Mariusz Dabrowski - Academia.edu (original) (raw)

Papers by Mariusz Dabrowski

Nutrients, Apr 17, 2018

The phase angle (PhA) seems to be a reliable screening tool for the identification of malnutritio... more The phase angle (PhA) seems to be a reliable screening tool for the identification of malnutrition risk in hospitalized children with inflammatory bowel disease (IBD). The aim of the present study was to assess the body composition and nutritional status of hospitalized children and adolescents with IBD by using bioelectrical impedance analysis (BIA) with phase angle (PhA) calculation, which has not been evaluated in hospitalized children with IBD yet. A total of 59 children and adolescents aged 4-18 years, with IBD: 34 ulcerative colitis (UC) and 25 Crohn's disease (CD) were included in the study. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. In both groups, BIA was performed and PhA was calculated. IBD patients had significantly lower PhA (UC: 5.34 ± 1.34 vs. 5.96 ± 0.76, p = 0.040; CD: 5.16 ± 1.18 vs. 5.90 ± 0.62, p = 0.009) compared to the control subjects. Significant changes in selected body composition parameters were observed particularly in CD, especially in fat free mass components. Lower phase angle score together with lower body composition parameters and selected nutrition indicators in children and adolescents with IBD demonstrate their worse nutritional and functional status compared to healthy subjects.

Oncotarget, May 9, 2017

Background: The aim of this multicenter, retrospective, case-control study was to identify differ... more Background: The aim of this multicenter, retrospective, case-control study was to identify differences in risk factors of malignancy between men and women with type 2 diabetes. Results: Among women the most prevalent malignancies were: breast and uterine cancers (35.6% and 14.4% respectively), while among men there were: colorectal and prostate cancers (24.5% and 13.3% respectively). In both gender metformin use was associated with lower cancer risk. Obesity and insulin treatment in dose-dependent and time-varying manner were associated with significantly increased risk of malignancy in females. In men, unexpectedly, cardiovascular disease was more prevalent in control group. Other variables did not show significant association with malignancy risk. Materials and Methods: 118 women and 98 men with type 2 diabetes mellitus who developed cancer after diagnosis of diabetes and the same number of strictly age matched controls with type 2 diabetes and without malignancy were included into the study. Diabetes duration, antidiabetic medications use, glycated hemoglobin level, body mass index, smoking habits, occupation, presence of comorbidities and aspirin use were included into analyses. Conclusions: Metformin demonstrated protective effect against cancer in both sexes. Obesity and insulin treatment seem to have greater impact on cancer risk among women.

Clinical Diabetology, 2014

Cukrzyca typu 2 jest chorobą postępującą, wymagającą stopniowej intensyfikacji leczenia w celu ut... more Cukrzyca typu 2 jest chorobą postępującą, wymagającą stopniowej intensyfikacji leczenia w celu utrzymania dobrej kontroli metabolicznej. W zaleceniach towarzystw naukowych końcowym etapem terapii jest intensywna insulinoterapia metodą wielokrotnych wstrzyknięć. W praktyce jednak często można się spotykać z sytuacją, gdy pomimo takiego leczenia nie osiąga się zadowalającej kontroli glikemii. Pojawia się pytanie, czy jedyną opcją terapeutyczną w tej sytuacji pozostaje systematyczne zwiększanie dawki insuliny? Nowe leki przeciwcukrzycowe dają możliwość szukania innych rozwiązań. Celem tej pracy jest przedstawienie przypadków klinicznych pacjentów, u których zamiast zwiększania dawki insuliny, do terapii dodano inhibitor dipeptydylopeptydazy-4 (DPP-4). Obserwacja trwająca ≥ 6 miesięcy potwierdziła skuteczność i bezpieczeństwo tej strategii. (Diabet. Klin. 2014; 3, 3: 125-130) Słowa kluczowe: cukrzyca typu 2, intensywna insulinoterapia, inhibitor DPP-4, wildagliptyna

Pediatric Rheumatology, Dec 1, 2018

Background: Juvenile idiopathic arthritis (JIA) is the most common chronic, systemic autoimmune c... more Background: Juvenile idiopathic arthritis (JIA) is the most common chronic, systemic autoimmune connective tissue disease diagnosed in children and adolescents. An important aspect of monitoring of children with JIA is a precise assessment of the nutritional status to identify children and adolescents at risk of malnutrition. The aim of the study was to assess the body composition and phase angle in children diagnosed with JIA in comparison to age and sex matched healthy children since there are scarce reports in paediatric patients. Methods: A total of 46 children and adolescents aged 4-18 years, with JIA were included in the cross-sectional study. Controls were selected from the group of healthy children and adolescents. Children with diagnosed JIA and healthy children were strictly matched for age and gender. In both groups BIA with phase angle calculation was performed. Results: Phase angle score was significantly lower in the study group compared to control group (5.45 ± 0.64 vs. 5.85 ± 0.80, p = 0.010). Also lower percentage of body cell mass (50.63 ± 3.46 vs. 52.70 ± 4.06, p = 0.010) and muscle mass (46.02 ± 6.32 vs. 49.53 ± 6.67, p = 0.005) were revealed. In the analysis of subtypes of JIA we found significant differences between children and adolescents with polyarthritis compared to control group, while no significant differences were found between patients with oligoarthritis and control group. Conclusions: The obtained results indicate a higher risk of malnutrition in children and adolescents with JIA compared to healthy peers, predominantly in patients with polyarthritis.

Scientific Reports, Aug 13, 2020

the prevalence of diabetes mellitus is increasing worldwide, including the nation of poland. the ... more the prevalence of diabetes mellitus is increasing worldwide, including the nation of poland. the aim of this prospective and observational study was to determine risk factors and the predictors of diabetes incidence in elderly women, and to calculate the diabetes incidence ratio in this population. Two-hundred women, aged 65-74, who were non-diabetic at baseline in 2012 were followed for 6.5 years. All women were checked for incident diabetes. In non-diabetic subjects, diagnostic procedures for diabetes were performed according to poland's Diabetes recommendations. Between April 2012 and September 2018, 25 women developed diabetes and the next 11 cases were diagnosed based on FPG or oral glucose tolerance test. Women with incident diabetes had significantly higher baseline FPG, triglycerides (TG), TG/HDL cholesterol ratio and visceral adiposity index (VAI) score, and lower abdominal aorta diameter (AAD), HDL cholesterol and eGFR. In the Cox proportional hazard regression analysis, only AAD < 18 mm and VAI score ≥ 3.8 were independently associated with diabetes risk, hazard ratio (HR) 2.47 (95% confidence interval 1.21-5.02), P = 0.013 and HR 2.83 (1.35-5.94), P = 0.006 respectively. In the backward stepwise regression analysis including all variables, diabetes incidence could be predicted from a linear combination of the independent variables: AAD < 18 mm (P = 0.002), VAI score ≥ 3.8 (P < 0.001) and FPG ≥ 5.6 mmol/L (P = 0.011). The calculated incidence of diabetes was 2769.2 new cases/100,000 persons per year. AAD below 18 mm seem to be a novel, independent marker of diabetes risk in elderly women, and AAD assessment during routine abdomen ultrasound may be helpful in identifying females at early elderliness with high risk of diabetes incidence. The rising tide of diabetes mellitus prevalence and incidence is being observed worldwide with 463 million people suffering from diabetes in the year 2019 1. The same trend has also been observed in Poland. In the year 2014, 2.34 million people (6.08% of the total population) were treated with antidiabetic medications 2. Type 2 diabetes is especially highly prevalent among people aged over 65 and roughly one third of all cases are diagnosed in this age range 1,3. In SouthEastern Poland, its prevalence in 2018 among people aged over 65 reached 26% of population in this age range (data on request from National Health Fund, unpublished). According to data published by the National Health Fund and Central Statistical Office, diabetes incidence in the Kuyavian-Pomeranian Voivodeship (central Poland) in women aged > 65 was 1860.7 new cases per 100,000 persons per year, consisting 45.6% of all new cases of diabetes in 2016 4. Established risk factors of diabetes incidence include: family history of diabetes, increased BMI, abdominal obesity, low physical activity, hypertension, impaired glucose metabolism in the past, high-risk race/ethnicity, elevated triglycerides (TG) and/or low HDL cholesterol level, and, among women, delivering children with birth weight over 4000 g, a history of gestational diabetes mellitus (GDM), and having polycystic ovary syndrome (PCOS) 1,5,6. In our study conducted in 2012 other factors significantly associated with diabetes prevalence were also found: anthropometric and metabolic indices, such as waist-to-hip ratio (WHR), weight-to-height ratio (WHtR), triglycerides to HDL cholesterol (TG/HDL) ratio and Visceral Adiposity Index (VAI), as well as impaired kidney function, and lower abdominal aorta diameter (AAD) (in newly diagnosed patients only) 7 .

Clinical Diabetology, Nov 17, 2017

Introduction. Prevalence of gestational diabetes mellitus (GDM) is continuously increasing worldw... more Introduction. Prevalence of gestational diabetes mellitus (GDM) is continuously increasing worldwide. Nutritional factors are considered to play important role in GDM development. The aim of this pilot study was to assess a relationship between frequency of consuming particular foods and GDM. Also pre-pregnancy BMI, weight gain during gestation, maternal age, pregnancy week at the time of delivery, newborn birthweight, family history of diabetes, educational status and place of residence were included into analysis. Material and methods. Study group consisted of 25 women who developed GDM, while control group consisted of 25 age-matched women with normal glucose tolerance (NGT) during gestation. All study participants completed the food frequency questionnaire with additional socio-demographic, anthropometric and pregnancy course data. Results. Women with GDM significantly more frequent consumed white bread, white rice, sausages/frankfurters and fast-foods, while they significantly less frequent consumed wholegrain bread, milk, sour dairy products, fruit and vegetables. They had also higher pre-pregnancy BMI, greater weight gain during pregnancy, and their newborns had higher birthweight. Conclusions. Results of our study indicate a crucial role of food choices during pregnancy in GDM development. It also indicate the need for professional dietary advice from the very beginning of gestation or even before conception, and during the entire pregnancy.

International Journal of Environmental Research and Public Health, Sep 19, 2019

Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mell... more Given the fact that physical exertion leads to blood glucose fluctuations, type one diabetes mellitus (T1D) may potentially constitute a barrier for obtaining a sufficient amount of exercise. The main purpose of the study was to compare the level of physical activity between children with T1D (n = 215) and healthy controls (n = 115) and to assess the physical activity of the study group in relation to the applied method of insulin therapy, i.e., the use of insulin pen vs. insulin pump. The level of physical activity was assessed with a hip-worn tri-axial accelerometer (ActiGraph GT3X+) used by the subjects for an uninterrupted period of seven days. Children with T1D had significantly lower median values of total time of moderate (213.3 vs. 272.1 min), vigorous (135.3 vs. 19.6 min) and moderate-to-vigorous (347.4 vs. 467.4 min) physical activity compared to healthy peers respectively, (p < 0.001) in all cases. In addition, the total median number of steps was significantly lower (53,631 vs. 67,542 steps), (p < 0.001). The method of insulin therapy was not associated with significant differences in physical activity level (p > 0.001). The level of physical activity in children and adolescents with T1D is lower than in their healthy peers and does not depend on the insulin therapy method.

Diabetologia Praktyczna, 2017

BMC Cancer, Oct 10, 2016

Background: The risk of several types of cancer is increased in type 2 diabetes mellitus. The ear... more Background: The risk of several types of cancer is increased in type 2 diabetes mellitus. The earliest possible diagnosis of cancerdifficult within regular outpatient diabetes care-is of utmost importance for patients' survival. The aim of this multicenter, retrospective (years 1998-2015), case-control study was to identify risk factors associated with malignancy in subjects with diabetes treated in a typical outpatient setting. Methods: In the databases of 3 diabetic and 1 primary care clinics 203 patients (115 women) with type 2 diabetes mellitus who developed malignancy while treated for diabetes were identified. The control group consisted of 203 strictly age-and gender matched subjects with type 2 diabetes without cancer. Factors associated with diabetes: disease duration, antidiabetic medications use and metabolic control of diabetes were analyzed. Also other variables: BMI (body mass index), smoking habits, place of residence and comorbidities were included into analysis. Results: The most prevalent malignancies in men and women together were breast cancer (20.7 %) and colorectal cancer (16.3 %). HbA 1c (hemoglobin A 1c) level ≥8.5 %, obesity and insulin treatment in dose-dependent and timevarying manner demonstrated significant association with increased risk of malignancy, while metformin use was associated with a lower risk of cancer. Diabetes duration, comorbidities, smoking habits, place of residence and aspirin use did not show significant association with risk of malignancy. Conclusions: In the outpatient setting the obese patients with poorly controlled insulin treated type 2 diabetes mellitus should be rigorously assessed towards malignancies, particularly breast cancer in women and colorectal cancer in men.

WSTĘP. Celem niniejszego badania obserwacyjnego byla ocena skuteczności i bezpieczenstwa wildagli... more WSTĘP. Celem niniejszego badania obserwacyjnego byla ocena skuteczności i bezpieczenstwa wildagliptyny u osob nieosiągających zadowalającej kontroli glikemii przy terapii dwoma doustnymi lekami przeciwcukrzycowymi i niewyrazających zgody na rozpoczecie insulinoterapii. MATERIAŁ I METODY. Obserwacją objeto 21 osob, w tym 6 kobiet, w wieku 46–90 lat (średnio 63,5 ± 10,4 roku), chorujących na cukrzyce typu 2 od roku do 22 lat (średnio 10,6 ± 5,6 roku), stosujących wildagliptyne przez okres 4–22,5 miesiecy (średnio 12,5 ± 6,0 miesiecy). Ocenie poddano wplyw leczenia wildagliptyną na kontrole metaboliczną cukrzycy, mase ciala, wartośc ciśnienia tetniczego i czestośc hipoglikemii. WYNIKI. Po dodaniu wildagliptyny do terapii dwoma innymi doustnymi lekami przeciwcukrzycowymi hemoglobina glikowana (HbA 1c ) obnizyla sie znamiennie o 0,7% z wyjściowej wartości 8,19 ± 0,77% do 7,49 ± 0,96% (p = 0,002). Poprawa kontroli glikemii utrzymywala sie przez caly czas trwania obserwacji. W trakcie lecz...

Clinical Diabetology, 2012

U chorych na cukrzyce typu 2 wystepuje podwyzszone ryzyko raka trzustki w porownaniu z pozostalą ... more U chorych na cukrzyce typu 2 wystepuje podwyzszone ryzyko raka trzustki w porownaniu z pozostalą populacją. W ostatnim czasie pojawily sie tez podejrzenia podwyzszonego ryzyka zapalenia i raka trzustki u pacjentow leczonych lekami osi inkretynowej. Wczesne stadia choroby zwykle przebiegają bezobjawowo, stąd 80–85% przypadkow raka trzustki jest rozpoznawanych w zaawansowanym stadium. Bezobjawowa zoltaczka, bole w gornej cześci brzucha i bole plecow, zespol zlego wchlaniania, wyniszczenie, depresja i zakrzepica zylna są najczestszymi klinicznymi objawami tej choroby.W niniejszej pracy zaprezentowano opis przypadku 68-letniego mezczyzny z niewielką nadwagą i dlugoletnim wywiadem w kierunku cukrzycy typu 2. Pacjent byl leczony pochodnymi sulfonylomocznika, metforminą i inhibitorem dipeptydylopetydazy IV (DPP-IV). Kontrola metaboliczna cukrzycy utrzymywala sie w rekomendowanym zakresie (HbA1c ≤ 7,0%). W czasie jednej z kolejnych, planowych wizyt odnotowano istotny, 5-kilogramowy spadek m...

Clinical Diabetology, 2010

Związek miedzy cukrzycą a chorobami nowotworowymi stal sie w ostatnich latach przedmiotem szczego... more Związek miedzy cukrzycą a chorobami nowotworowymi stal sie w ostatnich latach przedmiotem szczegolnego zainteresowania. W odniesieniu do wynikow prac opublikowanych w ostatnich kilku latach cukrzyce mozna traktowac jako czynnik ryzyka pewnych typow nowotworow. W pierwszej cześci niniejszej pracy przedstawiono dane ukazujące podwyzszone ryzyko zapadalności i umieralności z powodu nowotworow w populacji chorych na cukrzyce. W kolejnej cześci przedyskutowano mechanizmy patogenetyczne lączące cukrzyce, otylośc, insulinoopornośc, hiperinsulinemie, zapalenie i hiperglikemie z ryzykiem nowotworow. W trzeciej cześci zaprezentowano wplyw lekow przeciwcukrzycowych na ryzyko chorob nowotworowych. W podsumowaniu przedstawiono praktyczne implikacje dla codziennej praktyki klinicznej, a takze ukazano kierunki dalszych badan. (Diabet. Prakt. 2010; 11, 2: 54-63)

Clinical Diabetology, 2020

Background. The cost of diabetes care increases worldwide and is highest in the United States (US... more Background. The cost of diabetes care increases worldwide and is highest in the United States (US), while the quality of care remains unsatisfactory. The aim of this study was to compare the quality and cost of type 2 diabetes mellitus (DM) care between Waukesha, Wisconsin, US and Rzeszow, Poland. Methods. DM quality data for the Polish cohort were abstracted from the charts of 79 DM patients in Rzeszow, Podkarpacie from 1 January 2013 to 31 December 2014. Cost data were attained from the Polish National Health Fund. Seventy-nine DM patients, matched for age, body mass index, and sex, from Waukesha, Wisconsin were chosen as comparators. DM quality data was obtained from the medical record and cost data from health system decision support staff. Results. Average HbA1c (%, mean ± SD) in the Polish and US cohorts were 7.4 ± 1.4 and 8.0 ± 2.1, respectively (P = 0.03). Mean systolic/diastolic blood pressure (mm Hg) in the two cohorts was 150 ± 17/81 ± 12 and 132 ± 17/74 ± 11 (P < 0.00...

Cardiology Journal, 2021

Several mechanisms have been suggested to explain positive cardiovascular effects observed in stu... more Several mechanisms have been suggested to explain positive cardiovascular effects observed in studies with sodium-glucose co-transporter 2 (SGLT2) inhibitors. The reduction in glucose reabsorption in proximal tubuli induced by SGLT2 inhibitors increases urinary glucose and sodium excretion resulting in increased osmotic diuresis and consequently in decreased plasma volume, followed by reduced preload. In addition, the hemodynamic effects of SGLT2 inhibition were observed in both hyper and euglycemic patients. Due to the complex and multidirectional effects induced by SGLT2 inhibitors, this originally antidiabetic group of drugs has been successfully used to treat patients with heart failure as well as for subjects with chronic kidney disease. Moreover, their therapeutic potential seems to be even broader than the indications studied to date.

Nutrients, 2021

A gluten-free diet provides relief from symptoms for patients with celiac disease, although there... more A gluten-free diet provides relief from symptoms for patients with celiac disease, although there is still a risk of nutritional deficiencies. These patients can potentially consume an excessive amount of fat and insufficient amounts of fiber, iron, vitamin D, and calcium. This study aimed to assess the knowledge of medical students and healthcare professionals in Poland regarding nutritional deficiencies and the prevention of such deficiencies in patients with celiac disease who are on a gluten-free diet. Of the 430 survey participants, 46% did not realize the risk of nutritional deficiencies in patients with celiac disease. The knowledge of the participants was lowest regarding the risk of being overweight or obese. Among the healthcare professionals, an acceptable level of correct answers was provided by only 37% of individuals and was highest for the dietitians’ group. Our results demonstrate the need to improve the education of healthcare professionals concerning nutrition in p...

International Journal of Environmental Research and Public Health, 2020

Strong preferences for sweet and fat tastes (characters) are associated with the consumption of f... more Strong preferences for sweet and fat tastes (characters) are associated with the consumption of foods high in calories. The taste preferences, especially the sweet and fat tastes (characters), might be one of the factors predisposing children to become overweight and/or develop obesity. The aim of the study is to assess taste preferences in children and their mothers in association with their weight status. In the study, 150 children aged 8–15 were included; among them, 75 had overweight and/or obesity, and 150 mothers of whom 69 were overweight and/or obese. Body composition estimates were obtained using a bioelectrical impedance analysis-body height was measured using a stadiometerSeca 213. Sensory tests were carried out using apple juice of various sugar content and crackers of various fat content. Results show that children prefer a sweet taste more often than their mothers (50.0% vs. 35.3%, p = 0.009). In the group of children who preferred the high-sweet taste, there were twic...

Journal of Clinical Medicine, 2018

The aim of this study was to assess the body composition and nutritional status of hospitalized p... more The aim of this study was to assess the body composition and nutritional status of hospitalized pediatric patients with newly diagnosed type 1 diabetes by using bioelectrical impedance analysis (BIA) with phase angle (PA) calculation. PA is considered to be a useful and very sensitive indicator of the nutritional and functional status, and it has not yet been evaluated in such a population. Sixty-three pediatric patients aged 4 to 18 years, with newly diagnosed type 1 diabetes, were included in the study. The control group consisted of 63 healthy children and adolescents strictly matched by gender and age in a 1:1 case: control manner. In both groups, BIA with PA calculation was performed. Diabetic patients, in comparison to control subjects, had a highly significantly lower PA of 4.85 ± 0.86 vs. 5.62 ± 0.81, p < 0.001. They also demonstrated a lower percentage of body cell mass (BCM%), 46.89 ± 5.67% vs. 51.40 ± 4.19%, p < 0.001; a lower body cell mass index (BCMI), 6.57 ± 1.8...

Diabetes/Metabolism Research and Reviews, 2018

BackgroundThe visceral adiposity index (VAI) is considered to be a reliable indicator of adipose ... more BackgroundThe visceral adiposity index (VAI) is considered to be a reliable indicator of adipose tissue dysfunction and cardiometabolic disease risk. The aim of this study was to evaluate its usefulness in assessing cardiometabolic risk in a sample of elderly women living in a rural‐urban community in central Poland.MethodsA total of 365 women aged 65 to 74 years were included in this cross‐sectional study. All patients were interviewed to obtain their history of diabetes mellitus, myocardial infarction, stroke, and revascularization. For all participants, anthropometric measurements were performed, then body mass index (BMI) and waist/hip ratio were calculated. Blood pressure was measured on the arm and on both ankles, and the ankle/brachial index was calculated. Blood samples were collected for the assessment of glycemia, lipid profile, and creatinine level. In patients with elevated fasting glucose, the test was repeated, or an oral glucose tolerance test was performed where appr...

The primary and proven therapy, in cases of celiac disease (CD), is a rigorous gluten-free diet. ... more The primary and proven therapy, in cases of celiac disease (CD), is a rigorous gluten-free diet. However, there are reports of its negative effects in the form of nutritional deficiencies, obesity and adverse changes in body composition. The aim of the study was to assess the impact of a gluten free diet (GFD) on the body composition of children with CD. In a case-controlled study (n = 41; mean age 10.81 y; SD = 3.96) children with CD, in various stages of treatment, underwent medical assessment. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. More than half of the examined children (n = 26) followed a GFD. CD children had significantly higher mean values of the fat free mass (FFM% = 80.68 vs. 76.66, p = 0.015), and total body water (TBW% = 65.22 vs. 60.47, p = 0.012), and lower mean values of the fat mass (FM% = 19.32 vs. 23.34, p = 0.015). Children who were on a GFD presented slightly higher, but no...

Journal of Pre-Clinical and Clinical Research, 2017

Introduction. Diabetes is associated with a lower quality of life (QoL). Insulin therapy is perce... more Introduction. Diabetes is associated with a lower quality of life (QoL). Insulin therapy is perceived as an additional factor affecting QoL. The objective of this study, using standardized tools, was to evaluate to what extent insulin treatment has an effect on QoL in diabetes. Materials and method. 60 diabetic patients treated with insulin and 90 with oral drugs, all aged over 30, were included into the study. To assess the QoL of patients, SF-36 v.2 and WHOQOL-BREF questionnaires were used. In addition, demographic data were collected. Results. Insulin treated patients had a significantly lower Mental Component Score in SF-36 v.2 questionnaire. No significant differences between the two groups were found in the components of physical domain of SF-36 v.2 and in four domains of WHOQOL-BREF questionnaires. Insulin therapy was significantly associated with lower educational level. The strongest association with QoL in both questionnaires was found for professional activity and age. Conclusions. The results of this study indicate the need for psychological support for patients with diabetes treated with insulin to improve their mental coping. Diabetic patients should also be advised to continue their professional activity for as long as possible due to its important role in maintaining QoL.