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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    RELATIONSHIP BETWEEN THE MEATABOLIC SYNDROME AND THE INDIVIDUAL METABOLIC RISCK FACTORS AND SYMPTOMATIC AND ASYMPTOMATIC CAROTID ARTERY DISEASE: IS THE WHOLE LARGER THAN ITS PARTS
    (Macedonian Association of Anatomists and Morphologists, 2021)
    Deleva Stoshevska, Tatjana
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    Nikoloska, Sofija
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    Stoshevski, Bojan
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    Nikoloski, Marko
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    Metabolic syndrome (MetS) is a group of at least three of the following metabolic risk factors : central obesity, elevated glycaemia, high serum triglycerides, low serum high-density lipoprotein (HDL), and high blood pressure. Atherosclerosis is the most common cause of extracranial CAD. It may be asymptomatic and symptomatic with clinical presentation of cerebrovascular insult (CVI) and transient ischemic attack (TIA). Aim: to determine the relationship between MetS as a whole compared to individual metabolic risk factors and CAD. This analytical unicentric cross-sectional study included 160 subjects divided into two groups: 80 subjects with MetS according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria in the examined group (EG) and 80 subjects who have 1 or 2 individual metabolic risk factors and do not meet the diagnostic criteria for MetS in the control group (CG). CAD was diagnosed with the Esaote My Lab70 HVG device, with a linear probe (7.5 MHz), according to the Ultrasound consensus criteria for CAD of the Association of Radiologists (2002, San Francisco). CAD was significantly more frequently diagnosed in 77 (96.25%) EG subjects, compared to 34 (42.5%) CG subjects (p <0.0001). In EG symptomatic CAD had 52 subjects (67.5%) compared to only 2 (5.9%) subjects in CG. With asymptomatic CAD were 25 (32.47%) EG and 32 (94.12%) CG subjects, which was statistically confirmed as significant (p <0.0001). MetS is significantly associated with CAD, which is of cardinal importance for primary and secondary prevention of CVI and TIA.
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    ASSOCIATION OF THE NUMBER OF COMPONENTS OF THE MEATBOLIC SYNDROME AND CAROTID ARTERY DISEASE
    (Macedonian Association of Anatomists and Morphologists, 2021)
    Deleva Stoshevska, Tatjana
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    Nikoloska, Sofija
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    Nikoloski, Marko
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    Stoshevski, Bojan
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    Metabolic syndrome (MetS) is a group of at least three of the following metabolic disorders: central obesity, elevated glycaemia, high serum triglycerides, low serum high-density lipoprotein (HDL), and high blood pressure. Carotid artery disease (CAD) involves changes in the arterial wall that cause thickening of the intima-media (IMT), narrowing, or complete obstruction of the carotid artery lumen. Objective:To determine the impact of the number of MetS components on CAD. This analytical unicenteric cross-sectional study included 80 subjects with MetS according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. CAD was diagnosed with the Esaote My Lab70 HVG device, with a linear probe (7.5 MHz), according to the Ultrasound consensus criteria for CAD of the Association of Radiologists (2002, San Francisco). 34 subjects (42.5%) had 4 components of MetS, 24 subjects (30%) had 3 components, 22 subjects (27.5%) had 5 components. Gender and age have no statistically significant effect on the influence of metabolic risk factor as components of MetS (p = 0.38, p = 0.72, respectively). CAD was diagnosed in 77 subjects (96.25%), in 21 subject (87.5%) with 3 components of MetS and in all subjects with 4 and 5 components of MetS.This statistically confirmed that subjects with a smaller number of MetS components significantly have less CAD (p = 0.026). The increase in the number of components and the synergistic effect of individual MetS components is significantly associated with CAD.
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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.