Reviews
P. Andreeva-Gateva
Peroxisome Proliferator-activated Receptors (PPARs) ­ Cross-linking Site of  Lipid 
and Carbohydrate Metabolism, Inflammation and Oxidative Stress. 4
I. Topouzov
Endocrine and Metabolite Mechanisms Involved in the Formation and Maintenance
of the "Women's Pool" 14
 Original Articles
A. Kurtev, N. Mireva
Autoimmune Thyroiditis in Children with Juvenile Chronic Arthritis and 
Systemic Lupus Erythematosus 21
N. Ovcharova, P. Angelova-Gateva, D. Koev, D. Tcharatchiev
Serum Peroxidized Lipids in Diabetes Type 2 Patients with Retinopathy and Hypertension 27
P. Andreeva-Gateva, V. Orbetzova
Sex-Differentiated Modulation of Metabolic Effects in Rats Fed 
Fructose-Enriched Diet Through Antioxidant Pretreatment 35
 Calendar  43
 New Items  47
 Instructions to Authors  48
 

Peroxisome Proliferator-activated Receptors (PPARs) - Cross-linking Site of Lipid 
and Carbohydrate Metabolism, Inflammation and Oxidative Stress 
P. Andreeva-Gateva
Central Clinical Laboratory and Clinical Lipidology
University Hospital "Tzaritza Joanna" ­ Sofia

Abstract
Peroxisome proliferator-activated receptors (PPARs) are made up of 3 types of nuclear receptors, endowed with considerable homology between each other, but differing by tissue distribution.  In the last few years, their pleiotropic role was clearly outlined against the background of their widespreading in the organism, as well as on the basis of the numerous genes under genetic control discovered.  Lipid and carbohydrate metabolism, inflammation, antioxidant defence, cell differentiation and proliferation, i.e.  rather differing in essence processes in the organism may be successfully influenced through this particular type of receptors.  This focused attention on the possibility to treat diseases, such as obesity, diabetes, atherosclerosis, as well as some cancer conditions, by diet or drugs. It has been demonstrated that certain medicaments ­ fibrates, thiazolidindiones, non-steroidal antiinflammatory drugs exert their effect through binding PPARs. The pleiotropism of these receptors points to a variety of possible effects anticipated after their activation which renders them a topic of interest and clinical relevance.
KEY WORDS: peroxisome proliferator-activated receptors (PPARs) -  structure,  function,  activators; metabolism, inflammation, antioxidants.
 
 

Endocrine and Metabolite Mechanisms Involved in the Formation and Maintenance
of the "Women's Pool"
I. Topouzov
Department of Kinesitherapy
South-Western University ­ Blagoevgrad

Abstract
This is a summed up report on data concerning the most important endocrine and metabolic mechanisms involved in forming and maintaining the women's pool.  The fat cell, or functional entity of white adipose tissue, is mainly designed for energy storage and mobilization.  Adipose tissue metabolism varies from one to another body region and therefore lipolytic processes are characterized by regional differences. For instance, the women's pool fat does not lend itself readily to mobilization owing to the increased alpha-2-adrenergic receptor activity which depends on estrogen and other hormones and enzymes. Lipolysis in adipocytes may be induced through beta-adrenergic receptor stimulation. The physiological implications of alpha-2 and beta-3-receptors depend on the gender and anatomical location of fat deposits.  Also there are differences in terms of recruitment and hormonal regulation for each fat cell receptor subtype.
The increase in adipocytes during gaining weight, and the physiological retention of liquids during the monthly cycle may give rise to local hypoxia development in these particular zones.  This in turn is associated with the triggering of vicious circles, contributing to the formation and maintenance of the "women's pool". In this context skin and hypoderm are interpreted as regulators of metabolism, since they transform various hormones, and may also inactivate potentially noxious substances of exo- and endogenous origin.
KEY WORDS: women's pool, adaptation, obesity, cellulites, metabolism.
 
 

Autoimmune Thyroiditis in Children 
with Juvenile Chronic Arthritis 
and Systemic Lupus Erythematosus
A. Kurtev, N. Mireva
Chair of Pediatrcs 
Medical University ­ Sofia

Abstract 
The underlying causes of the frequent association of some systemic connective tissue diseases, such as juvenile chronic arthritis (JCA) and systemic lupus erythematosus (SLE), with autoimmune thyroiditis (AT) in children are still not well enough clarified.
This is a report on 29 children with JCA aged  12,81±3,4 yrs, range 5, 7 to 19, and three children aged l0,4-17,64 yrs presenting SLE with different evolution, undergoing appropriate treatment - nonsteroid antiinflammatory drugs (NSAID) plus glucocorticoids and/or cytostatics.
As shown by the results there is moderate thyroid hyperplasia (mainly I B degree) in half of the JCA children, and in three with SLE; subclinical hypothyroidism in 17,9% of JGA cases; increased antithyroid antibodies - TAT in 24,1%, MAT in 54,4% of JCA, and in 2/5 children with SLE. AT is diagnosed in 41,4% of the children with JCA (nearly half of them presenting atrophic version) and in two of the children with SLE. Among JCA children no changes in OGTT and in cell mediated and humoral immunity indicators are documented.
In all children with JCA and SLE periodical testing of the thyroid gland - size, function and antibody formation - is strongly recommended with a special reference to the ever increasing association of the diseases with AT.
KEY WORDS: autoimmune thyroiditis, juvenile chronic  arthritis, systemic lupus erythematosus, thyroid gland, antithyroid antibodies,  cellular immunity.
 
 

Serum Peroxidized Lipids in Diabetes Type 2 Patients with Retinopathy and Hypertension
N. Ovcharova, P. Angelova-Gateva, D. Koev, D. Tcharakchiev
Clinical Center of Endocrinology and Gerontology
Medical University ­ Sofia

Abstract 
Peroxidized lipids (LP, TBARS) have an essential practical bearing on diabetic complications occurrence. It is the purpose of the study to characterize peroxidized lipids in diabetes mellitus type 2 (DM-2) with retinopathy and DM-2 with hypertension.
The study covers 28 DM-2 patients with retinopathy (mean age 59 years), 33 DM-2 patients with hypertension (mean age 61 years), 12 DM-2 patients free of complications and hypertension (mean age 58 years) and a control group of 23 healthy individuals (mean age 60 years).
Significantly higher values of total cholesterol (TCh), triglycerides (Tg), cholesterol in low-density-lipoproteins (LDLchol) are established among diabetics with retinopathy and hypertension, as compared to controls. Total lipid peroxides (LP) and LP in LDL are significantly higher in DM-2 plus hypertension, by comparison with controls. In DM-2 free of complications TCh, Tg and total LP are significantly lower, by comparison with patients with hypertension. In DM-2 without complications Tg values are significantly lower by comparison with DM-2 plus retinopathy. In DM-2 with retinopathy LDLchol is 3,.73±2.60 mmol/1 (p<0,01 vs controls), in patients with hypertension ­ 3,99±1.12 mmol/1 (p<0,01 vs controls); in the group free of complications ­ 3,06±0.37 mmol/1 (p<0,001 vs controls), and in the control group ­ 2,21± 0,.95 mmol/1.
Total serum lipoproteins in patients with retinopathy ­ 2,60±0,99 mmol/1 (p>0,05/controls), 3,44±1,19 mmol/l in hypertensive patients (p<0,001/controls), 2,.39 ± 0,29 nmol/l in patients without complications, and 2,32±0,32nmol/l in the controls.
LP in LDL is 1,42±0,64 nmol/l in patients with retinopathy, 1,56±0,62 nmol/l in hypertensive diabetics (p<0,01/controls), 1,28±0, 42 nmol/l in patients free of complications, and 1,09±0,57 nmol/1 in controls.
The percentage of high-density-lipoproteins cholesterol (HDLchol) amounts to 25,80% in the retinopathy group, 21,40% - in the hypertension group, 24,40°/o in the patients free of complications, and 33,6 % in the controls.
KEY WORDS: lipids, diabetes mellitus, retinopathy, hypertension.
 
 

Sex-Differentiated Modulation of Metabolic Effects in Rats Fed Fructose-Enriched Diet Through Antioxidant Pretreatment
P. Andreeva-Gateva, V. Orbetzova
Central Clinical Laboratory and Clinical Lipidology
University Hospital "Tzaritza Joanna" ­ Sofia

Abstract 
Fructose treatment of rats is a model frequently used in evaluating metabolic changes, similar to the ones in insulin resistance. Changes in prooxidant-antioxidant homeostasis are likewise observed in this experimental model, pointing to fructose induced increase in oxidative stress.  It is the purpose of the study to assay the metabolic effects in fructose-fed rats with or without antioxidant pretreatment, using dietary supplementation.
The study covers 107 Wistar rats (55 female and 52 male). At the start of experimentation they were 5-month-old, divided up randomly into 4 groups, as follows: C - controls (16 male, 13 female), Z - treated with antioxidant dietary supplementation ZeIlSchutz for 5 months (16 male, 15 female), F - fructose supplemented during the last month of experimentation (10 male, 12 female) and ZF - treated over three months with antioxidant dietary supplementation, with fructose added in the last month (10 male, 15 female).
In fructose treated rats are observed sex-related differences -hypertriglyceridemia induction in male rats, and lack of induction in female ones.  Induction of superoxide dismutase activity in erythrocytes of female rats as the result of fructose treatment is also noted.
Preliminary 5-month treatment with antioxidant dietary supplementation in rats modulates the fructose effect on triglyceridemia in male rats, and decreases fructose induced superoxide dismutase activity.
KEY WORDS: fructose, rats,  antioxidant supplementation.