Списък от научни трудове на доц д-р Красимира Икономова Учебници К. Икономова

52. K. Ikonomova, S. Handjiev. Obesity, fat distribution and metabolic disturbances in transport workers in Bulgaria. Obezite, 4, 2004, 46-51.

Unbalanced nutrition and some professional factors promote the appearance of metabolic and cardiovascular lesions in transport workers.

The aim of the study is searching a relationship among the android and gynoid fat mass distribution in transport workers and indexes, characterizing metabolic disturbances.

Ninty four obese transport workers (46 males and 48 females) mean age 31,7±10,1 years were examined. BMI, waste to hip ratio, fat mass accumulation were determined. Examinations of blood glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, ApoA, ApoB, urea, creatinin, uric acid and fibrinogen were carried out.

In 94% of obese patient single or multiple metabolic disturbances were found out. The most frequent metabolic deviations were the increased sera concentrations of fibrinogen, uric acid and Apo B, followed by total cholesterol and LDL-cholesterol. The combination of four, five and six metabolic disturbances is mainly in patients with abdominal obesity. When we grouped the patients on the base of waste to hip ratio significant changes in uric acid, total cholesterol, LDL-cholesterol and Apo B between android and gynoid obese patients were observed ( p<0,05). In groups form on the base of BMI and % fat mass increasing sera concentrations of uric acid and fibrinogen parallel with the increasing of anthropometric indexes was established ( p<0,05). The distribution of patients according to waste to hip ratio gave better information about the metabolic deviations, comparing with BMI and % fat mass.

The evaluation of metabolic diseases in transport workers is of particular importance in view of traffic security.

53. Ikonomova, K. Inflammation and metabolic syndrome. Turkish Journal of Endocrinology and Metabolism, 3, 2004, 85-89.

The relation among inflammatory markers – C-reactive protein (CRP), fibrinogen, white blood cells count (WBC) and metabolic syndrome is observed in experimental, clinical and epidemiological studies.

High levels of inflammatory markers are related to increased body mass index (BMI), increased sera lipids, high blood glucose, hyperinsulinemia, insulin resistance. Probably the chronic inflammation trigger insulin resistance and diabetes type 2. In genetic and metabolic predisposed persons different stimuli (overnutrition, increased hypothalamus-hypophyseal activity) can cause proinflammatory cytokine oversecretion and to provoke insulin resistance and diabetes.

The increased acute phase protein levels can be related to decreased insulin sensitivity of hepatocytes. Insulin exerted selective effects on liver protein synthesis with increased albumin synthesis and decreased fibrinogen and CRP production. Insulin resistance leads to increased synthesis of fibrinogen and CRP.

The level of inflammatory markers is predictable for cardiovascular diseases developing. CRP is pointed out as the most perspective marker for chronic subclinical inflammation, participating in metabolic syndrome.

The evidences for the role of inflammation in the genesis of metabolic syndrome is still not well defined. Additional population, clinic and basic investigation are needed to confirm the relation. The future investigations will help to estimate the efficiency of inflammatory marker examinations in the prophylactics and treatment of cardiovascular diseases.

54. Toncheva A., Remichkova M., Ikonomova K., Dimitrova P., Ivanovska M. Inflammatory response in patients with active and inactive osteoarthritis. Rhreumatol. Int. 29, 2009, 1197-1203.
Joint destruction and excessive bone loss in osteoarthritis (OA) and rheumatoid arthritis (RA) are associated with high expression of soluble receptor activator of nuclear factor B ligand (sRANKL). The aim of this study was to follow the changes in levels of sRANKL in sera and joint extracts and its expression on peripheral neutrophils during the development of zymosan-induced arthritis (ZIA) and collagenase-induced osteoarthritis (CIOA) in mice. To analyze sRANKL and TLR2 expression on blood neutrophils from patients with active or inactive osteoarthritis (OA).

For the induction of ZIA Balb/c mice were injected intraarticularly (i.a.) with 180 g of zymosan. For the induction of CIOA mice were injected i.a. with 2 U of collagenase at day 0 and day 2. Blood neutrophils were obtained by gradient centrifugation on Histopaque 1083 after dextran sedimentation. Concentrations of sRANKL in joint extracts and sera were determined by enzyme-linked immunosorbent assay (ELISA). sRANKL and TLR2 expression by neutrophils were analyzed by flowcytometry and sRANKL positive cells in joints of arthritic mice were stained using specific immunohistochemistry.

The development of ZIA and CIOA was associated with proteoglycan (PG) loss and sRANKL expression in the bone. sRANKL concentrations in joint exudates and plasma were increased at the early and established phases of both models. Neutrophils from mice with ZIA showed a low expression of sRANKL but no expression was observed in CIOA. The percentage of sRANKL and TLR2 positive blood neutrophils was higher in patients with OA than in healthy donors.

The results of this study prove that higher local and systemic levels of sRANKL might be used as a marker of arthritic disorders in mouse models and humans. Neutrophils can participate in RANKL and TLR2-dependent joint inflammatory processes.

55. А. Тончева, В. Tрьiнкова, К. Икономова, Р. Стоилов, Ф. Мартинова – Ассоциация HLA авнигенов у больнiх остеоартрозом и псориатическим артритом в болгарской популяции. Научно-практическая ревматология, (under press)

Ассоциация отдельных детерминантов HLA системой с генетично предрасположенными заболеваниями сильнее выражена в области ревматологии.

Настоящая работа направлена на изучению вопросов о генетической предразположености к развитию псориатического артрита и остеоартроза.

Обследовали 100 больных псориатическим артритом и 125 больных остеоартрозом. Данны сравнивали контрольной группы здоровых лиц болгарской популяции.

Типирование HLA антигенов провели при помощью микролимфоцитотоксическим тестом Dausset для антигенов І^ого класа и пролонгированным тестом – для ІІ^ого класса.

Обнаружена достоверная корреляция антигенами HLA-В13, В21, В27, DR4 и DR7 у больных псориатическим артритом и А10, В21 и DR4 у больных остеоартрозом.

Научная и практическая ценность работы тесно связаны между собой. Результаты исследования генетической метки у обследованных больных могут быть исспользованы для прогнозирования клинического течения заболевания и выявления относительного риска развития.

Резюмета от доклади, отпечатани в чужди медицински списания
56. K. Ikonomova, K. Nedelcheva, B.Miteva, V. Mincheva. Evaluation of some metabolite risk factors in android and gynoid obesity. Balkan Journal of Clinical Laboratory, v. 2, 1998, p.9.

57. K. Ikonomova , B. Miteva, K. Nedelcheva - Effect of Urovaxom on some laboratory parameters in patients with chronic pyelonephritis. Balkan Journal of Clinical Laboratory, 1999, v. 2, , p.9.

58. Sv. Handjiev, L. Balabansky, K. Ikonomova – Role of Orlistat and Diet in the Treatment of Obesity and Dislipidemias, Taplalkozas-Allergica-Dieta, 2001. 6. Evf. 3-4 sz. 17.

60. Sv. Handjiev, Ikonomova K. Handjieva T – Role of Orlistat for changing nutritional habits in patients with obesity and dyslipidemia - Int. J. Obesity, 27, 2003.