Faculty of Medicine

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    ASSOCIATED RISK FACTORS AND PREVALENCE OF METABOLIC SYNDROME IN PEOPLE WHO ARE LIVING WITH HIV AND ARE ON ANTIRETYROVIRAL TREATMENT
    (Macedonian Association of Anatomists, 2025-05-02)
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    Saveski, Velimir
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    The extended life expectancy of people living with HIV infection increases the risk of metabolic syndrome (MS). To assess the prevalence of MS, the association of triple regimen antiretroviral therapy (ART) and the role of the chronic inflammatory process caused by the HIV virus with the onset of MS. A prospective cross-sectional study was conducted on 141 HIV infected adult patients with confirmed HIV infection who regularly receive ART at the University Clinic for infectious diseases and febrile conditions in Skopje. In all patients, the presence of MS was determined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel ATP III (NCEP ATPIII) 2005. The statistical software SPSS (ver. 23.0; IBM, SPSS, USA) was used for statistical analysis. The prevalence of MS in persons with HIV infection in RNM was 17.96%. The group of patients with MS were significantly older and had significantly higher Body Mass Index and greater waist circumference (28.82 ± 4.6 kg/m2 vs 23.91 ± 3.6 kg/m2 p<0.0001) and (101.04 ± 12.4 vs 87.19 ± 9.8cm,p<0.0001), respectively. Treatment of patients with ART did not show a significant difference in the group with and without MS. There is a significant difference regarding the frequency of IL 6 (p=0.012). Aging and increasing Body Mass Index are significant risk factors in the developing of MS in persons with HIV infection who are on ART treatment.
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    Metabolic Syndrome (MetS) as a comorbidity of Chronic Obstructive Pulmonary Disease (COPD)
    (European Respiratory Society, 2021-09-05)
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    Mickovski, Ivana
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    Kamchevska, Nade Kochovska
    We aimed to investigate the association between COPD and MetS, the relation to the severity of airflow limitation and the level of serum C-reactive protein (CRP). Cross-sectional study including 120 patients with initially diagnosed COPD, aged 40-75 years and 60 non-COPD controls, matched by age, smoking status, body mass index. All study participants underwent anthropometric measurements, fasting blood sugar (FBS), lipid profile, CRP, pulmonary evaluation (dyspnea severity assessment, baseline and post-bronchodilator spirometry, gas analyses, chest X-ray). Results presented statistically significant difference in presence of MetS in COPD patients compared to controls (47.5% vs 20.0%, p=0.0004). According to the GOLD classification, the frequencies of MetS in COPD patients were categorized in stages I, II, III, IV (40.0%, 45.8%, 46.7%, 43.0% respectively), and according to combined assessment test in A, B, C, D (29.2%, 37.5%, 35.0%, 41.7% respectively). COPD patients with MetS presented significant association with CRP (p=0.001) and no association with pulmonary function. FBS was higher in COPD compared to controls (8.4±1.1mmol/L vs. 4.9±2.1mmol/L, p<0.0001), but HDL was lower in COPD than non-COPD (39.1±6.4mg/dl vs 49.6±3.9mg/dl, p<0.0001). Waist circumference and blood pressure (BP) were higher in COPD 95.8±3.4cm vs. control group 91.8±2.9cm, p<0.0001. Mean systolic BP was 138.3±12.2mmHg vs. 125.5±6.1mmHg, p<0.0001 in non-COPD. We found higher prevalence of MetS in patients with COPD even in early COPD stages compared to non-COPD group. Our findings suggest an urgent need to develop comprehensive strategies for prevention, screening and start of treatment in the early stage of the disease.
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    Metabolic Syndrome and Myocardial Infarction in Women
    (Bentham Science Publishers, 2021-04-29)
    Djuro Macut
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    Sanja Ognjanovic
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    Milka Ašanin
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    Gordana Krljanac
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    Abstract: Metabolic syndrome (MetS) represents a cluster of metabolic disorders that arise from insulin resis-tance (IR) and adipose tissue dysfunction. As a consequence, there is an increased risk for type 2 diabetes melli-tus and atherosclerotic cardiovascular disease (CVD). MetS is associated with a 2-fold increase in cardiovascu-lar outcomes. Earlier population analyses showed a lower prevalence of MetS in women (23.9%) in comparisonto men (27.8%), while later analyses suggest significantly reduced difference due to an increase in the preva-lence in women aged between 20 and 39. However, the prevalence of MetS in specific populations of women,such as in women with polycystic ovary syndrome, ranges from 16% to almost 50% in some geographical re-gions. Abdominal fat accumulation and IR syndrome are recognized as the most important factors in the patho-genesis of MetS. After menopause, a decline in insulin sensitivity corresponds to an increase in fat mass, circu-lating fatty acids, low-density lipoproteins, and triglycerides. Prevalence of MetS in acute coronary syndrome(ACS) is significantly more present in women (55.9%-66.3%) than in men (40.2%-47.3%) in different cohorts.Younger women with ACS had a higher mortality rate than younger men. Acute myocardial infarction (AMI)remains a leading cause of death in aging women. Women with AMI had significantly higher rates of prior con-gestive heart failure, hypertension history, and diabetes. The role of androgens in CVD pathogenesis in womenhas not yet been clarified. The current review aims to provide an insight into the role of MetS components andinflammation for the development of atherosclerosis, CVD, and AMI in women.