Otilia Nita - Academia.edu (original) (raw)
Papers by Otilia Nita
PubMed, Oct 20, 2012
Aim: Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modificat... more Aim: Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modifications is the loss of normal sudomotor function, a sign of autonomic neuropathy. The aim of this study is to evaluate sudomotor dysfunction using a new tool (Neuropad) in diabetic patients with foot ulceration. Material and methods: We included 58 diabetic patients with foot ulceration admitted in 2010 in the Clinical Center for Diabetes, Nutrition and Metabolic Diseases. We collected data regarding age, gender, type and duration of diabetes, glycated hemoglobin (HbAlc), history of amputations and duration of hospital admission. Peripheral neuropathy was evaluated through the Neuropathy Disability Score (NDS) and autonomic neuropathy was tested through Neuropad. Results: 95% of patients had NDS > or = 6, among which 76% had also positive Neuropad test. Patients with both peripheral and autonomic neuropathy had longer duration of diabetes (p = 0.027) but similar HbA1c as patients with only peripheral neuropathy (p = 0.09). The former also had longer duration of current admission (p = 0.022) and a higher percentage of these patients had history of amputations (p = 0.041). Conclusions: Neuropad is a reliable, easy to use test for the diagnosis of autonomic neuropathy, which puts patients at greater risk for foot ulceration and amputation.
The Medical-Surgical Journal, 2012
Aim: Obstructive Sleep Apnea Syndrome (OSAS) is an under diagnosed condition with significant con... more Aim: Obstructive Sleep Apnea Syndrome (OSAS) is an under diagnosed condition with significant consequences on health. The aim of this study is to estimate the prevalence of symptoms and key features of OSAS in a rural population. Material and methods: 254 subjects were enrolled. We measured height (H) and weight (W), calculated body mass index (BMI) and determined glycated hemoglobin (HbA1c). Information about age, gender, medical history (diabetes, hypertension) was collected. All the participants filled in the Berlin questionnaire, which has separate questions regarding the symptoms of OSAS. Results: Snoring was reported by 44.1% of the subjects, observed apneas by 6.7% and excessive daytime sleepiness by 36.6%. All symptoms were more frequently reported by women. A higher percentage of obese, hypertensive and diabetics reported snoring (p<0.001). When analyzing gender differences, the significance was maintained, except for diabetic men. Witnessed apneas were more prevalent in hypertensive subjects (p=0.034), but were significantly associated with hypertension only in (p=0.003). No correlation was found regarding excessive daytime sleepiness and the risk factors studied. Conclusions: Prevalence of OSAS symptoms and risk factors in this rural population was noticeable and efforts for early diagnosis and treatment are recommended.
PubMed, Jul 1, 2016
Aim: To estimate specific nutrient intake in patients with type 2 diabetes. Materials and methods... more Aim: To estimate specific nutrient intake in patients with type 2 diabetes. Materials and methods: The study was conducted on a group of subjects with type 2 diabetes. The collected data included: anthropometry, lifestyle, blood measurements, and the mean daily nutrient intake assessed by the EPIC food frequency questionnaire. Results: The study group included 101 subjects with type 2 diabetes mellitus (DM) with a mean age of 60.6±10 years, of which 45 men (59±10.6 years) and 56 women (62±9.6 years). The average energy intake was 1714.4±713.9 Kcal/day, with a statistically significant gender difference (1877.7±850.9 kcal/day for men, 1583.1±554.9 kcal/day for women, p = 0.039, and the average daily micronutrient intake was 2.44±1.44 μg/day for vitamin D, 724.5μ263.2 mg/day for Calcium (Ca), 266.7±98 mg/day for magnesium (Mg), which was low compared to dietary recommendations. Calcium intake was correlated with intake of carbohydrates, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), fiber and energy. Vitamin D intake was correlated only with protein intake (R=0.695), while magnesium intake correlated with intake of fibers, energy, carbohydrates and SFA. Conclusions: Our study in patients with type 2 diabetes showed a reduced average intake of calcium, magnesium and vitamin D compared to standard recommendations, requiring an individualized approach.
PubMed, Aug 1, 2014
Aim: The aim of the study was to explore the anthropometric maternal characteristics and prenatal... more Aim: The aim of the study was to explore the anthropometric maternal characteristics and prenatal care as determinants of pregnancy weight gain. Material and methods: We conducted a cross-sectional study on a total of 400 pregnant women admitted to Cuza-Vodă Obstetrics and Gynecology Clinical Hospital, Iaşi. Information on demographic characteristics, number of prenatal visits, and education on nutrition and food changes occurring during pregnancy were recorded in a structured questionnaire. Anthropometric parameters analyzed were pregestational BMI (body mass index) and weight gain during pregnancy. Results: Weight gain was associated with pregestational BMI category. An increase in weight more than recommended occured more frequently in overweight (53.1%) and obese women (66.7%) (p < 0.001). Weight gain during pregnancy was related to area of residence, age, APCU (adequate prenatal care utilization) index. The multivariate analysis identified the following variables as significant determinants of pregnancy weight gain: inadequate prenatal care, BMI and changes in diet. Conclusions: Pregestational BMI and changes in diet during pregnancy identified as determinants of weight gain suggests that overweight and underweight women must carefully be counseled regarding recommendations for weight gain in pregnancy. Tracking diet changes is important to ensure that a weight gain lies within the guidelines recommendations.
PubMed, Oct 20, 2012
Aim: Obstructive Sleep Apnea Syndrome (OSAS) is an under diagnosed condition with significant con... more Aim: Obstructive Sleep Apnea Syndrome (OSAS) is an under diagnosed condition with significant consequences on health. The aim of this study is to estimate the prevalence of symptoms and key features of OSAS in a rural population. Material and methods: 254 subjects were enrolled. We measured height (H) and weight (W), calculated body mass index (BMI) and determined glycated hemoglobin (HbA1c). Information about age, gender, medical history (diabetes, hypertension) was collected. All the participants filled in the Berlin questionnaire, which has separate questions regarding the symptoms of OSAS. Results: Snoring was reported by 44.1% of the subjects, observed apneas by 6.7% and excessive daytime sleepiness by 36.6%. All symptoms were more frequently reported by women. A higher percentage of obese, hypertensive and diabetics reported snoring (p < 0.001). When analyzing gender differences, the significance was maintained, except for diabetic men. Witnessed apneas were more prevalent in hypertensive subjects (p = 0.034), but were significantly associated with hypertension only in (p = 0.003). No correlation was found regarding excessive daytime sleepiness and the risk factors studied. Conclusions: Prevalence of OSAS symptoms and risk factors in this rural population was noticeable and efforts for early diagnosis and treatment are recommended.
PubMed, Nov 4, 2011
Background and aims: Prevention and reduction of cardio-vascular mortality are in relationship wi... more Background and aims: Prevention and reduction of cardio-vascular mortality are in relationship with understanding and being able to modify risk factors, among which overweight and obesity become the most significant. The aim of this paper is to define cardio-metabolic risk factors which are specific to the studied population, and also to find elements of lifestyle that lead to overweight. We targeted smoking, alcohol consumption, stress, physical exercise, income and educational level. Material and methods: We studied a sample of 172 subjects, representative for the population of Deleni, a rural community in Iaşi County; among these subjects, 67 were men, 105 were women, with an average age of 54. For each a chart was filled, containing demographic data, socio-economic status, personal and family medical history. We measured anthropometric parameters: weight (W), height (H), waist circumference (WC) and we calculated body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). We performed interviews to fill in a food frequency questionnaire, the Perceived Stress Scale and the International Physical Activity Questionnaire. Results: In the lot studied, 44.2% are overweight and 18.6% are obese, the majority of these being women. Regarding WC, among normal weight, 52.4% have large WC (> or = 94cm for men and > or = 80cm for women). Obesity markers positively correlate with increase in age and decrease in income (p=0.024), with low educational level, regular consumption of coffee (p=0.093), and negatively correlate with excessive alcohol consumption (p=0.049) and smoking (p=0.003). As expected, there is an inverse relationship between increased physical exercise and BMI (p=0.015) and a direct relationship between increased stress level and WC. Conclusions: Anthropometric parameters are sensible markers in evaluating the influence of lifestyle on cardio-metabolic risk.
PubMed, 2013
The aim of this study was to evaluate comparatively the predictive power of body mass index (BMI)... more The aim of this study was to evaluate comparatively the predictive power of body mass index (BMI) and waist circumference (WC), two anthropometric parameters used in daily practice, for detecting cardio-metabolic diseases, in a rural community in north-east Romania. Material and methods: We evaluated 3248 persons, aged 19 or over, for whom we collected the following data: medical history, anthropometric parameters, blood pressure value and biochemical parameters. Results and conclusions: Both WC and BMI help correctly determine the presence of arterial hypertension, diabetes and dislipidemia. However, the cut-off value of each of these parameters differs for each pathology. The predictive value of WC for different cardio-metabolic diseases is maintained even at normal or borderline overweight values of BMI.
PubMed, Aug 1, 2014
Aim: The aim of this study was to assess the preoperative nutritional status of patients undergoi... more Aim: The aim of this study was to assess the preoperative nutritional status of patients undergoing thoracic surgery using different nutritional tools. Material and method: . We conducted a prospective study on a sample of 43 thoracic patients, including 23 with neoplasms and 20 with non-neoplastic pathology who underwent thoracic surgery procedures between July-September 2011, in the Thoracic Surgery Clinic in Iaşi. Weight and height were measured and body mass index (BMI) was calculated. WHO classification for BMI categories was used. Preoperative serum level of transthyretin (TTR) and demographic data (gender, age) were also assessed. All patients were examined by the Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002). Results: After performing SGA, 67.9% of the patients were well-nourished, 21.4% were moderately or suspected of being malnourished and 10.7% were severely malnourished. The level of TTR was significantly lower in the moderately or severely malnourished group, compared to those considered well-nourished. According to NRS-2002, 42.9% of the patients were considered at nutritional risk. The level of TTR of these patients was lower than the level of TTR of the patients without nutritional risk, but without statistical significance. Conclusions: Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002) are useful in identifying patients with nutritional risk, so that appropriate nutritional management could be initialised even before surgery.
PubMed, 2013
Aim: To evaluate the prevalence of steatosis and to assess its correlations with the classical ca... more Aim: To evaluate the prevalence of steatosis and to assess its correlations with the classical cardiovascular (CV) risk factors, components of metabolic syndrome (MS) in a rural population. Material and methods: A sample of 254 subjects was enrolled in the study. Collected data included: age, gender, complete medical history, anthropometric and blood pressure (BP) measurements. The biological evaluation included metabolic and hepatic parameters. Ultrasound evaluation of steatosis relied on the criteria of the National Health and Nutrition Examination Survey (NHANES) III. Results: Two thirds of the study population were obese or overweight (64.96%); 32.66% had systolic BP and 27.16% diastolic BP levels higher than normal. 38% of the subjects had abnormal fasting blood glucose levels, 14.56% having glycated hemoglobin (HbA1c) values corresponding to pre-diabetes, and 9.84% to overt diabetes; 8% had low HDL-cholesterol and 14.96% high triglycerides (Tg) levels. MS was present in 50.8% of individuals. Only 10.8% of all subjects did not have an ultrasound appearance of steatosis; 28.8% had moderate and 32% severe steatosis. There were statistically significant differences in subjects with steatosis vs. subjects without steatosis with regard to body mass index (BMI), WC, presence of MS, and BP and Tg levels, but not to ALAT, ASAT and GGT values. Conclusions: The important prevalence of obesity, fasting hyperglycamia, steatosis and MS shows a particularly metabolic fragile population; early diagnosis and interventional strategies are mandatory.
PubMed, Oct 20, 2012
Non-alcoholic fatty liver disease (NAFLD) covers a spectrum of liver disease from steatosis to no... more Non-alcoholic fatty liver disease (NAFLD) covers a spectrum of liver disease from steatosis to non-alcoholic steatohepatitis (NASH) and cirrhosis. Most NAFLD patients are hyperinsulinaemic and more insulin resistant compared with nonsteatotic healthy subjects, and there is a near universal association between NAFLD and insulinresistance (IR) irrespective of obesity. The metabolic syndrome (MS) is highly prevalent in the general adult population (approximatively 22%) and it carries an increased cardiovascular morbidity and mortality. Pathophysiologic considerations, clinical associations, and laboratory investigations support that IR and hyperinsulinaemia have a central role in pathogenesis of both MS and NAFLD. The fatty liver is resistant to the action of insulin to suppress hepatic glucose production, which results in hyperglycaemia and, further, in hyperinsulinemia. The MS is associated with maldistribution of body fat, increased free fatty acids (FFAs) and IR, leading to type 2 diabetes, hypertension, dyslipidemia. Visceral fat is an important clinical marker of metabolic cardiovascular risk and a marker of IR in multiple tissues, independent of body mass index (BMI). NAFLD and atherosclerosis share common molecular mediators and NAFLD itself might play an early role in the development and progression of atherosclerosis. These data suggest that NAFLD should be considered part of a multi-organ system derangement in insulin sensitivity, and help explain why NAFLD is so closely linked with diabetes, MS and is an important risk factor for coronary heart disease. NAFLD may be the hepatic manifestation of the MS and raises the possibility that it may play an early role in the etiology of MS.
Romanian Journal of Diabetes Nutrition and Metabolic Diseases, Aug 15, 2011
Objective. To investigate which anthropometric parameter best correlates with modifications in bl... more Objective. To investigate which anthropometric parameter best correlates with modifications in blood glucose and blood pressure (BP). Material and method. 135 subjects were included in the study. We measured weight, height, waist circumference (WC), BP and calculated body mass index (BMI) and waist-to-height ratio (WHtR). We determined glycated hemoglobin A1c (HbA1c) and performed an oral glucose tolerance test (OGTT) under standard conditions. Results. HbA1c increased with BMI, WC and WHtR. We found statistically higher values of fasting blood glucose (FBG) in obese (P=0.001), in those with large WC (P=0.
Proceedings of the Nutrition Society, Apr 1, 2020
We conducted a narrative review on the interaction between dietary patterns with demographic and ... more We conducted a narrative review on the interaction between dietary patterns with demographic and lifestyle variables in relation to health status assessment. The food pattern has the advantage of taking into account the correlations that may exist between foods or groups of foods, but also between nutrients. It is an alternative and complementary approach in analysing the relationship between nutrition and the risk of chronic diseases. For the determination of dietary patterns one can use indices/scores that evaluate the conformity of the diet with the nutrition guidelines or the established patterns (a priori approach). The methods more commonly used are based on exploratory data (a posteriori): cluster analysis and factor analysis. Dietary patterns may vary according to sex, socioeconomic status, ethnicity, culture and other factors, but more, they may vary depending on different associations between these factors. The dietary pattern exerts its effects on health in a synergistic way or even in conjunction with other lifestyle factors, and we can therefore refer to a 'pattern of lifestyle'.
Revista De Chimie, Jan 15, 2019
Recent studies have shown that as the average life expectancy increases, more people will suffer ... more Recent studies have shown that as the average life expectancy increases, more people will suffer a stroke in their lives, diminishing their quality of life. Secondary stroke prevention involves reducing the cardiovascular risk factors and administering medication for preventive purposes, where statins play an important role. The purpose of this study is to highlight the correlations of statins dosage with cardiovascular risk factors (atheromatosis, uric acid value, obesity, etc), in stroke patients receiving hypolipidemic treatment with statins.
Healthcare, Jul 20, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Nutrients, Apr 26, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
European Respiratory Journal, Sep 1, 2012
Body: Introduction. The prevalence of obstructive sleep apnea syndrome (OSAS) is known to be high... more Body: Introduction. The prevalence of obstructive sleep apnea syndrome (OSAS) is known to be higher in individuals with prediabetes and diabetes mellitus. Aims and objectives. This study aims to evaluate the risk of OSAS in individuals with dysglycaemia, comparative with those with normal glucose tolerance, in a rural population, and to find out whether those with prediabetes or diabetes have a higher risk of OSAS. Methods. We conducted a cross-sectional study in a sample of 254 men and women, aged >18 years, from a rural population. Dysglycaemia was evaluated by fasting plasma glucose-FPG and performing an oral glucose tolerance test-OGTT in all individuals without diabetes and by determining glycated haemoglobin-HbA1c. WHO (1999) criteria for diagnosing diabetes and prediabetes and American Diabetes Association recommendations for HbA1c diagnostic values were used. The risk of OSAS was assessed using Berlin Questionnaire. Results. We found that a statistically higher percentage of those with diabetes and prediabetes, diagnosed by HbA1c (66,7% and 32,8% respectively) and by OGTT (57,1% and 30,3% respectively) had a high risk of OSAS (p=0,001 and p=0,022, respectively) as compared to those with normal glucose tolerance (27,5% and 31,3% respectively). When assessing dysglycaemia by FPG, our results showed no statistically significant differences in what concerns the risk of OSAS between the two categories, normoglycaemia and dysglycaemia (p=0,051). Conclusions. The evaluation of risk of OSAS should be performed in individuals with prediabetes and diabetes, thus allowing the identification of individuals who should be referred to a sleep center.
The Medical-Surgical Journal, 2012
Aim. Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modificat... more Aim. Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modifications is the loss of normal sudomotor function, a sign of autonomic neuropathy. The aim of this study is to evaluate sudomotor dysfunction using a new tool (Neuropad®) in diabetic patients with foot ulceration. Material and methods. We included 58 diabetic patients with foot ulceration admitted in 2010 in the Clinical Center for Diabetes, Nutrition and Metabolic Diseases. We collected data regarding age, gender, type and duration of diabetes, glycated hemoglobin (HbA1c), history of amputations and duration of hospital admission. Peripheral neuropathy was evaluated through the Neuropathy Disability Score (NDS) and autonomic neuropathy was tested through Neuropad®. Results. 95% of patients had NDS ≥ 6, among which 76% had also positive Neuropad® test. Patients with both peripheral and autonomic neuropathy had longer duration of diabetes (p=0.027) but similar HbA1c as patients with only peripheral neuropathy (p=0.09). The former also had longer duration of current admission (p=0.022) and a higher percentage of these patients had history of amputations (p=0.041). Conclusions. Neuropad® is a reliable, easy to use test for the diagnosis of autonomic neuropathy, which puts patients at greater risk for foot ulceration and amputation.
Practica medicală, Jun 30, 2021
Diabetic foot represents the consequence of changes caused by diabetes in the foot, meaning an as... more Diabetic foot represents the consequence of changes caused by diabetes in the foot, meaning an association of infection, ulceration and / or destruction of deep tissues with neuropathy and peripheral vascular disease in the foot, below the ankle. The aim of the study was to evaluate the factors that may influence the length of hospital stay in patients with diabetic foot ulcers. Material and methods. An observational study was performed on a sample of patients hospitalized in the Diabetes, Nutrition and Metabolic Diseases Clinic within "St. Spiridon" County Emergency Clinical Hospital, Iași, between 01.01.2007 and 31.12.2017. Sociodemographic characteristics of the patients, history of the disease, biological parameters, duration of hospitalization were registered in a database. Severity of foot ulcerations was quantified using the San Elian Wound Scoring System (SEWSS). The relationships between length of hospital stay, severity of ulceration, biological parameters and complications of diabetes were analyzed. Results. The average length of hospital stay in the studied group was 19.68 ± 13.38 days. When analyzing the correlation between length of hospital stay and inflammatory parameters, we found that it correlated positively with white blood cells, neutrophils (PMN), C-reactive protein (CRP) and negatively with hemoglobin, hematocrit, total proteins, alkaline reserve and sideremia. Assessment of the severity of ulcerations using SEWSS (mild, moderate and severe) revealed a percentage of 85.7% of cases with moderate grade ulcers, and 9% of cases having severe grade ulcers. Severity of ulcerations correlated inversely with hemoglobin, hematocrit, total proteins and sideremia. Direct correlations were found between the severity score and the following parameters: white blood cells, PMN, fibrinogen, CRP. The length of hospital stay was significantly correlated with the severity of ulceration assessed by the SEWSS (r = 0.272, p < 0.001). Conclusions. Admission in the hospital with more severe ulcerations has been associated with increased length of hospital stay, thus suggesting the need for patient education and active screening of the diabetic foot.
Nutrients, Oct 29, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
The Medical-Surgical Journal, 2011
PubMed, Oct 20, 2012
Aim: Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modificat... more Aim: Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modifications is the loss of normal sudomotor function, a sign of autonomic neuropathy. The aim of this study is to evaluate sudomotor dysfunction using a new tool (Neuropad) in diabetic patients with foot ulceration. Material and methods: We included 58 diabetic patients with foot ulceration admitted in 2010 in the Clinical Center for Diabetes, Nutrition and Metabolic Diseases. We collected data regarding age, gender, type and duration of diabetes, glycated hemoglobin (HbAlc), history of amputations and duration of hospital admission. Peripheral neuropathy was evaluated through the Neuropathy Disability Score (NDS) and autonomic neuropathy was tested through Neuropad. Results: 95% of patients had NDS > or = 6, among which 76% had also positive Neuropad test. Patients with both peripheral and autonomic neuropathy had longer duration of diabetes (p = 0.027) but similar HbA1c as patients with only peripheral neuropathy (p = 0.09). The former also had longer duration of current admission (p = 0.022) and a higher percentage of these patients had history of amputations (p = 0.041). Conclusions: Neuropad is a reliable, easy to use test for the diagnosis of autonomic neuropathy, which puts patients at greater risk for foot ulceration and amputation.
The Medical-Surgical Journal, 2012
Aim: Obstructive Sleep Apnea Syndrome (OSAS) is an under diagnosed condition with significant con... more Aim: Obstructive Sleep Apnea Syndrome (OSAS) is an under diagnosed condition with significant consequences on health. The aim of this study is to estimate the prevalence of symptoms and key features of OSAS in a rural population. Material and methods: 254 subjects were enrolled. We measured height (H) and weight (W), calculated body mass index (BMI) and determined glycated hemoglobin (HbA1c). Information about age, gender, medical history (diabetes, hypertension) was collected. All the participants filled in the Berlin questionnaire, which has separate questions regarding the symptoms of OSAS. Results: Snoring was reported by 44.1% of the subjects, observed apneas by 6.7% and excessive daytime sleepiness by 36.6%. All symptoms were more frequently reported by women. A higher percentage of obese, hypertensive and diabetics reported snoring (p<0.001). When analyzing gender differences, the significance was maintained, except for diabetic men. Witnessed apneas were more prevalent in hypertensive subjects (p=0.034), but were significantly associated with hypertension only in (p=0.003). No correlation was found regarding excessive daytime sleepiness and the risk factors studied. Conclusions: Prevalence of OSAS symptoms and risk factors in this rural population was noticeable and efforts for early diagnosis and treatment are recommended.
PubMed, Jul 1, 2016
Aim: To estimate specific nutrient intake in patients with type 2 diabetes. Materials and methods... more Aim: To estimate specific nutrient intake in patients with type 2 diabetes. Materials and methods: The study was conducted on a group of subjects with type 2 diabetes. The collected data included: anthropometry, lifestyle, blood measurements, and the mean daily nutrient intake assessed by the EPIC food frequency questionnaire. Results: The study group included 101 subjects with type 2 diabetes mellitus (DM) with a mean age of 60.6±10 years, of which 45 men (59±10.6 years) and 56 women (62±9.6 years). The average energy intake was 1714.4±713.9 Kcal/day, with a statistically significant gender difference (1877.7±850.9 kcal/day for men, 1583.1±554.9 kcal/day for women, p = 0.039, and the average daily micronutrient intake was 2.44±1.44 μg/day for vitamin D, 724.5μ263.2 mg/day for Calcium (Ca), 266.7±98 mg/day for magnesium (Mg), which was low compared to dietary recommendations. Calcium intake was correlated with intake of carbohydrates, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), fiber and energy. Vitamin D intake was correlated only with protein intake (R=0.695), while magnesium intake correlated with intake of fibers, energy, carbohydrates and SFA. Conclusions: Our study in patients with type 2 diabetes showed a reduced average intake of calcium, magnesium and vitamin D compared to standard recommendations, requiring an individualized approach.
PubMed, Aug 1, 2014
Aim: The aim of the study was to explore the anthropometric maternal characteristics and prenatal... more Aim: The aim of the study was to explore the anthropometric maternal characteristics and prenatal care as determinants of pregnancy weight gain. Material and methods: We conducted a cross-sectional study on a total of 400 pregnant women admitted to Cuza-Vodă Obstetrics and Gynecology Clinical Hospital, Iaşi. Information on demographic characteristics, number of prenatal visits, and education on nutrition and food changes occurring during pregnancy were recorded in a structured questionnaire. Anthropometric parameters analyzed were pregestational BMI (body mass index) and weight gain during pregnancy. Results: Weight gain was associated with pregestational BMI category. An increase in weight more than recommended occured more frequently in overweight (53.1%) and obese women (66.7%) (p < 0.001). Weight gain during pregnancy was related to area of residence, age, APCU (adequate prenatal care utilization) index. The multivariate analysis identified the following variables as significant determinants of pregnancy weight gain: inadequate prenatal care, BMI and changes in diet. Conclusions: Pregestational BMI and changes in diet during pregnancy identified as determinants of weight gain suggests that overweight and underweight women must carefully be counseled regarding recommendations for weight gain in pregnancy. Tracking diet changes is important to ensure that a weight gain lies within the guidelines recommendations.
PubMed, Oct 20, 2012
Aim: Obstructive Sleep Apnea Syndrome (OSAS) is an under diagnosed condition with significant con... more Aim: Obstructive Sleep Apnea Syndrome (OSAS) is an under diagnosed condition with significant consequences on health. The aim of this study is to estimate the prevalence of symptoms and key features of OSAS in a rural population. Material and methods: 254 subjects were enrolled. We measured height (H) and weight (W), calculated body mass index (BMI) and determined glycated hemoglobin (HbA1c). Information about age, gender, medical history (diabetes, hypertension) was collected. All the participants filled in the Berlin questionnaire, which has separate questions regarding the symptoms of OSAS. Results: Snoring was reported by 44.1% of the subjects, observed apneas by 6.7% and excessive daytime sleepiness by 36.6%. All symptoms were more frequently reported by women. A higher percentage of obese, hypertensive and diabetics reported snoring (p < 0.001). When analyzing gender differences, the significance was maintained, except for diabetic men. Witnessed apneas were more prevalent in hypertensive subjects (p = 0.034), but were significantly associated with hypertension only in (p = 0.003). No correlation was found regarding excessive daytime sleepiness and the risk factors studied. Conclusions: Prevalence of OSAS symptoms and risk factors in this rural population was noticeable and efforts for early diagnosis and treatment are recommended.
PubMed, Nov 4, 2011
Background and aims: Prevention and reduction of cardio-vascular mortality are in relationship wi... more Background and aims: Prevention and reduction of cardio-vascular mortality are in relationship with understanding and being able to modify risk factors, among which overweight and obesity become the most significant. The aim of this paper is to define cardio-metabolic risk factors which are specific to the studied population, and also to find elements of lifestyle that lead to overweight. We targeted smoking, alcohol consumption, stress, physical exercise, income and educational level. Material and methods: We studied a sample of 172 subjects, representative for the population of Deleni, a rural community in Iaşi County; among these subjects, 67 were men, 105 were women, with an average age of 54. For each a chart was filled, containing demographic data, socio-economic status, personal and family medical history. We measured anthropometric parameters: weight (W), height (H), waist circumference (WC) and we calculated body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). We performed interviews to fill in a food frequency questionnaire, the Perceived Stress Scale and the International Physical Activity Questionnaire. Results: In the lot studied, 44.2% are overweight and 18.6% are obese, the majority of these being women. Regarding WC, among normal weight, 52.4% have large WC (> or = 94cm for men and > or = 80cm for women). Obesity markers positively correlate with increase in age and decrease in income (p=0.024), with low educational level, regular consumption of coffee (p=0.093), and negatively correlate with excessive alcohol consumption (p=0.049) and smoking (p=0.003). As expected, there is an inverse relationship between increased physical exercise and BMI (p=0.015) and a direct relationship between increased stress level and WC. Conclusions: Anthropometric parameters are sensible markers in evaluating the influence of lifestyle on cardio-metabolic risk.
PubMed, 2013
The aim of this study was to evaluate comparatively the predictive power of body mass index (BMI)... more The aim of this study was to evaluate comparatively the predictive power of body mass index (BMI) and waist circumference (WC), two anthropometric parameters used in daily practice, for detecting cardio-metabolic diseases, in a rural community in north-east Romania. Material and methods: We evaluated 3248 persons, aged 19 or over, for whom we collected the following data: medical history, anthropometric parameters, blood pressure value and biochemical parameters. Results and conclusions: Both WC and BMI help correctly determine the presence of arterial hypertension, diabetes and dislipidemia. However, the cut-off value of each of these parameters differs for each pathology. The predictive value of WC for different cardio-metabolic diseases is maintained even at normal or borderline overweight values of BMI.
PubMed, Aug 1, 2014
Aim: The aim of this study was to assess the preoperative nutritional status of patients undergoi... more Aim: The aim of this study was to assess the preoperative nutritional status of patients undergoing thoracic surgery using different nutritional tools. Material and method: . We conducted a prospective study on a sample of 43 thoracic patients, including 23 with neoplasms and 20 with non-neoplastic pathology who underwent thoracic surgery procedures between July-September 2011, in the Thoracic Surgery Clinic in Iaşi. Weight and height were measured and body mass index (BMI) was calculated. WHO classification for BMI categories was used. Preoperative serum level of transthyretin (TTR) and demographic data (gender, age) were also assessed. All patients were examined by the Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002). Results: After performing SGA, 67.9% of the patients were well-nourished, 21.4% were moderately or suspected of being malnourished and 10.7% were severely malnourished. The level of TTR was significantly lower in the moderately or severely malnourished group, compared to those considered well-nourished. According to NRS-2002, 42.9% of the patients were considered at nutritional risk. The level of TTR of these patients was lower than the level of TTR of the patients without nutritional risk, but without statistical significance. Conclusions: Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002) are useful in identifying patients with nutritional risk, so that appropriate nutritional management could be initialised even before surgery.
PubMed, 2013
Aim: To evaluate the prevalence of steatosis and to assess its correlations with the classical ca... more Aim: To evaluate the prevalence of steatosis and to assess its correlations with the classical cardiovascular (CV) risk factors, components of metabolic syndrome (MS) in a rural population. Material and methods: A sample of 254 subjects was enrolled in the study. Collected data included: age, gender, complete medical history, anthropometric and blood pressure (BP) measurements. The biological evaluation included metabolic and hepatic parameters. Ultrasound evaluation of steatosis relied on the criteria of the National Health and Nutrition Examination Survey (NHANES) III. Results: Two thirds of the study population were obese or overweight (64.96%); 32.66% had systolic BP and 27.16% diastolic BP levels higher than normal. 38% of the subjects had abnormal fasting blood glucose levels, 14.56% having glycated hemoglobin (HbA1c) values corresponding to pre-diabetes, and 9.84% to overt diabetes; 8% had low HDL-cholesterol and 14.96% high triglycerides (Tg) levels. MS was present in 50.8% of individuals. Only 10.8% of all subjects did not have an ultrasound appearance of steatosis; 28.8% had moderate and 32% severe steatosis. There were statistically significant differences in subjects with steatosis vs. subjects without steatosis with regard to body mass index (BMI), WC, presence of MS, and BP and Tg levels, but not to ALAT, ASAT and GGT values. Conclusions: The important prevalence of obesity, fasting hyperglycamia, steatosis and MS shows a particularly metabolic fragile population; early diagnosis and interventional strategies are mandatory.
PubMed, Oct 20, 2012
Non-alcoholic fatty liver disease (NAFLD) covers a spectrum of liver disease from steatosis to no... more Non-alcoholic fatty liver disease (NAFLD) covers a spectrum of liver disease from steatosis to non-alcoholic steatohepatitis (NASH) and cirrhosis. Most NAFLD patients are hyperinsulinaemic and more insulin resistant compared with nonsteatotic healthy subjects, and there is a near universal association between NAFLD and insulinresistance (IR) irrespective of obesity. The metabolic syndrome (MS) is highly prevalent in the general adult population (approximatively 22%) and it carries an increased cardiovascular morbidity and mortality. Pathophysiologic considerations, clinical associations, and laboratory investigations support that IR and hyperinsulinaemia have a central role in pathogenesis of both MS and NAFLD. The fatty liver is resistant to the action of insulin to suppress hepatic glucose production, which results in hyperglycaemia and, further, in hyperinsulinemia. The MS is associated with maldistribution of body fat, increased free fatty acids (FFAs) and IR, leading to type 2 diabetes, hypertension, dyslipidemia. Visceral fat is an important clinical marker of metabolic cardiovascular risk and a marker of IR in multiple tissues, independent of body mass index (BMI). NAFLD and atherosclerosis share common molecular mediators and NAFLD itself might play an early role in the development and progression of atherosclerosis. These data suggest that NAFLD should be considered part of a multi-organ system derangement in insulin sensitivity, and help explain why NAFLD is so closely linked with diabetes, MS and is an important risk factor for coronary heart disease. NAFLD may be the hepatic manifestation of the MS and raises the possibility that it may play an early role in the etiology of MS.
Romanian Journal of Diabetes Nutrition and Metabolic Diseases, Aug 15, 2011
Objective. To investigate which anthropometric parameter best correlates with modifications in bl... more Objective. To investigate which anthropometric parameter best correlates with modifications in blood glucose and blood pressure (BP). Material and method. 135 subjects were included in the study. We measured weight, height, waist circumference (WC), BP and calculated body mass index (BMI) and waist-to-height ratio (WHtR). We determined glycated hemoglobin A1c (HbA1c) and performed an oral glucose tolerance test (OGTT) under standard conditions. Results. HbA1c increased with BMI, WC and WHtR. We found statistically higher values of fasting blood glucose (FBG) in obese (P=0.001), in those with large WC (P=0.
Proceedings of the Nutrition Society, Apr 1, 2020
We conducted a narrative review on the interaction between dietary patterns with demographic and ... more We conducted a narrative review on the interaction between dietary patterns with demographic and lifestyle variables in relation to health status assessment. The food pattern has the advantage of taking into account the correlations that may exist between foods or groups of foods, but also between nutrients. It is an alternative and complementary approach in analysing the relationship between nutrition and the risk of chronic diseases. For the determination of dietary patterns one can use indices/scores that evaluate the conformity of the diet with the nutrition guidelines or the established patterns (a priori approach). The methods more commonly used are based on exploratory data (a posteriori): cluster analysis and factor analysis. Dietary patterns may vary according to sex, socioeconomic status, ethnicity, culture and other factors, but more, they may vary depending on different associations between these factors. The dietary pattern exerts its effects on health in a synergistic way or even in conjunction with other lifestyle factors, and we can therefore refer to a 'pattern of lifestyle'.
Revista De Chimie, Jan 15, 2019
Recent studies have shown that as the average life expectancy increases, more people will suffer ... more Recent studies have shown that as the average life expectancy increases, more people will suffer a stroke in their lives, diminishing their quality of life. Secondary stroke prevention involves reducing the cardiovascular risk factors and administering medication for preventive purposes, where statins play an important role. The purpose of this study is to highlight the correlations of statins dosage with cardiovascular risk factors (atheromatosis, uric acid value, obesity, etc), in stroke patients receiving hypolipidemic treatment with statins.
Healthcare, Jul 20, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Nutrients, Apr 26, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
European Respiratory Journal, Sep 1, 2012
Body: Introduction. The prevalence of obstructive sleep apnea syndrome (OSAS) is known to be high... more Body: Introduction. The prevalence of obstructive sleep apnea syndrome (OSAS) is known to be higher in individuals with prediabetes and diabetes mellitus. Aims and objectives. This study aims to evaluate the risk of OSAS in individuals with dysglycaemia, comparative with those with normal glucose tolerance, in a rural population, and to find out whether those with prediabetes or diabetes have a higher risk of OSAS. Methods. We conducted a cross-sectional study in a sample of 254 men and women, aged >18 years, from a rural population. Dysglycaemia was evaluated by fasting plasma glucose-FPG and performing an oral glucose tolerance test-OGTT in all individuals without diabetes and by determining glycated haemoglobin-HbA1c. WHO (1999) criteria for diagnosing diabetes and prediabetes and American Diabetes Association recommendations for HbA1c diagnostic values were used. The risk of OSAS was assessed using Berlin Questionnaire. Results. We found that a statistically higher percentage of those with diabetes and prediabetes, diagnosed by HbA1c (66,7% and 32,8% respectively) and by OGTT (57,1% and 30,3% respectively) had a high risk of OSAS (p=0,001 and p=0,022, respectively) as compared to those with normal glucose tolerance (27,5% and 31,3% respectively). When assessing dysglycaemia by FPG, our results showed no statistically significant differences in what concerns the risk of OSAS between the two categories, normoglycaemia and dysglycaemia (p=0,051). Conclusions. The evaluation of risk of OSAS should be performed in individuals with prediabetes and diabetes, thus allowing the identification of individuals who should be referred to a sleep center.
The Medical-Surgical Journal, 2012
Aim. Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modificat... more Aim. Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modifications is the loss of normal sudomotor function, a sign of autonomic neuropathy. The aim of this study is to evaluate sudomotor dysfunction using a new tool (Neuropad®) in diabetic patients with foot ulceration. Material and methods. We included 58 diabetic patients with foot ulceration admitted in 2010 in the Clinical Center for Diabetes, Nutrition and Metabolic Diseases. We collected data regarding age, gender, type and duration of diabetes, glycated hemoglobin (HbA1c), history of amputations and duration of hospital admission. Peripheral neuropathy was evaluated through the Neuropathy Disability Score (NDS) and autonomic neuropathy was tested through Neuropad®. Results. 95% of patients had NDS ≥ 6, among which 76% had also positive Neuropad® test. Patients with both peripheral and autonomic neuropathy had longer duration of diabetes (p=0.027) but similar HbA1c as patients with only peripheral neuropathy (p=0.09). The former also had longer duration of current admission (p=0.022) and a higher percentage of these patients had history of amputations (p=0.041). Conclusions. Neuropad® is a reliable, easy to use test for the diagnosis of autonomic neuropathy, which puts patients at greater risk for foot ulceration and amputation.
Practica medicală, Jun 30, 2021
Diabetic foot represents the consequence of changes caused by diabetes in the foot, meaning an as... more Diabetic foot represents the consequence of changes caused by diabetes in the foot, meaning an association of infection, ulceration and / or destruction of deep tissues with neuropathy and peripheral vascular disease in the foot, below the ankle. The aim of the study was to evaluate the factors that may influence the length of hospital stay in patients with diabetic foot ulcers. Material and methods. An observational study was performed on a sample of patients hospitalized in the Diabetes, Nutrition and Metabolic Diseases Clinic within "St. Spiridon" County Emergency Clinical Hospital, Iași, between 01.01.2007 and 31.12.2017. Sociodemographic characteristics of the patients, history of the disease, biological parameters, duration of hospitalization were registered in a database. Severity of foot ulcerations was quantified using the San Elian Wound Scoring System (SEWSS). The relationships between length of hospital stay, severity of ulceration, biological parameters and complications of diabetes were analyzed. Results. The average length of hospital stay in the studied group was 19.68 ± 13.38 days. When analyzing the correlation between length of hospital stay and inflammatory parameters, we found that it correlated positively with white blood cells, neutrophils (PMN), C-reactive protein (CRP) and negatively with hemoglobin, hematocrit, total proteins, alkaline reserve and sideremia. Assessment of the severity of ulcerations using SEWSS (mild, moderate and severe) revealed a percentage of 85.7% of cases with moderate grade ulcers, and 9% of cases having severe grade ulcers. Severity of ulcerations correlated inversely with hemoglobin, hematocrit, total proteins and sideremia. Direct correlations were found between the severity score and the following parameters: white blood cells, PMN, fibrinogen, CRP. The length of hospital stay was significantly correlated with the severity of ulceration assessed by the SEWSS (r = 0.272, p < 0.001). Conclusions. Admission in the hospital with more severe ulcerations has been associated with increased length of hospital stay, thus suggesting the need for patient education and active screening of the diabetic foot.
Nutrients, Oct 29, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
The Medical-Surgical Journal, 2011