Background and objective Type 2 diabetes mellitus (T2DM) is a global health issue that has seen a significant increase in prevalence worldwide. Oxidative stress plays a crucial role in the pathogenesis of numerous chronic diseases. Oxidative stress induced by hyperglycemia has a central role in the development of insulin resistance, as well as micro- and macrovascular complications of diabetes mellitus. This study aimed to investigate the influence of the duration of T2DM on blood glucose levels, glycated hemoglobin (HbA1c), renal function parameters, oxidative stress, and von Willebrand factor (vWf) activity in individuals with diabetes. Methodology A total of 135 participants from both genders with T2DM were included in this study. The participants were divided into three groups based on the duration of their disease: up to five years (46 participants), from 6-10 years (49 participants), and over 10 years (40 participants). The investigated parameters were as follows: fasting glucose, two-hour postprandial glucose, HbA1c, total antioxidant capacity (TAC), glomerular filtration rate (GFR), and vWf activity. Statistical analysis was performed using SPSS Statistics (IBM Corp., Armonk, NY). The Kolmogorov-Smirnov test was applied to assess the normality of distribution. Differences between the groups were analyzed using the Kruskal-Wallis test and analysis of variance (ANOVA), with appropriate post-hoc tests. A p-value <0.05 was considered statistically significant. Results The average age of the participants was 60.86 ± 8.87 years, the average weight was 86 ± 14.6 kg, the average height was 168 ± 9.18 cm, the waist circumference was 99 ± 11.4 cm, the systolic blood pressure was 127 ± 15.6 mmHg, and the diastolic blood pressure was 77 ± 6.7 mmHg. The study revealed statistically significant differences between the groups (p<0.05) for the following parameters: two-hour postprandial glucose (p=0.001), HbA1c (p=0.048), GFR (p=0.038), and vWf activity (p=0.006). No statistical significance was found for TAC values (p>0.05). Conclusions Higher levels of vWf activity were found in people who had been treated for type 2 diabetes for more than 10 years. These findings indicate that the level of vWf activity in people with type 2 diabetes 10 years after the onset of the disease can be used as a marker of vascular pathology.

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has underscored the significant role of cardiovascular risk factors in determining the severity and outcomes of the disease. Pre-existing conditions such as hypertension, diabetes, obesity, and cardiovascular diseases have emerged as key contributors to increased susceptibility to severe forms of COVID-19, influencing both short-term and long-term health outcomes. This review examines the complex interplay between these risk factors and the virus’s direct impact on the cardiovascular system. Key findings suggest that conditions like hypertension, diabetes, and obesity not only predispose individuals to more severe disease but also exacerbate complications such as myocardial injury, arrhythmias, and heart failure. Furthermore, the long-term cardiovascular effects of COVID-19, including myocarditis and pericarditis, are of growing concern, particularly in patients with pre-existing cardiovascular conditions. The virus’s ability to induce myocardial damage through mechanisms involving ACE2 receptor binding and inflammatory cytokine storms has been well-documented. The pandemic has also highlighted significant cardiovascular complications, including left and right ventricular dysfunction, myocardial injury, and elevated pulmonary arterial pressure, with the right ventricle being particularly affected due to pulmonary damage. Imaging modalities such as echocardiography and cardiac magnetic resonance have proven valuable for diagnosing myocardial injury and complications, although accessibility may be limited in routine clinical practice. Survivors of severe COVID-19, especially those with pre-existing cardiovascular conditions, face an elevated risk of major adverse cardiovascular events for up to two years post-infection. Evaluation of post-COVID patients includes ECGs, laboratory tests, echocardiography, and cardiac MRI, which provide critical insights into myocardial injury and complications. Preventive measures, including vaccination, regular monitoring of cardiovascular health, and lifestyle modifications, play a crucial role in reducing the long-term risk of cardiovascular complications. The role of vaccination in mitigating the risk of severe disease and cardiovascular complications is well-established, despite rare cases of vaccine-related myocarditis. Understanding these interactions is essential for developing targeted management strategies, improving patient outcomes in both acute and long-term COVID-19 effects, and addressing the broader challenges posed by COVID-19’s impact on cardiovascular health.

SUMMARY The aim of the present study was to assess mild cognitive impairment (MCI) and cardiometabolic risk factors (CMRF) in Bosnian and Herzegovinian patients with heart failure (HF). This study included 80 patients with HF and 40 healthy controls. Montreal Cognitive Assessment (MoCA) testing was used to evaluate cognitive function. Abdominal obesity was assessed by waist circumference, and hypertension was assessed by the auscultatory method. Data on other CMRF and comorbidities, such as diabetes, smoking, alcohol consumption, and atrial fibrillation (AF), were gathered with a specially designed questionnaire. Lipids, C-reactive protein (CRP), and fibrinogen were assessed with standard laboratory methods. Student, Mann-Whitney, and Chi-square tests were used to determine significant differences between groups. Associations between categorical variables and correlation coefficients were assessed by the Chi-square and Spearman test, respectively. The prevalence of MCI in patients with HF was 77.5%. We found significant associations between MCI and diabetes, hypertension, AF, and smoking in patients with HF. We found no significant associations between MCI, abdominal obesity, and alcohol consumption. A significant positive correlation between MCI and total cholesterol was observed in patients with HF. Furthermore, a lower MoCA score was associated with higher values of CRP and fibrinogen in HF patients. The present study showed a high prevalence of MCI in Bosnian and Herzegovinian HF patients as well as its association with various CMRFs. These results suggest it is necessary to begin MCI screening in HF patients, especially since data from the literature point to improvement in cognitive performance with appropriate HF and concomitant CMRF treatment.

Objectives: The purpose of the present study was to assess neck-to-height ratio (NtHR) and its possible association with other anthropometric measures of obesity and blood pressure (BP) values in Bosnian university students stratified by new 2017 American College of Cardiology/American Heart Association Task Force hypertension (HT) guidelines.Methods: The present study included 417 subjects with median age 20 (19-21) years that were divided into normal BP, elevated BP, stage 1 HT, and stage 2 HT groups based on BP measurements using auscultatory methods. Standard anthropometric indices including neck circumference (NC) were measured. NtHR (cm/m) was calculated in each participant based on the NC and height. Differences between groups were assessed by Kruskal-Wallis followed by Man-Whitney test and correlations were determined by Spearman test.Results: The prevalence of elevated BP was 19.2%, stage 1 HT 21.6%, and stage 2 HT 11.0 %. NtHR was highest in the stage 2 HT group. NtHR correlated significantly with all anthropometric measures in all groups. No correlation between NtHR, systolic BP, and diastolic BP was found, except in the stage 1 HT group, where a significant correlation between NtHR and systolic BP was uncovered.Conclusions: Based on the observed correlations between NtHR and standard measures of obesity, NtHR could be included in clinical practice, since it is simple and does not induce discomfort. The high prevalence of elevated BP found in the present study suggests HT prevention requires the implementation of programs aimed at promoting healthy dietary habits, physical activity, as well as effective stress management and coping mechanisms.

Abstract Objective. The present study assessed the impact of type 2 diabetes mellitus (T2DM) duration on the serum asymmetric dimethylarginine (ADMA) and C-reactive protein (CRP) concentration in Bosnian patients. Methods. Participants for this cross-sectional study were randomly selected from the Family Medicine Clinic (Sarajevo, Bosnia and Herzegovina). Serum ADMA concentration was determined by ELISA. Serum high-sensitivity (hs-CRP) was determined by particle-enhanced immunonephelometry. ANOVA test followed by Scheffe post-hoc test or Kruskal-Wallis test followed by Man-Whitney test were used for statistical analysis. Results. The study included 38 patients in up to 10 years diabetes duration (≤10 years T2DM) group, 22 patients in greater than 10 years diabetes duration (>10 years T2DM) group, and 60 controls. Serum ADMA concentration in the >10 years T2DM group (1.81±0.15 μmol/L) was significantly higher compared to serum ADMA concentration in the ≤10 years T2DM group (1.38±0.41 μmol/L; p<0.001) and in controls (0.62±0.15 μmol/L; p<0.001). A significant difference in serum ADMA concentration was found between the <10 years T2DM group and the controls (p<0.001). The serum CRP concentration in the >10 years T2DM group [5.95 (4.20–9.12) mg/L] was significantly higher compared to serum CRP concentration in the <10 years T2DM group [2.35 (1.40–4.30) mg/L; p<0.001] and controls [0.85 (0.50–1.30) mg/L; p<0.001]. Significant difference in serum CRP concentration was observed between the <10 years T2DM group and controls (p<0.001). Conclusions. The present study showed an increase in the serum ADMA and CRP concentrations with the advancement of T2DM. These results suggest that ADMA and CRP may serve as indicators of endothelial dysfunction and chronic low-grade inflammation progression in patients with T2DM. Larger prospective studies are required to confirm the observed findings.

Different qualitative and quantitative changes in platelets are involved in the pathophysiological processes in inflammatory bowel diseases (IBD): ulcerative colitis (UC) and Crohn's disease (CD). The aim of the study was to determine the diagnostic accuracy of Platelet mass Index (PMI) and other platelet parameters in assessment disease activity in patients with UC and CD. A cross-sectional, observational study consisted of 60 IBD patients (30 UC and 30 CD) and 30 healthy subjects (Control group). Patients were grouped according to disease activity into active and inactive (remission). Platelet count (PLC), Plateletcrit (PCT), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) and PMI were determined for all study participants. Receiver operating characteristic (ROC) curve and their corresponding areas under the curve (AUC) were used to determine diagnostic accuracy. Although PLC had the highest AUC (0.756) compared to PCT (AUC: 0.731), PDW (AUC: 0.722) and PMI (AUC: 0.724), they all had fair diagnostic accuracy in distinguishing active and inactive UC patients. Discriminatory accuracy of PLC was excellent (AUC: 0.909), PCT and PMI good to excellent (AUC: 0.809 and AUC: 0.893, respectively) and PDW fair (AUC: 0.789) in classifying CD patients as active and inactive. Platelet parameters are simple, routinely available biomarkers more useful for assessing disease activity for patients with CD than for patients with UC. Our results indicate, for the first time, that PMI may serve as a novel and simple marker in identifying whether IBD patients are in the active or inactive phase of the disease.

Different qualitative and quantitative changes in platelets are involved in the pathophysiological processes in inflammatory bowel diseases (IBD): ulcerative colitis (UC) and Crohn's disease (CD). The aim of the study was to determine the diagnostic accuracy of Platelet mass Index (PMI) and other platelet parameters in assessment disease activity in patients with UC and CD. A cross-sectional, observational study consisted of 60 IBD patients (30 UC and 30 CD) and 30 healthy subjects (Control group). Patients were grouped according to disease activity into active and inactive (remission). Platelet count (PLC), Plateletcrit (PCT), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) and PMI were determined for all study participants. Receiver operating characteristic (ROC) curve and their corresponding areas under the curve (AUC) were used to determine diagnostic accuracy. Although PLC had the highest AUC (0.756) compared to PCT (AUC: 0.731), PDW (AUC: 0.722) and PMI (AUC: 0.724), they all had fair diagnostic accuracy in distinguishing active and inactive UC patients. Discriminatory accuracy of PLC was excellent (AUC: 0.909), PCT and PMI good to excellent (AUC: 0.809 and AUC: 0.893, respectively) and PDW fair (AUC: 0.789) in classifying CD patients as active and inactive. Platelet parameters are simple, routinely available biomarkers more useful for assessing disease activity for patients with CD than for patients with UC. Our results indicate, for the first time, that PMI may serve as a novel and simple marker in identifying whether IBD patients are in the active or inactive phase of the disease.

Aim To present haemoglobin and ferritin parameters in donors to highlight the importance of serum ferritin testing for the purpose of evaluating iron depots in order to make recommendations for preserving a population of blood donors. Method A prospective study was conducted on 80 blood donors divided in two groups: group I (regular donors, n =40) and group II (irregular donors, n=40). Haemoglobin and ferritin were measured twice every 45 days, before two consecutive blood donations. Results By measuring haemoglobin and ferritin values before donation in both groups, a decrease of initial ferritin value in Group I relative to Group II was observed (without statistical significance). A significant decrease was found between repeated measurements for both parameters in both groups, indicating equal intensity of the decline in value regardless of a donor status. Measurement of ferritin before and after donation revealed statistically significant loss of ferritin in all examinees (p=0.011). The decline in haemoglobin after donation, although significant, did not fall below the reference value for donation in either women or men. Conclusion Results indicate the need for periodic monitoring of the plasma value of ferritin in voluntary donors who donate blood more than twice a year and the possible oral supplementation with iron.

Introduction: Optical coherence tomography angiography (OCT-A) is a useful diagnostic tool for assessing eyes’ health in patients with chronic diseases, such as diabetes, hypertension, Parkinson’s disease and chronic kidney disease (CKD). Aim: To detect changes in macular structure and retinal vascular meshwork in the macular area and peripapillary in patients with chronic kidney disease (CKD). Methods: This cross-sectional study included 80 eyes of patients with CKD in stages 2, 3 or 4, who were followed-up in the Nephrology Clinic of University Clinical Center Sarajevo. All patients were categorized according to the stage of CKD. All patients were scanned by a high-speed 840-nm-wavelength spectral-domain optical coherence tomography instrument (RTVue XR Avanti; Optovue, Inc, Fremont, California, USA). Blood flow was detected using a split-spectrum amplitude-decorrelation angiography algorithm. A fully automated microstructural analysis of the foveal avascular zone (FAZ), FAZ perimeter, foveal vessel density in a 300-μm area around the FAZ (FD), nonflow area, flow index in superficial and deep vascular plexus, choriocapillary flow, vascular density, radial peripapillary capillary density was performed. Results: When comparing patients with CKD stage 2 and stage 3 there were no statistically significant changes in microvascular parameters on OCT angiography, as well as when comparing patients with CKD stage 3 and stage 4. But in the comparison between patients with less developed CKD (stage 2) and terminal CKD (stage 4) there was a significant difference between some microvascular parameters such as FAZ area, FAZ perimeter, choriocapillary flow. Conclusion: Many studies demonstrated that evaluation of the microvascular changes in different retinal layers using SS-OCTA may be considered as a key to assessing the systemic perfusion status. Evaluation of retinal microvasculature may ease the management and approach of patients with CKD, having in mind that the retinal and the kidney vascular network are, concerning structure, development and the function, very similar.