both for life-style modification and for pharmacological intervention, including the use of ACE-inhibitors, statins, fibrates and intensive insulin treatment. This fact suggests the possibility that even after several years, the body “remembers” the beneficial effects of the cardiovascular risk reduction achieved years earlier. The phenomenon may be called “cardiometabolic therapeutic memory”.]

LAM Extra for General Practicioners

[Special problems of hypertension in women]

KAPOCSI Judit, DEÁK György

[Menopause and pregnancy are especially vulnerable periods of women’s life regarding hypertension. The “Guidelines for the Management of Arterial Hypertension”, issued by the European Society of Hypertension and the European Society of Cardiology, dedicates a separate chapter to hypertension in women. The renewed guidelines of the Hungarian Society of Hypertension also pays a special attention to hypertension detected during pregnancy. In this article, the euthors review the topics of hypertension detected during menopause and pregnancy, discussing pathomechanism and therapy.]

LAM KID

[Modern medical and dietary treatment of gout in light of the new American guidelines]

SZEKANECZ Zoltán

[After several decades of “silence”, in the past few years a number of new data and treatment options have become available regarding the management of hyperuricaemy and gout. We also have a better understanding of the immunpathogenic processes of the disease, resulting in new medicines, as well as dietary and lifestyle modifications. Finally, in 2012, the American College of Rheumatology (ACR) has published new guidelines, which provide detailed algorhythms for each stage of gout and for special clinical situations. Although some aspects of clinical practice in Europe are different from that in the US, the new guidelines are applicable - with the necessary adaptations - in Hungary for the efficient treatment of gout and its comorbidities.]

Lege Artis Medicinae

[THE PROBLEM OF CHILDHOOD OBESITY]

RODÉ Magdolna

[Obesity represents a major public health problem in both developed and developing countries having rapidly increased in prevalence in the past two decades. Childhood obesity is of particular concern. Two of its associated diseases require special attention; metabolic syndrome and type 2 diabetes one of its components that are increasingly diagnosed in childhood. A key to prevention and treatment is healthy lifestyle. The importance of education to healthy lifestyle from early childhood cannot be overemphasized.]

Lege Artis Medicinae

[TISSUE HORMONAL SHOCK: INTRACRINOLOGY - THE IMPORTANCE OF LOCALLY PRODUCED HORMONES IN THE PATHOGENESIS OF VARIOUS DISEASES]

SPEER Gábor, LAKATOS Péter

[This review describes the function and tissuespecific expression of the 11- and 17-beta-hydroxysteroid- dehydrogenase enzyme families as well as the aromatase and 1-alpha-hydroxylase enzymes. Recently, in situ formation of active steroids by these enzymes at the sites of their actions from biologically inactive precursors in the circulation have been demonstrated to play an important role in sex steroid-dependent neoplasms (such as breast and prostate cancer), and in some metabolic diseases (such as obesity, osteoporosis and insulin resistance). Tissuespecific Cushing syndrome (local hypercortisolism) may contribute to the pathogenesis of the latter group of diseases, suggesting that obesity may be considered the Cushing-syndrome of the omentum and that osteoporosis is the obesity of bone. Intracrinology is the science of alterations in tissue hormone synthesis catalysed by enzymes such as those mentioned above, which cannot be detected by measuring circulating hormone levels. The effects of local hormone production differ from those of the well-described autocrine, paracrine and endocrine actions. Based on the hormonal changes within various tissues, the pathogenesis of a number of diseases may be interpreted in a novel way.]