Faculty of Medicine
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Item type:Publication, METABOLIC VARIATIONS AMONG WOMEN WITH POLYCISTIC OVARY SYNDROME ACCORDING TO BODY MASS INDEX(Македонско лекарско друштво = Macedonian medical association, 2025-12); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, BIOMARKERS IN OBESITY-RELATED METABOLIC SYNDROME: FROM PATHOPHYSIOLOGY TO CLINICAL APPLICATION(Macedonian Association of Anatomists and Morphologists, 2025-11-25) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, KIDNEY FUNCTION DECLINE AND MORTALITY IN DONORS WITH EXPANDED CRITERIA - FIVE YEARS FOLLOW UP STUDY(Macedonian Association of Anatomists and Morphologists, 2024); ; ; ; Kidney donors are considered healthy, but with a need for continued medical follow up and encouragement for continued healthy lifestyle, especially when expanded criteria for donation are applied. This study aims to analyse the five years follow up of kidney donors after explanation, encountering risks of kidney function decline and donors’ mortality. In a retrospective study we evaluated a donor cohort with 5 years of follow up. Demographic characteristics as age, gender and the presence comorbidities as diabetes, hypertension, hyperlipidemia and Body Mass Index (BMI) >30kg/m2 were analyzed. Estimated glomerular filtration rate (eGFR) by CKD EPI formula was notified prior donation, and annually afterwards. Consultations with nephrologist or other specialists were notified. In a multivariate regression analysis, the reduction ratio (RR) of eGFR was explored as dependent variable. Cox regression analysis exploited mortality; Kaplan Meier survival curve was applied in respect of BMI. Seventy-five donors with average age above 55 years were predominantly women (69%), nearly every nineth patient had diabetes or obesity (9%). Proportion of donors referred to nephrologist at the 12 months, declined up to 58% at the fifth year, ignoring medical checks showed ascending trend to 16% at the end of second and third year and 12% at the end of observational period. The univariate regression analysis found diabetes, hyperlipidemia and hypertension, the presence of multiple comorbidities, gender and age as insignificant predictors of eGFR 12 months reduction ratio. The nephrologist referral showed borderline significance (β = - 0.103, p=0.076). Only BMI over 30kg/m2 worsened the kidney function (β = 0.600, p=0.001). Five years mortality rate was 6.7%. The diseased donors were significantly older, more frequently had diabetes and obesity also they had significantly lower eGFR pre-donation, at the end of the first year but also and more step decline of it after 12 months. In the multivariate analysis BMI>30kg/m2 emerged as most powerful predictor of mortality (HR 40.02; CI: [4.11-389), p=0.0001). Survival of obese patients was significantly shorter when compared with patients with lower body weight (43.28 ± 7.51 vs. 59.33±0.65, Log rank p=0.000), respectively. Our study demonstrates that the mortality and declination of renal function after donation are associated with nephrologist referral and other potentially modifiable factors, especially obesity. Improved protocols for pre-donation information, education and adequate after-donation follow up is mandatory to achieve better longevity and kidney function survival in these frail and precious individuals. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Anthropometric indices: waist circumference and waist-to-hip ratio cut-off percentiles to identify abdominal obesity in children from North Macedonia(Firenze University Press, 2024-09-04); ; ; ; Abdominal obesity (AO) has been associated with children’s risk of metabolic and cardiovascular disease. For this reason, this study aimed to provide gender-specific cut-off percentiles of anthropometric indices WC and WHR to identify AO in children aged 9 from North Macedonia. In this study, a total of 320 children aged 9 (160 boys and 160 girls) were investigated. We selected four parameters to measure (weight and height) and two circumferences (waist and hip) using a standard protocol. The following indices are taken into consideration Body-Mass Index (BMI), Waist Circumference (WC), and Waist-to-Hip Ratio (WHR). The percentile distribution of the tested parameters was done by gender. General obesity based on the BMI cut-off occurs at 5.63% in boys and 6.88 % in girls. Abdominal obesity across cut-off points WHR and WC-for age>=90th percentile occur at 11.88% and 6.26% in boys and 12.5 and 11.25% in girls respectively. Both the WHR and WC identify more children with abdominal obesity, but we note that more girls were classified as obese than boys. However, the anthropometric indices of WC and WHR, complement nutritional evaluation and are of great importance for the early detection of AO in our 9-year-old children. These findings support the need to use WC and WHR as strong predictors for AO in routine clinical practice. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, NUTRITIVNI STATUS MAKEDONSKIH ADOLESCENATA I ODNOS PREMA NIVOU OBRAZOVANJA I ZAPOSLENI STATUS NJIHOVIH RODITELJA(ANTROPOLOŠKO DRUŠTVO SRBIJE, Niš / ANTHROPOLOGICAL SOCIETY OF SERBIA, Niš, 2023-09); ; ; ; The aim of this study was to evaluate the nutritional status in Macedonian adolescents and relation with the level of education and employments status of their parents. In this study 1207 adolescent students (616 males and 591 females) at age of 11 to 14 years were included. We measured weight and height using standard procedures while body mass index was calculated and these values were used to assess nutritional status. The examinees fill the questionnaire with the data for parent’s education and employment. We found significant difference between male students who were with risk of obesity and overweight, with high persentage of students with employed mother, contrary to those students with unemployed mother. According to the level of education in father, there was significant difference in the group of underweight females with the higher percentage being underweight with father with lower education, primary school, and only 1,4% were underweight with father with university education. Our data suggest that parental level of education and employment status are in relation with the nutritional status of Macedonian adolescents. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, RISK FACTORS IN HOSPITALIZED PATIENTS WITH STROKE POSITIVE ON SARS-COV-2-INFECTION(Macedonian Association of Anatomists and Morphologists, 2023-11); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Spontaneous omental infarction in an obese young female patient treated with laparoscopy: a case report(Oxford University Press (OUP), 2024-06); ; ; Argirov, IvanPartial infarction of the great omentum is a rare cause of abdominal pain and may present as a surgical emergency. Omental infarction might occur due to its torsion, but cases without obvious cause are reported. Risk factors related to this condition are overweight, obesity, abdominal trauma, recent abdominal surgery, hypercoagulability, postprandial vascular congestion and an increase in intra-abdominal pressure. Because of the condition's rarity, most patients are treated with surgery and the diagnosis is established intraoperatively. Preoperative diagnosis allows successful conservative treatment with analgesics and anti-inflammatory drugs. This case reports a young female patient with class III obesity presented with spontaneous partial infarction of the great omentum treated with laparoscopy. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Frequency of Left Atrial Enlargement According to Different Modes of Indexing in Overweight and Obese Individuals(Macedonian Academy of Sciences and Arts, 2023-03); ; Background: Current guidelines recommend indexing left atrial volume (LAV) by body surface area (BSA). However, in overweight and obese individuals this may result in the underestimation of left atrial enlargement (LAE). The aim of our study was to assess whether alternative LAV indexing to height and/or height-squared better identifies individuals with LAE among those who are overweight and/or obese. Methods: LAV was indexed to BSA (LAVI), height (LAVh), and height-squared (LAVh2) in 127 individuals with a mean age of 45.7 years and a mean body mass index (BMI) of 34.9 kg/m2 who underwent outpatient echocardiography at the University clinic of cardiology in Skopje. Results: LAVI, LAVh, and LAVh2 showed a progressive increase of respective values with the extent of BMI showing the most enlarged LA size in individuals with Class III obesity. There was a progressive significant increase in the prevalence of LAEh and LAEh2 in obese groups with the highest prevalence among those with class III obesity (p=0.002, p=0.002, respectively), on the contrary of LAEBSA where we could not find any significance in its distribution among obese classes. The greatest degree of reclassification occurred when indexing for height-squared, having relatively less reclassification when indexing for height (p=0.0001). The degree of reclassification varied depending on BMI with the greatest impact among the Class III obese patients, where as many as 76.5% and 88.2% of individuals were reclassified according to height or height-squared, respectively. Conclusions: The use of height, and especially height-squared, in comparison to BSA-based indexing methods are more successful in identifying the LAE prevalence in each class of obesity. Using allometric indexation leads to the significant reclassification of LA size from normal to dilated, especially in women and those with severe obesity, thereby providing an opportunity to identify more individuals at increased risk of adverse events. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Influence of a School Environment on Obesity in Children(MDPI Proceedings, 2024-02); Obesity is a complex, multifactorial and widespread condition that affects all age groups of children. The rising prevalence of childhood obesity has become an important public health challenge because it affects the physical and mental health of children and is becoming an economic burden on the health systems. North Macedonia, as part of WHO’s Childhood Obesity Surveillance Initiative (COSI), is collecting data to show the importance of the surveillance of obesity in school-aged children and to provide evidence for informed policy making. Objectives: The aim of this cross-sectional study is to further investigate the influence of a school environment on obesity in 7-year-old schoolchildren and therefore improve children’s nutrition by targeting the food environment in and around schools. Materials and methods: Anthropometric measurements of body height and body weight were performed, and data from a school environment were collected, following the COSI protocol and data-collecting procedures. Results: The results from the previous rounds show that the overweight (including obesity) prevalence in 7–9-year-old schoolchildren is 31%. While physical education lessons in schools consist of 120 minutes of physical activity per week, only one-third of the schools studied organize sport activities outside school hours, and 39% of schools do not have indoor gyms. Only 31.2% of the schools are free of sugary beverage and calorie-dense food advertisements, but there are nutritional education classes in the curriculum in almost every school. One-third of the schools provide fresh fruit and one-third have vending machines on their premises, enabling children to acquire unhealthy snacks and beverages other than water and fruit juice. Conclusion: By comparing the previous and latest anthropometric data, there is a rising trend of childhood obesity in the country. School environments should be improved towards providing healthier nutrition and physical activity practices for pupils. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE IMPACT OF OBESITY AND FAT DISTRIBUTION ON ENDOMETRIAL CANCER RISK IN POSTMENOPAUSAL PATIENTS(Macedonian Association of Anatomists, 2023); ; ; ; Endometrial cancer (EC) is the fourth most common cancer in women worldwide, with rising incidence partly due to changing reproductive trends and ever increasing obesity. Obesity, especially central adiposity, is linked with endometrial adenocarcinoma, possibly due to elevated estrogen and decreased sex hormone-binding globulin levels. The study aims to evaluate the impact of obesity on endometrial malignancy and to determine whether central adiposity (measured by the waist-to-hip circumference ratio) serves as a better indicator of endometrial cancer risk than BMI. In this cross-sectional study, we studied 164 postmenopausal patients from the University Clinic of Obstetrics and Gynaecology in Skopje. Patients were admitted to the hospital for histopathological examination of endometrial layer because of vaginal bleeding with endometrial thickness >4mm, or other sonographic endometrial abnormalities. Histopathological findings subdivided them into two categories: with malignancy (group I) or benign abnormality (group II). Standard examinations and measurements, including BMI and waist-to-hip ratio, were performed. A significant association was observed between endometrial malignancy and obesity as measured by waist-to-hip ratio. In the distribution of data related to BMI and histopathological findings from the endometrial biopsy for Pearson Chi-square=8.35 and p<0.01(p=0.004) there is a significant difference. For Odds Ratio=2.71 (95.%CI:1.36-5.38), patients who had a BMI ≥ 30 kg/m2 were 2.71 times more likely to have endometrial malignancy than patients who had a BMI <30 kg/m2, (p<0.01). There is a significant difference in the shown distribution of data related to waist circumference/hip circumference and histopathological findings of endometrial sampling Pearson Chi-square=79.22 and p<0.001(p=0.000). For Odds Ratio=40.89 (95.% CI:15.23-109.78), patients who had waist circumference/hip circumference ≥ 0.85 were 40.89 times more likely to have endometrial malignancy than patients who had waist circumference/hip circumference <0.85, (p<0.001). Upon analysing the contribution of central obesity determined by waist-to-hip ratio, it was found to have a more substantial impact (Wald = 37.76, p < 0.001) compared to BMI (Wald = 0.97, p= 0,32). Our study confirms that obesity is a risk factor for endometrial malignancy. Furthermore, fat distribution proves to be a more crucial and accurate indicator of endometrial cancer risk than overall obesity. The statistical significance of the waist circumference to hip circumference ratio exceeded that of BMI. Therefore, even if a patient has a normal BMI, but a waist-to-hip circumference ratio greater than 0,80, she should be considered at increased risk for endometrial malignancy and should be closely monitored in the future in order to detect any malignant changes.