Digital Public Defence: Sasha Dushanov

MD Sasha Dushanov at Institute of Clincal Medicine will be defending the thesis Metabolic syndrome, gastrointestinal hormones and persistent organic pollutants in morbid obesity and effects of diet on persistent organic pollutants for the degree of PhD (Philosophiae Doctor).

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The public defence will be held as a video conference over Zoom.

The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.

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Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.

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Adjudication committee

  • First opponent: Senior Consultant Eirik Søfteland, Haukeland University Hospital, Bergen
  • Second opponent: Associate Senior Lecturer Samira Salihovic, Örebro University, Sweden
  • Third member and chair of the evaluation committee: Professor Emeritus Ingebjørg Seljeflot, Institute of Clinical Medicine, University of Oslo

Chair of defence

Professor II Jøran Hjelmesæth, Institute of Clinical Medicine, University of Oslo

Principal Supervisor

Group Leader Serena Tonstad, Oslo University Hospital

Summary

Obesity is one of the most complex public health challenges the world faces today. According to WHO, 13% of the global population is affected. Persons with a body mass index (BMI) ≥ 35 kg/m2 with co-morbidities are considered morbidly obese, while BMI ≥ 40 kg/m2 characterizes extreme obesity.

Metabolic syndrome is a cluster of risk factors that includes increased waist circumference, disturbances in lipids and glucose, as well as high blood pressure. Metabolic syndrome increases the risk of inflammation resulting in cardiovascular disease and diabetes, and is influenced by genes, lifestyle, socio-economic status and hormones. Persistent organic pollutants (POPs) are novel markers that may lead to metabolic disorders. 

Papers I-III
The studies were designed to understand whether metabolic syndrome is more prevalent with increasing BMI in persons with morbid and extreme obesity, and its relation to the gastrointestinal hormone peptide YY3-36 (PYY3-36) and POPs. Cross-sectional studies were based on participants referred to the Oslo University Hospital, Section for preventive cardiology (2005 - 2010). We examined the associations between metabolic syndrome and PYY3-36 (I), metabolic syndrome and BMI (II), and metabolic syndrome and POPs (III). The results showed that in extremely obese patients PYY3-36 was associated with systolic blood pressure (r = 0.21; P< 0.0001), but not with other metabolic risk factors. BMI showed expected associations with inflammatory markers, but paradoxical relationships between fat distribution and metabolic syndrome were seen in women (r =- 0.20, P= 0.02 for truncal fat; r=-0.42, P< 0.0001 for peripheral fat). In the morbidly obese, metabolic syndrome was related to high circulating levels of POPs (odds ratio 2.0-2.5). 

Paper IV
Both fatty fish and nuts in the diet may help to prevent cardiovascular diseases, but it is still uncertain whether fatty fish may increase levels of POPs. We performed a randomized controlled diet trial in volunteers with at least 1 component of metabolic syndrome in addition to high waist circumference. Men and women (n=131) were randomized to consume fatty fish (500-560 g farmed salmon and one tin of mackerel)/week, to 200g nuts (mixed hazelnuts, walnuts and almonds)/week,  or to avoid both fatty fish and nuts for a period of 6 months.  The results indicated that short term of high fatty fish or nuts intake did not increase levels of POPs in comparison to a diet without fatty fish or nuts.

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Published Apr. 20, 2021 11:30 AM - Last modified May 5, 2021 12:30 PM