Multidisciplinary approach in management of individuals with overweight and obesity

A08 Metabolic syndrome in testicular germ cell tumor survivors is modulated by habitual physical activity

       Vplyv pohybovej aktivity na metabolický syndróm u onkologických pacientov vyliečených z nádoru semenníkov

Amiri A1, Krumpolec P1, Mego M2, Ukropcová B1,3, Chovanec M2, Ukropec J1

1Biomedical Research Center of the Slovak Academy of Sciences, Bratislava, Slovakia

22^nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia

3Institute of Pathophysiology, Faculty of Medicine, Comenius University in Bratislava, Slovakia

Background: Late cardiometabolic toxicity deteriorates health and quality of life in cancer survivors. The key objective of this study was to evaluate the effects of cumulative chemotherapy (CHT) dose, post-treatment time and habitual physical activity (PA) on metabolic syndrome (MetS) prevalence in testicular germ-cell tumor (TGCT) survivors. Methods: TGCT-survivors (n = 195, age 41.1 ± 8.1 yrs, 11.7 ± 5.2 yrs post-therapy) were stratified into low- & high-PA groups. Ninety-eight patients were further stratified into three age/BMI-matched groups differing in number of chemotherapy cycles (≤ 3/> 3) and post-treatment time (5–15/15–30 yrs) and compared to healthy men. Prevalence of MetS, PA (Baecke questionnaire), systemic immune inflammation index (SII) and atherogenic risk were examined. Results: TGCT-survivors had higher MetS prevalence compared to controls. Patients with higher PA had lower waist circumference and SII. Physical activity correlated positively with HDL-cholesterol and testosterone, and negatively with waist circumference and atherogenic risk. The highest MetS prevalence was found in patients treated with > 3 cycles and examined 15–30 yrs post-treatment. Neither the number of CHT cycles nor its absence seemed to affect MetS prevalence in TGCT survivors cured in their thirties and examined 5–15 years post-treatment. However, higher habitual PA was paralleled by lower MetS prevalence, waist circumference and cholesterol. Conclusions: Metabolic syndrome prevalence was higher in TGCT survivors, than in controls. The highest MetS prevalence was found in patients treated in their early twenties with > 3 chemotherapy cycles and examined 15–30 yrs post-treatment. Benefits of higher PA comparable to those found in healthy men were irrespective of chemotherapy dose found in patients treated in their thirties and examined 5–15 yrs post-treatment.

Grantová podpora: APVV 19/0411, VEGA 2/0164/20.

A09 Idiopathic inflammatory myopathy is linked with altered levels of muscle-specific microRNAs in skeletal muscle: regulation by systemic inflammatory & metabolic factors

       Idiopatické zápalové myopatie asociované so zmenenými hladinami svalovošpecifických mikroRNA: regulácia systémovými zápalovými a metabolickými faktormi

Barková D1, Alchus-Laiferová N2, Kurdiová T1, Ukropec J1, Ukropcová B1,2

1Biomedical Research Center of the Slovak Academy of Sciences, Bratislava, Slovakia

2 Institute of Pathophysiology, Faculty of Medicine, Comenius University in Bratislava, Slovakia

Muscle weakness, low endurance and myalgia are typical symptoms of idiopathic inflammatory myopathies (IIM), autoimmune diseases with complex pathogenesis which has not yet been elucidated. Changes in body composition, such as an increase in body fat mass, a decrease in lean body mass as well as metabolic dysregulation contribute to disease pathogenesis. Manifestation of the different types of IIM likely results from complex interactions of genetic and environmental risk factors. We and others have shown that metabolic dysregulation and altered microRNAs expression could contribute to IIM pathogenesis. Here we explored effects of inflammatory (TNFα) and metabolic (glucose, insulin) systemic factors as well as immunosuppressive therapy (dexamethasone) on the expression of the most abundant muscle-specific miRNAs (miR-1, miR-206, miR-133a/b) in primary human muscle cell cultures. This model enables us to separate muscle from the systemic environment, and identify factors that could regulate the expression of target myomirs. Methods: Differentiated muscle cells (myotubes), derived from patients with IIM (biopsy of vastus lateralis muscle), were treated with TNF-α, dexamethasone, insulin, or glucose for 24 hours. Myotubes were harvested for RNA extraction and selected myomirs were quantified by RT-PCR. Treated vs untreated cells were compared. Results: TNFα treatment induced a substantial decrease in the expression of miR-1 and miR-206 (2 and 3-fold decrease, respectively). A similar effect has also been observed with increasing concentration of glucose, and expression of miR-1 in myotubes inversely correlated with glucose concentration in the media. Insulin increased miR-133a & miR-133b expression levels, while dexamethasone induced a two-fold decrease in the expression of miR-133a & miR-133b, and a five-fold decrease in miR-206. Conclusion: A decreased expression of miRNAs involved in skeletal muscle growth and regeneration observed in response to a proinflammatory cytokine, metabolic overload, and the anti-inflammatory treatment in muscle cells in vitro could contribute to the reduced regenerative potential of skeletal muscle in idiopathic inflammatory myopathy.

Grantová podpora: APVV 20–0466, VEGA 2/0076/22.

A26 The role of adipokines in the regulation of glucose metabolism in pregnant women with a history of RYGB-operation

       Úloha adipokínov v regulácii metabolizmu glukózy u žien s históriou RYGB počas tehotenstva

Leutner M1, Bellach L1, Kautzky-Willer A1,2

1Department of Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Austria

2Institute for Gender Medicine, Austria

Background: A Roux-En-Y-gastric bypass (RYGB) operation not only entails stark changes in the glucose homeostasis but also alters the profile of adipokines. As this is also true for pregnancy, this study aims to investigate the relationship of adipokines and glucose metabolism during the pregnancy of women with a history of RYGB operation. Methods: In this prospective clinical study, an oral glucose tolerance test (OGTT) and an intravenous glucose tolerance test (IVGTT) were performed between the 24^th and 28^th week of pregnancy and 3 to 6 months post-partum in a cohort of obese and normal-weight pregnant women, as well as in women with a history of RYGB operation. Levels of the adipokines betatrophin, leptin, adiponectin, fibroblast-growth-factor 21 (FGF21) and adipocyte fatty acid binding protein (AFABP) were measured in EDTA plasma samples. Results: Compared to pregnant obese controls, pregnant RYGB women had lower leptin levels (RYGB: 17.74 ± 1 0.08 ng/ml and NW: 19.14 ± 5.90 ng/ml vs.OB: 31.28 ± 8.86 ng/ml, p <0.01), betatrophin levels (RYGB: 13.66 ± 5.88 vs. OB: 19.03 ± 4.15 vs. NW: 15.68 ± 6.48, p = 0.016) and AFABP levels (RYGB: 2.42 ± 0.43 ng/ml and NW: 2.65 ± 0.34 vs. OB: 3.36 ± 0.27 ng/ml, p < 0.01) as well as higher adiponectin levels (RYGB: 10 334.48 ± 4 527.27 ng/ml and NW: 9 158.37 ± 3 291.20 ng/ml vs OB: 4 642.11 ± 1 970.55 ng/ml, p < 0.01). There is a positive correlation between leptin and the area under the curve (AUC) of glucose (R = 0.5, p < 0.05) and negative correlations between leptin and the disposition and MATSUDA index (R = -0.51 and R = -0.5, p < 0.05). It was only in the RYGB group that betatrophin was negatively related to the disposition index (rho = -0.53, p = 0.014). There was a pregnancy-postpartum decrease in FGF21 levels in the obese cohort (5.28 ± 1.05 pg/ml vs 4.69 ± 0.99 pg/ml, p < 0.05) and a FGF21 increase in the normal-weight cohort (4.62 ± 1.15 pg/ml vs 5.20 ± 0.65 pg/ml, p < 0.05). After pregnancy, there was a decrease in basal and stimulated betatrophin levels during the OGTT in all three patient groups. Conclusion: As there are distinct relationships between adipokines and parameters of the glucose metabolism in the respective cohorts to be seen, adipokines might play and important role in the glucose homeostasis during pregnancy.

A36 Food supply and obesity incidence in east and middle european countries

       Zásobovanie potravín a výskyt obezity v krajínach východnej a strednej európy

Ruszkiewicz K1,2, Kimáková T1, Sieradzka K3, Yip C4

1Regional Center of Occupational Medicine, Rzeszów, Poland

2Department of Public Health and Hygiene, Faculty of Medicine UPJŠ in Košice, Slovakia

31^st Department of Cardiology, East Slovak Institute of Cardiovascular Diseases, Košice, Slovakia

4Cavan General Hospital, Cavan, Ireland

Aim: The aim of the study was to analyze and compare food supply in certain countries of East and Middle Europe – Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland and Slovakia and their trends over the years (2000– 2018) as well as to compare obesity incidence in those countries. Material and methods: Data from OECD statistics online database was used. Results and discussion: Lithuania, presented highest percentage of normal weight population among mentioned countries in 2019. Lithuania had highest total protein supply in years 2000–2019, lowest total fat supply in years 2000–2004 and 2014–2018, as well as highest sugar supply in years 2012–2018. On the other hand, Hungary had least normal weight citizens and most obese population. In years 2013–2018 it had the biggest total fat supply and lowest sugar supply in years 2005, 2010, 2011, 2014, 2016–2018. Regarding protein supply – in years 2010–2016 Hungary was second country with least protein supply, third in years 2017–2019. Given data describes supply, not intake of certain macronutrients. We do not have the information about food export and waste at various levels (transport, grocery, household). Conclusions: Lithuania, which showed the highest percentage of normal weight population among mentioned countries – had lowest total fat supply and highest total protein supply, as well as highest sugar supply. As obesity is multifactorial disease, other parameters (e.g. lifestyle, physical activity, alcohol consumption) should be analyzed to explain why Lithuania has the lowest percentage of obese population. Moreover, data about consumption, in contrary to supply, should be obtained and compared. It is very broad topic and needs further research.