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Chang TI, Tanner JM, Harada ND, Garrett NR, Friedlander AH. Prevalence of calcified carotid artery atheromas on the panoramic images of patients with syndrome Z, coexisting obstructive sleep apnea, and metabolic syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:134-41. [PMID: 22669072 DOI: 10.1016/j.tripleo.2011.07.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 05/31/2011] [Accepted: 07/26/2011] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The objective of this study was to compare the prevalence of calcified carotid artery atheromas (CCAAs) on panoramic images of individuals (n = 31) with obstructive sleep apnea (OSA) with individuals (n = 117) with syndrome Z (SZ: OSA with concomitant metabolic syndrome [MetS]). STUDY DESIGN Images of patients with OSA or SZ referred from the Sleep Service to Dentistry were evaluated. Descriptive statistics and t tests (Bonferroni correction) were conducted to determine significant differences between atheroma prevalence and proatherogenic factors (age, apnea-hypopnea index, body mass index, lipid profile, blood pressure, glucose) between OSA and SZ groups. RESULTS Individuals with OSA had an atheroma prevalence of 35% and those with SZ 42% (P = .52). Individuals with SZ also had significantly more severe atherogenic profiles (obesity, dyslipidemia, hyperglycemia) than OSA patients (P ≤ .05). Greatest CCAA prevalence (63%) was evidenced by SZ patients with severe OSA and moderate MetS. CONCLUSION Individuals with SZ have significantly greater atherogenic burden and slightly higher prevalence of CCAAs when compared with individuals with OSA.
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Affiliation(s)
- Tina I Chang
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California 90073, USA
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High-fat diet induces emergence of brown-like adipocytes in white adipose tissue of spontaneously hypertensive rats. Hypertens Res 2011; 35:279-86. [DOI: 10.1038/hr.2011.188] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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53
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Gupta ND, Greve J. Overweight and obesity and the utilization of primary care physicians. HEALTH ECONOMICS 2011; 20 Suppl 1:53-67. [PMID: 21351183 DOI: 10.1002/hec.1711] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Revised: 11/23/2010] [Accepted: 12/08/2010] [Indexed: 05/30/2023]
Abstract
We investigate whether overweight or obese individuals utilize more medical care than normal weight individuals by estimating a finite mixture model which splits the population into frequent and non-frequent users of primary care physician (GP) services. Based on a survey sample aged 25-60 years from the National Health Interview (NHI) 2000 merged to Danish register data, we compare differences in the impact of being overweight and obese relative to being normal weight on the utilization of GP services. Estimated bodyweight effects vary across latent classes and show that being obese or overweight does not increase the utilization of GP services among infrequent users but does so among frequent users. Obese (and to a lesser extent, overweight) infrequent users are observed 5 years later to substantially increase their health-care usage as measured by doctor visits, hospitalizations, and number of bed days.
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Kim HO, Park MJ, Han JS. Effects of Fermented Red Ginseng Supplementation on Blood Glucose and Insulin Resistance in Type 2 Diabetic Patients. ACTA ACUST UNITED AC 2011. [DOI: 10.3746/jkfn.2011.40.5.696] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Tanner JM, Chang TI, Harada ND, Santiago SM, Weinreb JE, Friedlander AH. Prevalence of comorbid obstructive sleep apnea and metabolic syndrome: syndrome Z and maxillofacial surgery implications. J Oral Maxillofac Surg 2011; 70:179-87. [PMID: 21601341 DOI: 10.1016/j.joms.2011.01.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 01/04/2011] [Indexed: 12/18/2022]
Abstract
PURPOSE To determine the prevalence of the recently identified syndrome Z (SZ), which is the co-occurrence of obstructive sleep apnea (OSA; hypoxia, systemic and pulmonary hypertension, nocturnal arrhythmias) and metabolic syndrome (MetS; increased abdominal girth, hypertriglyceridemia, decreased high-density lipoprotein, hypertension, increased fasting glucose), which places the surgical patient at heightened risk of perioperative complications (myocardial infarction, stroke, pneumonia, wound infection). MATERIALS AND METHODS Electronic medical records of 296 male veterans were assessed for the presence of SZ using the American Academy of Sleep Medicine definition of OSA and a modified Adult Treatment Panel III definition of MetS, where obesity was defined by a body mass index of at least 30 kg/m(2) rather than by waist circumference. RESULTS SZ was diagnosed in 59% of patients. These individuals commonly exhibited severe OSA and least commonly mild OSA. The more severe the OSA, the more likely (60%) that patients manifested moderate (4 risk markers) or severe (5 risk markers) MetS. Furthermore, with increasing apnea-hypopnea index values, the more severe were the MetS elements. CONCLUSIONS The results of this study demonstrate the high prevalence rate of MetS in patients with OSA seeking treatment. Given the risk of perioperative complications, it is suggested that all patients scheduled for maxillofacial surgical procedures to treat OSA be evaluated for SZ.
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Affiliation(s)
- Jeffrey M Tanner
- Oral and Maxillofacial Section, Dental Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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The metabolic syndrome and mind-body therapies: a systematic review. J Nutr Metab 2011; 2011:276419. [PMID: 21773016 PMCID: PMC3136147 DOI: 10.1155/2011/276419] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Accepted: 03/18/2011] [Indexed: 11/18/2022] Open
Abstract
The metabolic syndrome, affecting a substantial and increasing percentage of the worldwide population, is comprised of a cluster of symptoms associated with increased risk of type 2 diabetes, cardiovascular disease, and other chronic conditions. Mind-body modalities based on Eastern philosophy, such as yoga, tai chi, qigong, and meditation, have become increasingly popular worldwide. These complementary therapies have many reported benefits for improving symptoms and physiological measures associated with the metabolic syndrome. However, clinical trial data concerning the effectiveness of these practices on the syndrome as a whole have not been evaluated using a systematic and synthesizing approach. A systematic review was conducted to critically evaluate the data from clinical trials examining the efficacy of mind-body therapies as supportive care modalities for management of the metabolic syndrome. Three clinical trials addressing the use of mind-body therapies for management of the metabolic syndrome were identified. Findings from the studies reviewed support the potential clinical effectiveness of mind-body practices in improving indices of the metabolic syndrome.
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Chao CY, Yin MC, Huang CJ. Wild bitter gourd extract up-regulates mRNA expression of PPARα, PPARγ and their target genes in C57BL/6J mice. JOURNAL OF ETHNOPHARMACOLOGY 2011; 135:156-161. [PMID: 21392566 DOI: 10.1016/j.jep.2011.03.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 01/02/2011] [Accepted: 03/02/2011] [Indexed: 05/30/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Wild bitter gourd (Momordica charantia Linn. var. abbreviata ser.) was commonly used as a medicinal herb in Asia, Africa, and South America because of its anti-diabetic, antibacterial, anti-viral, and chemopreventive functions. MATERIALS AND METHODS C57BL/6J mice were orally administered with 250, 500 or 1000mg/kg BW of WBGE in 0.2mL/mouse of olive oil daily for 2 weeks. RESULTS Compared to control (vehicle treated) mice, mice receiving WBGE showed significantly higher PPARα, ACO (acyl-CoA oxidase) and L-FABP (liver-fatty acid binding protein) mRNA expression, ACO activity and protein in the liver (P<0.05), as clofibrate-treated mice. WBGE treatment also resulted in significantly higher PPARγ and LPL (lipoprotein lipase) mRNA (P<0.05) in the epididymal adipose tissue. Liver triglyceride and non-esterified fatty acid concentration in WBGE treated mice were significantly lower than those of control mice (P<0.05). Plasma adiponectin level was significantly higher in mice receiving WBGE than in control mice (P<0.05), as the rosiglitazone treated mice. CONCLUSION Results of this study demonstrated that WBGE also activates PPARα and PPARγ signaling pathway in vivo.
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Affiliation(s)
- Che-Yi Chao
- Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan.
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Yorulmaz E, Adali G, Yorulmaz H, Ulasoglu C, Tasan G, Tuncer I. Metabolic syndrome frequency in inflammatory bowel diseases. Saudi J Gastroenterol 2011; 17:376-82. [PMID: 22064334 PMCID: PMC3221110 DOI: 10.4103/1319-3767.87177] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIM Metabolic syndrome (MetS) is a clinical condition characterized by central obesity, elevated triglycerides, low-high density lipoproteins, impaired fasting glucose, and hypertension. There is insufficient data on the prevalence of MetS in patients with inflammatory bowel disease (IBD). This study sought to determine the prevalence of MetS in a Turkish cohort of patients with IBD and the association between insulin resistance (IR) and the MetS parameters, in this population. PATIENTS AND METHODS A total of 177 patients over 18 years of age (62 with Crohn's disease (CD) and 115 with ulcerative colitis (UC)) were enrolled in the study. The presence of at least three criteria of the International Diabetes Federation (IDF) was accepted for the diagnosis of MetS. The Homeostasis Model Assessment (HOMA) was used to determine IR. HOMA values < 1 were considered normal and values > 2.5 indicated a high probability of IR. RESULTS MetS frequency was higher in patients n=34 (29.5%) with UC than in patients n=11 (17.7%) with CD (P < 0.01). MetS was detected in 12 of the 117 patients (10.3%) with IBD, under 45 years of age, and in 33 of 60 patients (55%) over 45 years of age. HOMA value in n=31 patients (27%) with UC was > 2.5. Body mass index, insulin (P < 0.001), waist circumference, fasting plasma glucose, leukocyte count (P < 0.01), triglycerides, C-reactive protein, and uric acid values (P < 0.05) were significantly higher in UC patients with IR than those without IR. CONCLUSION Frequent occurrence of MS with increasing age in IBD, particularly in UC, showed the importance of early diagnosis and treatment of cardiovascular disease risk factors in the long-term follow-up of these diseases.
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Affiliation(s)
- Elif Yorulmaz
- Department of Gastroenterology, Goztepe, Training and Research Hospital, Istanbul, Turkey.
| | - Gupse Adali
- Department of Gastroenterology, Goztepe, Training and Research Hospital, Istanbul, Turkey
| | - Hatice Yorulmaz
- Department of Nursing, Halic University School of Nursing, Istanbul, Turkey
| | - Celal Ulasoglu
- Department of Gastroenterology, Goztepe, Training and Research Hospital, Istanbul, Turkey
| | - Guralp Tasan
- Department of Gastroenterology, Goztepe, Training and Research Hospital, Istanbul, Turkey
| | - Ilyas Tuncer
- Department of Gastroenterology, Goztepe, Training and Research Hospital, Istanbul, Turkey
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Metabolic Syndrome and Physical Fitness in a Sample of Azorean Adolescents. Metab Syndr Relat Disord 2010; 8:443-9. [DOI: 10.1089/met.2010.0022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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The G protein β3 subunit C825T polymorphism is associated with microalbuminuria in hypertensive women and cardiovascular disease in hypertensive men. Am J Hypertens 2010; 23:1114-20. [PMID: 20577224 DOI: 10.1038/ajh.2010.131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The aim of the study was to examine the association between the G protein β3 subunit C825T polymorphism, associated with cardiovascular risk factors like hypertension (HT) and obesity and microalbuminuria (MA), reflecting the endothelial dysfunction in the atherosclerotic process. Second, we wanted to examine the association between the polymorphism and cardiovascular disease (CVD). METHODS In the large population-based, cross-sectional Nord-Trøndelag Health Study, HUNT 1995-1997, a total of 5,755 treated hypertensive individuals attended the MA substudy. A randomly selected sample of 1,000 of these was genotyped. A total of 402 men and 540 women were included in the final analyses. MA was measured as albumin/creatinine ratio (ACR) in three urine samples. Logistic regression was used to calculate odds ratios (ORs) for the association between MA or CVD and the genotype. RESULTS The study demonstrated a positive association between the TT genotype and MA in women (OR 3.2, 95% confidence interval (CI): 1.1-8.7, P = 0.03), but not in men. The association became stronger with increasing number of positive urine samples and with increasing cutoff value in women with TT genotype compared to the CC genotype. Additionally, there was a positive association between TT genotype and CVD in men and postmenopausal women without hormone therapy. CONCLUSIONS Increased MA in TT homozygous women might be explained by other mechanisms of albuminuria or inflammation than the atherosclerotic process. We postulate that the association between CVD and the genotype are mediated through mechanisms other than the classical risk factors and endothelial dysfunction, reflected by MA, which have to be further investigated.
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Researchers in sports medicine are key players in the field of preventive health care. Clin J Sport Med 2010; 20:338-9. [PMID: 20818189 DOI: 10.1097/jsm.0b013e3181f193da] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Moebus S, Balijepalli C, Lösch C, Göres L, von Stritzky B, Bramlage P, Wasem J, Jöckel KH. Age- and sex-specific prevalence and ten-year risk for cardiovascular disease of all 16 risk factor combinations of the metabolic syndrome - A cross-sectional study. Cardiovasc Diabetol 2010; 9:34. [PMID: 20696055 PMCID: PMC2929217 DOI: 10.1186/1475-2840-9-34] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2010] [Accepted: 08/09/2010] [Indexed: 01/26/2023] Open
Abstract
Background Based on the AHA/NHLBI-definition three out of five cardiometabolic traits must be present for the diagnosis of the metabolic syndrome (MetS), resulting in 16 different combination types. The associated cardiovascular risk may however be different and specific combination may be indicative of an increased risk, furthermore little is known to which extent these 16 combinations contribute to the overall prevalence of MetS. Here we assessed the prevalence of all 16 combination types of MetS, analyzed the impact of age and gender on prevalence rates, and estimated the 10-year risk of fatal and non-fatal myocardial infarction (MI) of each MetS combination type. Methods We used data of the German Metabolic and Cardiovascular Risk Project (GEMCAS), a cross-sectional study, performed during October 2005, including 35,869 participants (aged 18-99 years, 61% women). Age-standardized prevalence and 10-year PROCAM and ESC risk scores for MI were calculated. Results In both men and women the combination with elevated waist-circumference, blood pressure and glucose (WC-BP-GL) was the most frequent combination (28%), however a distinct unequal distribution was observed regarding age and sex. Any combination with GL was common in the elderly, whereas any combination with dyslipidemia and without GL was frequent in the younger. Men without MetS had an estimated mean 10-year risk of 4.7% (95%-CI: 4.5%-4.8%) for MI (PROCAM), whereas the mean 10-year risk of men with MetS was clearly higher (age-standardized 7.9%; 7.8-8.0%). In women without MetS the mean 10-year risk for MI was 1.1%, in those with MetS 2.3%. The highest impact on an estimated 10-year risk for MI (PROCAM) was observed with TG-HDL-GL-BP in both sexes (men 14.7%, women 3.9%). However, we could identify combinations with equal risks of non-fatal and fatal MI compared to participants without MetS. Conclusions We observed large variations in the prevalence of all 16 combination types and their association to cardiovascular risk. The importance of different combinations of MetS changes with age and between genders putting emphasis on a tailored approach towards very young or very old subjects. This knowledge may guide clinicians to effectively screen individuals and prioritize diagnostic procedures depending on age and gender.
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Affiliation(s)
- Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Germany.
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Warensjo E, Nolan D, Tapsell L. Dairy food consumption and obesity-related chronic disease. ADVANCES IN FOOD AND NUTRITION RESEARCH 2010; 59:1-41. [PMID: 20610172 DOI: 10.1016/s1043-4526(10)59001-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Dairy food comprises a range of different products with varying nutritional components. In the context of a healthy diet, dairy food may provide protection against and amelioration of chronic diseases related to obesity. These include overweight, insulin resistance/metabolic syndrome/type 2 diabetes, hypertension/stroke, and cardiovascular disease. Eliciting how dairy food may have this impact represents a challenge for modern nutritional science and requires an integration of knowledge from observational studies of population dietary patterns and disease prevalence, and experimental studies testing the effect of dairy food consumption. It also benefits from the recent identification of biomarkers of dairy fat intake and from mechanistic studies that support the plausibility of the observed effects. Future research might discriminate between types of dairy foods and focus on the synergy provided by the food matrix, rather than simply the component parts of the food.
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Affiliation(s)
- Eva Warensjo
- Department of Surgical Sciences, Orthopedics, and Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala, Sweden
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Rodríguez-Sanabria F, Rull A, Aragonès G, Beltrán-Debón R, Alonso-Villaverde C, Camps J, Joven J. Differential response of two models of genetically modified mice fed with high fat and cholesterol diets: relationship to the study of non-alcoholic steatohepatitis. Mol Cell Biochem 2010; 343:59-66. [PMID: 20512524 DOI: 10.1007/s11010-010-0498-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Accepted: 05/12/2010] [Indexed: 12/31/2022]
Abstract
Research on the molecular basis of the hepatic alterations associated to obesity is dependent on the availability of suitable animal models. Apolipoprotein E deficient mice (ApoE(-/-)) and LDL-receptor deficient mice (LDLr(-/-)) develop steatosis and steatohepatitis when given pro-atherogenic diets. However, previous data suggest that these two models are not completely interchangeable, and that their metabolic phenotype may partially differ in response to nutrient stimuli. The present study further investigates this question, by comparing changes in hepatic inflammation, lipoprotein metabolism, and their related gene expressions. LDLr(-/-) mice were more susceptible to the development of obesity and hepatic steatosis, while the ApoE(-/-) model increased the amount of macrophages and inflammatory nodules in the liver. These changes were accompanied by a differential expression of selected members of the MAPK family and PPARs in the liver.
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Affiliation(s)
- Fernando Rodríguez-Sanabria
- Centre de Recerca Biomèdica, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Reus, Spain
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Koya-Miyata S, Arai N, Mizote A, Taniguchi Y, Ushio S, Iwaki K, Fukuda S. Propolis prevents diet-induced hyperlipidemia and mitigates weight gain in diet-induced obesity in mice. Biol Pharm Bull 2010; 32:2022-8. [PMID: 19952422 DOI: 10.1248/bpb.32.2022] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We examined the hypolipidemic effect of propolis in a mouse obesity model induced by a high fat-diet. C57BL/6N mice were fed a high-fat diet ad libitum and given propolis extract intragastrically at 0 mg/kg (control), 5 mg/kg or 50 mg/kg twice daily for 10 d. Compared with mice in the control group, mice in the propolis extract-administrated groups displayed a reduction in all of the following parameters: body weight gain, weight of visceral adipose tissue, liver and serum triglycerides, cholesterol, and non-esterified fatty acids. Real-time polymerase chain reaction analysis of the liver showed down-regulation of mRNA expression associated with fatty acid biosynthesis, including fatty acid synthase, acetyl-CoA carboxylase alpha, and sterol regulatory element binding protein in the propolis-administrated mice. Subsequently, obese C57BL/6N mice that had been administered a high-fat diet were given propolis extract at 0 mg/kg (control), 2.5 mg/kg or 25 mg/kg for 4 weeks. The propolis extract treated mice showed a decrease in weight gain, a reduction of serum non-esterified fatty acids, and lipid accumulation in the liver. These results suggest that propolis extract prevented and mitigated high-fat diet-induced hyperlipidemia by down-regulating the expression of genes associated with lipid metabolism.
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Affiliation(s)
- Satomi Koya-Miyata
- Biomedical Institute, Research Center, Hayashibara Biochemical Laboratories, Inc., 675-1 Fujisaki, Naka-ku, Okayama 702-8006, Japan.
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Gao XR, Adhikari CM, Peng LY, Guo XG, Zhai YS, He XY, Zhang LY, Lin J, Zuo ZY. Efficacy of different doses of aspirin in decreasing blood levels of inflammatory markers in patients with cardiovascular metabolic syndrome. J Pharm Pharmacol 2010. [DOI: 10.1211/jpp.61.11.0010] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract
Objectives
Inflammation and platelet aggregation and activation are key processes in the initiation of a cardiovascular event. Patients with metabolic syndrome have a high risk of cardiovascular events. This study determined whether small and medium doses of aspirin have anti-inflammation and antiplatelet aggregation effects in patients with metabolic syndrome.
Methods
One hundred and twenty-one consecutive patients with metabolic syndrome were randomized into three groups, receiving 100 mg/day of aspirin, 300 mg/day of aspirin or a placebo, respectively, for 2 weeks. The blood levels of thromboxane B2 (TXB2), a stable product of the platelet aggregation mediator TXA2, 6-keto-prostaglandin F1-α (6-keto-PGF1-α), a stable product of the endogenous cyclooxygenase metabolite prostaglandin I2, and inflammatory mediators including high-sensitivity C-reactive protein (hs-CRP), tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6), were determined by ELISA and radioimmunoassay.
Key findings
The blood levels of hs-CRP, TNF-α, IL-6 and TXB2 were significantly decreased after 2 weeks of treatment with 300 mg/day of aspirin. Patients who received 100 mg/day of aspirin had decreased blood levels of hs-CRP and TXB2. The blood level of IL-6 in the 300 mg/day aspirin group was significantly lower than that in the other two groups after 2 weeks of therapy. Aspirin at either dose did not affect the blood level of 6-keto-PGF1-α.
Conclusions
Aspirin at all doses suppresses the blood levels of inflammatory markers and the platelet aggregation mediator TXA2 in Chinese patients with metabolic syndrome. Since the suppression induced by 300 mg/day of aspirin was greater than that induced by 100 mg/day of aspirin, these data suggest that 300 mg/day of aspirin may be beneficial in decreasing the risk of cardiovascular events in Chinese patients with metabolic syndrome.
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Affiliation(s)
- Xiu-ren Gao
- Department of Cardiology, First Affiliated Hospital, Zhong-Shan University, Guangzhou, China
| | - Chandar M Adhikari
- Department of Cardiology, First Affiliated Hospital, Zhong-Shan University, Guangzhou, China
| | - Long-yun Peng
- Department of Cardiology, First Affiliated Hospital, Zhong-Shan University, Guangzhou, China
| | - Xiao-gang Guo
- Department of Cardiology, First Affiliated Hospital, Zhong-Shan University, Guangzhou, China
| | - Yuan-sheng Zhai
- Department of Cardiology, First Affiliated Hospital, Zhong-Shan University, Guangzhou, China
| | - Xu-yu He
- Department of Cardiology, First Affiliated Hospital, Zhong-Shan University, Guangzhou, China
| | - Li-Yuan Zhang
- Department of Cardiology, First Affiliated Hospital, Zhong-Shan University, Guangzhou, China
| | - Jun Lin
- Department of Cardiology, First Affiliated Hospital, Zhong-Shan University, Guangzhou, China
| | - Zhi-yi Zuo
- Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA
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Gündogan K, Bayram F, Capak M, Tanriverdi F, Karaman A, Ozturk A, Altunbas H, Gökce C, Kalkan A, Yazıcı C. Prevalence of Metabolic Syndrome in the Mediterranean Region of Turkey: Evaluation of Hypertension, Diabetes Mellitus, Obesity, and Dyslipidemia. Metab Syndr Relat Disord 2009; 7:427-34. [DOI: 10.1089/met.2008.0068] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kürsat Gündogan
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Fahri Bayram
- Department of Metabolism and Endocrinology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Mehmet Capak
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Fatih Tanriverdi
- Department of Metabolism and Endocrinology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ahmet Karaman
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ahmet Ozturk
- Department of Biostatistics, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Hasan Altunbas
- Department of Endocrinology and Metabolism, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Cumali Gökce
- Department of Metabolism and Endocrinology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Ali Kalkan
- Department of Internal Medicine, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Cevad Yazıcı
- Department of Biochemistry and Clinical Biochemistry, Erciyes University Medical Faculty, Kayseri, Turkey
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Psychosocial Status and Health Related Quality of Life in Relation to the Metabolic Syndrome in a Swedish Middle-Aged Population. Eur J Cardiovasc Nurs 2009; 8:207-15. [DOI: 10.1016/j.ejcnurse.2009.01.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2008] [Revised: 12/12/2008] [Accepted: 01/27/2009] [Indexed: 11/19/2022]
Abstract
Background: The Metabolic Syndrome (MS) is a combination of risk factors related to increased risk of cardiovascular disease. Psychosocial factors and stress have been suggested to be important determinants. Aim: To analyse how psychosocial factors, perceived stress and health related quality of life are related to MS, and assess if observed associations are dependent of life-style. Methods: A cross-sectional study of a random sample of 502 men and 505 women aged 45–69, from southeast Sweden, including fasting blood samples, blood pressure, anthropometrics, self-reported data of life-style, psychosocial status and health related quality of life (SF-36). Linear regression models were adjusted for age and, in a second step, also for life-style. Results: Men and women with MS reported lower levels of physical activity, lower scores on physical and social dimensions of SF-36, and women with MS reported stronger effect of social change compared to those without MS ( p < 0.05), but we found no differences for mental health or perceived stress. The major part of observed associations was lost after adjustment for effects of life-style. Conclusion: Our data speak against a direct effect of social stress on MS via psychological strain but suggest an indirect pathway via a sedentary life-style.
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Ebenezer PJ, Mariappan N, Elks CM, Haque M, Soltani Z, Reisin E, Francis J. Effects of pyrrolidine dithiocarbamate on high-fat diet-induced metabolic and renal alterations in rats. Life Sci 2009; 85:357-64. [PMID: 19631668 DOI: 10.1016/j.lfs.2009.06.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Revised: 05/28/2009] [Accepted: 06/29/2009] [Indexed: 12/11/2022]
Abstract
AIMS We investigated the effects of the nuclear factor kappa B (NFkappaB) blocker pyrrolidine dithiocarbamate (PDTC) on high-fat diet (HFD)-induced metabolic and renal alterations in obese and lean Zucker rats (OZR and LZR, respectively). MAIN METHODS Rats were fed a HFD resembling the typical "Western" diet or a regular diet (RD) and allowed free access to tap water or tap water containing PDTC (150 mg/kg body weight) for 10 weeks; rats were then sacrificed. Total ROS production rates were measured using electron paramagnetic resonance spectroscopy, and superoxide production was measured with lucigenin assay. Blood, plasma, and urine were analyzed. Semi-quantitative reverse transcriptase-polymerase chain reaction and electrophoretic mobility shift assay were conducted to assess NFkappaB mRNA levels and DNA binding activities, respectively; immunofluorescence was performed to assess protein levels. KEY FINDINGS OZR-HFD rats exhibited significantly higher levels of total renal cortical reactive oxygen species production, plasma lipids, insulin, C-reactive protein, blood urea nitrogen, creatinine, and urinary albumin excretion than all other groups (p<0.05); these changes were accompanied by a significant decrease in plasma high density lipoprotein levels (p<0.05). Gene expression levels of desmin, cytokine and oxidative stress genes were significantly higher in the renal cortical tissues of OZR-HFD; NFkappaB p65 DNA binding activity was also significantly higher in these animals. PDTC attenuated these changes. SIGNIFICANCE Our data suggest that NFkappaB blockade may prove beneficial in treating the nephropathy often associated with metabolic syndrome.
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Affiliation(s)
- Philip J Ebenezer
- Department of Comparative Biomedical Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, LA 70803, USA
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70
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Relationship between long-term coffee consumption and components of the metabolic syndrome: the Amsterdam Growth and Health Longitudinal Study. Eur J Epidemiol 2009; 24:203-9. [DOI: 10.1007/s10654-009-9323-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Accepted: 02/23/2009] [Indexed: 10/21/2022]
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71
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Maynadier M, Basile I, Gary-Bobo M. Adiponectin normalization: a clue to the anti-metabolic syndrome action of rimonabant. Drug Discov Today 2009; 14:192-7. [DOI: 10.1016/j.drudis.2008.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Revised: 09/19/2008] [Accepted: 09/29/2008] [Indexed: 02/07/2023]
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72
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Mohler ML, He Y, Wu Z, Hwang DJ, Miller DD. Recent and emerging anti-diabetes targets. Med Res Rev 2009; 29:125-95. [DOI: 10.1002/med.20142] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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73
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Cardioprotection by Postconditioning Is Lost in WOKW Rats With Metabolic Syndrome: Role of Glycogen Synthase Kinase 3β. J Cardiovasc Pharmacol 2008; 52:430-7. [DOI: 10.1097/fjc.0b013e31818c12a7] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Oron-Herman M, Kamari Y, Grossman E, Yeger G, Peleg E, Shabtay Z, Shamiss A, Sharabi Y. Metabolic syndrome: comparison of the two commonly used animal models. Am J Hypertens 2008; 21:1018-22. [PMID: 18566592 DOI: 10.1038/ajh.2008.218] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The etiology of the metabolic syndrome (MS) includes both genetic and environmental factors. The two most commonly studied animal models of the MS are the high-sucrose diet given to spontaneously hypertensive rats (SHRs) and high-fructose diet given to Sprague Dawley rats (SDRs). This study compares between these two models. METHODS The two rat strains were examined; within each group, the rats were assigned to either the high-sugar diet (SDRs with fructose-enriched diet and SHRs with sucrose-enriched diet) or standard rat chow (control group). The rats were followed for 7 weeks. The main MS components (obesity, hypertension, impaired glucose tolerance, hyperinsulinemia, hypertriglyceridemia, and hypercholesterolemia) were measured. RESULTS At baseline systolic blood pressure (SBP), fasting blood levels of triglycerides and insulin, as well as glucose intolerance, were significantly higher among the SHRs compared to SDRs. Following fructose enrichment, SDRs became hyperinsulinemic, hypertriglyceridemic, hypercholesterolemic, hypertensive, and insulin resistant, whereas SHRs responded to sucrose supplementation by a significant elevation in blood pressure and mild worsening of insulin resistance. Endpoint results revealed superiority of sucrose--SHR model in terms of hypertension and superiority of fructose--SDR model in terms of hyperinsulinemia, hypertriglyceridemia, and hypercholesterolemia. Both models showed similar postintervention degree of glucose tolerance. CONCLUSIONS The fructose-fed SDR model represents a predominantly environmentally acquired MS, whereas the SHR model is less affected by dietary intervention and better displays the predominantly genetic spontaneous appearance of the syndrome. This fundamental difference should be taken into consideration when choosing an animal model to study the MS.
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Fenofibrate improves endothelial function and decreases thrombin-activatable fibrinolysis inhibitor concentration in metabolic syndrome. Blood Coagul Fibrinolysis 2008; 19:310-4. [PMID: 18469553 DOI: 10.1097/mbc.0b013e3283009c69] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Procoagulant state, inflammation, and endothelial dysfunction have been documented in metabolic syndrome. Endothelial dysfunction is a strong predictor of cardiovascular events. Studies on the association of thrombin-activatable fibrinolysis inhibitor and thrombosis are still controversial, but substantial evidence suggests that increased thrombin-activatable fibrinolysis inhibitor or thrombin-activatable fibrinolysis inhibits or protects against arterial thrombosis. This study aimed to assess concomitantly the effects of fenofibrate therapy on thrombin-activatable fibrinolysis inhibitor concentrations and endothelial functions in patients with metabolic syndrome. Twenty-five patients (16 women; mean age 50.4 +/- 7.0) were enrolled in the study. Plasma thrombin-activatable fibrinolysis inhibitor, C-reactive protein, and fibrinogen levels were measured before fenofibrate administration and after 8 weeks of fenofibrate treatment. Endothelial function was assessed by endothelial-dependent flow-mediated dilatation from brachial artery. Pretreatment (baseline) thrombin-activatable fibrinolysis inhibitor level was 52.3 (1.2-119.7) decreasing to 7.7 (0.9-51.2; P < 0.001) after 8 weeks of fibrate treatment. Endothelial functions, which were measured with flow-mediated dilatation, were significantly improved after treatment (mean flow-mediated dilatation was 6.76 +/- 2.21 at baseline and 10.66 +/- 1.17% after 8 week of fenofibrate treatment, P < 0.001). Fenofibrate decreases thrombin-activatable fibrinolysis inhibitor levels and improves endothelial function in metabolic syndrome and, thus, suggests a potential for protection against cardiovascular effects. Further studies are warranted to confirm the effects of fibrates on thrombin-activatable fibrinolysis inhibitor and for conclusive evidence on the association between thrombin-activatable fibrinolysis inhibitor and thrombosis.
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Mi J, Cheng H, Zhao XY, Hou DQ, Chen FF, Zhang KL. Developmental origin of metabolic syndrome: interaction of thinness at birth and overweight during adult life in Chinese population. Obes Rev 2008; 9 Suppl 1:91-4. [PMID: 18307707 DOI: 10.1111/j.1467-789x.2007.00446.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the present study we explore the association between the ponderal index (PI) at birth and the metabolic syndrome (MetS) in middle-aged population in China. A total of 975 men and women aged 41-52 years with detailed birth records were followed up and recruited for clinic examinations, involving anthropometry and measurements of blood pressure, fasting plasma glucose, serum lipid profile. The MetS was diagnosed according to the National Cholesterol Education Program (Adult Treatment Panel III) definition. Multivariate logistic regression analysis estimated the effect of PI on MetS and the interaction between PI at birth and adult body mass index (BMI). The average prevalence of MetS was 19.3%, with rates of 23.7%, 22.9%, 16.9% and 16.5% in those who at birth were <25th percentile, the 25th-50th percentile, the 50th-75th percentile and >75th percentile PI respectively, with a significant decreasing trend (x(2) (for trend) = 5.661, P = 0.017). Logistic regression analysis showed that 25.7% of the occurrence of MetS was attributable to PI at birth and adult BMI both acting independently and synergistically. In summary thinness at birth predicts the later occurrence of MetS, as well as modifying the association between later BMI and MetS. Overweight later in life was most deleterious for those with growth retardation at birth.
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Affiliation(s)
- J Mi
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
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78
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Kim M, Lee H, Park H, Kim W. Risk Factors Associated with Metabolic Syndrome in Korean Elderly. ANNALS OF NUTRITION AND METABOLISM 2008; 51:533-40. [DOI: 10.1159/000112977] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Accepted: 06/25/2007] [Indexed: 12/20/2022]
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McCullough ML, Patel AV, Patel R, Rodriguez C, Feigelson HS, Bandera EV, Gansler T, Thun MJ, Calle EE. Body mass and endometrial cancer risk by hormone replacement therapy and cancer subtype. Cancer Epidemiol Biomarkers Prev 2008; 17:73-9. [PMID: 18187388 DOI: 10.1158/1055-9965.epi-07-2567] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Epidemiologic studies unequivocally show that greater body mass increases the risk of endometrial cancer, but whether risk varies by use of postmenopausal hormone therapy (HT), location of fat deposition, or cancer subtype is still unclear. We examined these associations among 33,436 postmenopausal women in the Cancer Prevention Study II Nutrition Cohort, who completed questionnaires on diet, lifestyle, and medical history at baseline in 1992. A total of 318 cases were eligible through June 2003. Cox-proportional hazards analyses were used to estimate multivariate-adjusted rate ratios (RR). As expected, adult body mass index (BMI) was a strong predictor of risk [RR, 4.70; 95% confidence interval (CI), 3.12-7.07 for BMI 35+ versus 22.5-25.0, P trend < 0.0001]. Use of estrogen plus progestin postmenopausal HT modified the association. Among never-users, risk was significantly linear across the entire range of BMI examined (RR, 0.51; 95% CI, 0.29-0.92 for <22.5 versus 22.5-25.0; RR, 4.41; 95% CI, 2.70-7.20 for > or =35 versus 22.5-25.0, P trend < 0.0001), but among ever estrogen plus progestin users, the association was not significant (P trend = 1.0; P interaction < 0.0001). We observed no difference in risk according to tendency for central versus peripheral fat deposition. Greater BMI (> or =30 versus <25.0) increased risk of both "type I" (classic estrogen pathway, RR, 4.22; 95% CI, 3.07-5.81) and "type II" (serous, clear cell, and all other high grade) cancers (RR, 2.87; 95% CI, 1.59-5.16). The increased risk of endometrial cancer across the range of BMI in women who never used postmenopausal HT stresses the need to prevent both overweight and obesity in women.
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Affiliation(s)
- Marjorie L McCullough
- Epidemiology and Surveillance Research, American Cancer Society, 250 Williams Street, Atlanta, GA 30303-1002, USA.
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80
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Izumi Y, Ishibashi G, Nakanishi Y, Kikunaga S. Beneficial effect of 3% milled-rice on blood glucose level and serum lipid concentrations in spontaneously non-insulin-dependent diabetic rats. J Nutr Sci Vitaminol (Tokyo) 2007; 53:400-9. [PMID: 18079606 DOI: 10.3177/jnsv.53.400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Three percent milled-rice was evaluated for beneficial effect on blood glucose level and serum lipid concentrations in an experiment with Otsuka Long-Evans Tokushima Fatty (OLETF) rats, used as model animals for spontaneously non-insulin-dependent diabetes mellitus. The same experiment was carried out using Long-Evans Tokushima Otsuka (LETO) rats, the control of the OLETF rats. The results obtained from the rats given a diet containing 3% milled-rice (3% MRD) ad libitum were compared with those from rats given polished rice. During the feeding period of 140 d, body weight of the OLETF rats receiving the 3% MRD was significantly lower than that of the rats fed on the diet containing polished rice (PRD) from the 48th to the 124th days. The body weight of the LETO rats during the both periods of 90 to 104 d and 114 to 140 d was lower than that of the rats receiving the PRD. Though food intakes of the rats receiving 3% MRD were significantly lower in the OLETF and LETO rats during the two periods of days 48 to 124 and days 1 to 140 than in the rats of the PRD group, the feed efficiency of the OLETF or LETO rats did not show significant difference between the 3% MRD and the PRD groups during the same experimental periods. The excretion rate of feces of the OLETF rats receiving the 3% MRD was significantly higher than that of the rats receiving the PRD, both on the 126th day and during the period of days 129 to 131. The fasting blood glucose levels were significantly lower in the OLETF rats receiving the 3% MRD than the rats receiving the PRD on the 84th day, the 105th day and the 127th day, and also lower in the LETO rats receiving the 3% MRD on the 84th day and the 105th day. The incremental areas under the curve of blood glucose concentrations (IAUC-Glc) for 120 min after oral administration of glucose on the 133rd day was lower in the OLETF rats receiving 3% MRD than that of the PRD. The ratio of IAUC-Glc in the 3% MRD to PRD group, after ingestion of diets for 1 h after fasting for 18 h on the 138th day, was 0.89 in the OLETF rats, and 0.74 in the LETO rats. Compared with the PRD group, the amounts of cholesterol and bile acid in the feces of the OLETF rats in the 3% MRD group were significantly higher on days 129-131, and the cholesterol excretion was significantly higher on the 84th day in the OLETF rats in the 3% MRD group. The liver weight, the level of total lipids in liver, and the concentrations of triglyceride and total cholesterol in liver and serum of the OLETF rats on the 140th day were significantly lower in the 3% MRD than those of the PRD group. These results indicate that 3% milled-rice has beneficial effects on blood glucose level and serum lipid concentrations in spontaneously non-insulin-dependent diabetic rats.
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Affiliation(s)
- Yumiko Izumi
- Faculty of Sciences of Human Life, Notre Dame Seishin University, Okayama, Japan
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81
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82
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Nomikos T, Detopoulou P, Fragopoulou E, Pliakis E, Antonopoulou S. Boiled wild artichoke reduces postprandial glycemic and insulinemic responses in normal subjects but has no effect on metabolic syndrome patients. Nutr Res 2007. [DOI: 10.1016/j.nutres.2007.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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83
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Innes KE, Vincent HK. The influence of yoga-based programs on risk profiles in adults with type 2 diabetes mellitus: a systematic review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2007; 4:469-86. [PMID: 18227915 PMCID: PMC2176136 DOI: 10.1093/ecam/nel103] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2006] [Accepted: 11/13/2006] [Indexed: 12/12/2022]
Abstract
There is growing evidence that yoga may offer a safe and cost-effective intervention for Type 2 Diabetes mellitus (DM 2). However, systematic reviews are lacking. This article critically reviews the published literature regarding the effects of yoga-based programs on physiologic and anthropometric risk profiles and related clinical outcomes in adults with DM 2. We performed a comprehensive literature search using four computerized English and Indian scientific databases. The search was restricted to original studies (1970-2006) that evaluated the metabolic and clinical effects of yoga in adults with DM 2. Studies targeting clinical populations with cardiovascular disorders that included adults with comorbid DM were also evaluated. Data were extracted regarding study design, setting, target population, intervention, comparison group or condition, outcome assessment, data analysis and presentation, follow-up, and key results, and the quality of each study was evaluated according to specific predetermined criteria. We identified 25 eligible studies, including 15 uncontrolled trials, 6 non-randomized controlled trials and 4 randomized controlled trials (RCTs). Overall, these studies suggest beneficial changes in several risk indices, including glucose tolerance and insulin sensitivity, lipid profiles, anthropometric characteristics, blood pressure, oxidative stress, coagulation profiles, sympathetic activation and pulmonary function, as well as improvement in specific clinical outcomes. Yoga may improve risk profiles in adults with DM 2, and may have promise for the prevention and management of cardiovascular complications in this population. However, the limitations characterizing most studies preclude drawing firm conclusions. Additional high-quality RCTs are needed to confirm and further elucidate the effects of standardized yoga programs in populations with DM 2.
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Affiliation(s)
- Kim E. Innes
- Center for the Study of Complementary and Alternative Therapies and Department of Physical Medicine and Rehabilitation, University of Virginia Health Systems, Charlottesville, VA, USA
| | - Heather K. Vincent
- Center for the Study of Complementary and Alternative Therapies and Department of Physical Medicine and Rehabilitation, University of Virginia Health Systems, Charlottesville, VA, USA
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MacDonald MLE, Singaraja RR, Bissada N, Ruddle P, Watts R, Karasinska JM, Gibson WT, Fievet C, Vance JE, Staels B, Hayden MR. Absence of stearoyl-CoA desaturase-1 ameliorates features of the metabolic syndrome in LDLR-deficient mice. J Lipid Res 2007; 49:217-29. [PMID: 17960025 DOI: 10.1194/jlr.m700478-jlr200] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A combination of the interrelated metabolic risk factors obesity, insulin resistance, dyslipidemia, and hypertension, often described as the "metabolic syndrome," is known to increase the risk of developing cardiovascular disease and diabetes. Stearoyl-coenzyme A desaturase (SCD) activity has been implicated in the metabolic syndrome, but detailed studies of the beneficial metabolic effects of SCD deficiency have been limited. Here, we show that absence of the Scd1 gene product reduces plasma triglycerides and reduces weight gain in severely hyperlipidemic low density lipoprotein receptor (LDLR)-deficient mice challenged with a Western diet. Absence of SCD1 also increases insulin sensitivity, as measured by intraperitoneal glucose and insulin tolerance testing. SCD1 deficiency dramatically reduces hepatic lipid accumulation while causing more modest reductions in plasma apolipoproteins, suggesting that in conditions of sustained hyperlipidemia, SCD1 functions primarily to mediate lipid stores. In addition, absence of SCD1 partially ameliorates the undesirable hypertriglyceridemic effect of antiatherogenic liver X receptor agonists. Our results demonstrate that constitutive reduction of SCD activity improves the metabolic phenotype of LDLR-deficient mice on a Western diet.
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Affiliation(s)
- Marcia L E MacDonald
- Centre for Molecular Medicine and Therapeutics, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
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85
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Gabler NK, Spurlock ME. Integrating the immune system with the regulation of growth and efficiency. J Anim Sci 2007; 86:E64-74. [PMID: 17911231 DOI: 10.2527/jas.2007-0466] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Muscle growth in meat animals is a complex process governed by integrated signals emanating from multiple endocrine and immune cells. A generalized phenomenon among meat animal industries is that animals commonly fail to meet their genetic potential for growth in commercial production settings. Recent evidence indicates that adipocytes and myofibers are equipped with functional pattern recognition receptors and are capable of responding directly to the corresponding pathogens and other receptor ligands. Thus, these cells are active participants in the innate immune response and, as such, produce a number of immune and metabolic regulators, including proinflammatory cytokines and adiponectin. Specifically, the transcription factor, nuclear factor kappa B, is activated in adipocytes and muscle cells by bacterial lipopolysaccharide and certain saturated fatty acids, which are potent agonists for the Toll-like receptor-4 pattern recognition receptor. Receptor activation results in the local production of interleukin-6 and tumor necrosis factor-alpha, and creates a local environment by which these cytokines regulate both metabolic and immunological pathways. However, adipocytes are also the predominant source of the antiinflammatory hormone, adiponectin, which suppresses the activation of nuclear factor kappa B and the production of proinflammatory cytokines. The molecular ability to recognize antigens and produce regulatory molecules strategically positions adipocytes and myofibers to regulate growth locally and to reciprocally regulate metabolism in peripheral tissues.
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Affiliation(s)
- N K Gabler
- Departments of Food Science & Human Nutrition and Animal Science, Iowa State University, Ames, IA 50011, USA
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Tiwari S, Halagappa VKM, Riazi S, Hu X, Ecelbarger CA. Reduced expression of insulin receptors in the kidneys of insulin-resistant rats. J Am Soc Nephrol 2007; 18:2661-71. [PMID: 17855644 DOI: 10.1681/asn.2006121410] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Insulin resistance is accompanied by hyperinsulinemia and activation of the renin-angiotensin system, both of which are associated with hypertension. Because the kidney plays a major role in the regulation of blood pressure, we studied the regulation of insulin receptor expression in the kidney during states of insulin resistance. Using two rat models of insulin resistance, Western blot analysis demonstrated a significant reduction in the expression of insulin receptor subunits in the kidney compared to lean control rats. Treatment of insulin resistance in Zucker rats with the insulin-sensitizing drug rosiglitazone partially restored renal insulin receptor levels. Conversely, treatment with the angiotensin II type 1 receptor (AT1) antagonist candesartan increased renal insulin receptor expression compared to untreated rats. Streptozotocin-induced hyperglycemia, which results from hypoinsulinemia, reduced expression of renal insulin receptors. Hyperinsulinemia induced by insulin infusion, however, did not produce a similar effect. In conclusion, insulin receptors are downregulated in the kidneys of insulin resistant rats, possibly mediated by hyperglycemia and angiotensin II.
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Affiliation(s)
- Swasti Tiwari
- Department of Medicine, Georgetown University, Box 571412, Washington, DC 20057-1412, USA.
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87
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Bonfanti P, Giannattasio C, Ricci E, Facchetti R, Rosella E, Franzetti M, Cordier L, Pusterla L, Bombelli M, Sega R, Quirino T, Mancia G. HIV and metabolic syndrome: a comparison with the general population. J Acquir Immune Defic Syndr 2007; 45:426-31. [PMID: 17514013 DOI: 10.1097/qai.0b013e318074ef83] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To compare the prevalence of metabolic syndrome (MS) in HIV-positive patients with that from a sample of a general Italian population. DESIGN Cross-sectional study. METHODS A total of 1263 HIV-infected patients 18 years of age or older were recruited in 18 centers for infectious diseases in northern and central Italy. Controls were 2051 subjects aged 25 to 74 years representative of the residents of Monza, a town in Milan province, who were enrolled in the Pressioni Arteriose Monitorate E Loro Associazioni study. RESULTS The prevalence of MS in the HIV group was 20.8%, whereas in the control group, it was only 15.8%, with the difference being statistically significant. The age- and gender-adjusted risk of having MS in HIV-infected patients was twice as great as that in controls. Compared with controls, HIV-infected patients had a greater prevalence of the impaired fasting glucose, increased plasma triglycerides, and reduced high-density lipoprotein cholesterol components. MS prevalence was similar in treated and never-treated HIV-infected patients, and so were the various MS components. CONCLUSIONS The risk of MS is greater in HIV-infected patients compared with the general population because of a greater prevalence of lipid and glucose abnormalities. The prevalence of MS and its components is similar in treated and untreated HIV-positive patients.
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Affiliation(s)
- Paolo Bonfanti
- Department of Infectious Diseases, Luigi Sacco Hospital, Via G.B. Grassi 44, 20157 Milan, Italy.
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Hollman G, Kristenson M. The prevalence of the metabolic syndrome and its risk factors in a middle-aged Swedish population--mainly a function of overweight? Eur J Cardiovasc Nurs 2007; 7:21-6. [PMID: 17586094 DOI: 10.1016/j.ejcnurse.2007.05.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2006] [Revised: 05/17/2007] [Accepted: 05/21/2007] [Indexed: 11/26/2022]
Abstract
BACKGROUND The prevalence of obesity, one risk factor for developing the metabolic syndrome (MS), has increased during the last decades. It has therefore been assumed that the prevalence of MS would also increase. AIMS The aim was to analyse the prevalence of MS and its risk factors in a middle-aged Swedish population. METHODS Data were obtained between 2003 and 2004 from a random population based sample of 502 men and 505 women, 45-69 years old. Measures of plasma glucose, serum lipids, blood pressure, weight, height, waist circumference and self-reported data concerning presence of disease, medication and lifestyle were obtained. RESULTS The prevalence of MS was 14.8% among men and 15.3% among women, with an increase by age among women only, 10% to 25% (p=0.029). Among individuals with MS the most frequent risk factor was large waist circumference, present in 85% of men and 99% of women, followed by high blood pressure, high triglycerides, high glucose and HDL cholesterol (38% and 47% respectively). CONCLUSION The prevalence of MS was 15%, increasing with age only among women. Overweight was a dominant characteristic, and only half of the individuals with MS had glucose/HDL cholesterol levels beyond defined cut points of the syndrome.
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Affiliation(s)
- Gunilla Hollman
- Department of Medicine and Care, Division of Nursing Sciences, Faculty of Health Sciences, Linköping University, 581 85 Linköping, Sweden.
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Jacobi SK, Gabler NK, Ajuwon KM, Davis JE, Spurlock ME. Adipocytes, myofibers, and cytokine biology: new horizons in the regulation of growth and body composition. J Anim Sci 2007; 84 Suppl:E140-9. [PMID: 16582086 DOI: 10.2527/2006.8413_supple140x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Muscle growth in meat animals is a complex process governed by integrated signals emanating from multiple endocrine and immune cells. A generalized phenomenon among meat animal industries is that animals commonly fail to meet their genetic potential for growth in commercial production settings. Therefore, understanding the impact of stress and disease on muscle growth is essential to improving production efficiency. The adipocyte in particular seems to be well positioned as an interface between energy status and immune function, and may thus influence nutrient partitioning and growth through a combination of signals that influence fat metabolism, glucose uptake, and insulin sensitivity. Adipocytes and myofibers are active participants in the innate immune response, and as such, produce a number of metabolic regulators, including leptin, adiponectin, and proinflammatory cytokines. Specifically, adipocytes and muscle cells respond directly to bacterial lipopolysaccharide (LPS) by producing interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNFalpha). However, adipocytes are also the predominant source of the antiinflammatory hormone adiponectin, which regulates the nuclear factor kappa-B transcription factor. The ability to recognize antigens and produce regulatory molecules strategically positions adipocytes and myofibers to regulate growth locally, and to reciprocally regulate metabolism peripherally.
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Affiliation(s)
- S K Jacobi
- Department of Animal Sciences, Center for Comparative Medicine, Purdue University, West Lafayette, IN 47907, USA
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Ford ES, Li C, McGuire LC, Mokdad AH, Liu S. Intake of dietary magnesium and the prevalence of the metabolic syndrome among U.S. adults. Obesity (Silver Spring) 2007; 15:1139-46. [PMID: 17495189 DOI: 10.1038/oby.2007.628] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Limited data suggest that people with the metabolic syndrome have lower intakes or circulating concentrations of magnesium than those who do not have the syndrome. The aim of this study was to examine the associations between dietary intake of magnesium and the prevalence of the metabolic syndrome in a nationally representative sample of U.S. adults. RESEARCH METHODS AND PROCEDURES We used data for 7669 participants > or =20 years of age of the Third National Health and Nutrition Examination Survey (1988 to 1994). The metabolic syndrome was defined using the criteria of the National Cholesterol Education Program. Magnesium intake was determined from a single dietary 24-hour recall. RESULTS The unadjusted prevalences of the metabolic syndrome were 29.0% (quintile of lowest magnesium intake), 27.5%, 25.8%, 23.9%, and 21.8% for increasing quintiles of magnesium intake (p for trend = 0.002). After multiple adjustment, the odds ratios for the second through the fifth quintiles (highest intake) of magnesium intake among all participants included in the analysis were 0.84 [95% confidence interval (CI): 0.58, 1.23], 0.76 (95% CI: 0.54, 1.07), 0.62 (95% CI: 0.40, 0.98), and 0.56 (95% CI: 0.34, 0.92), respectively (p for trend = 0.029). The associations were similar for men and women. DISCUSSION Our results showing an inverse association between dietary magnesium intake and the prevalence of the metabolic syndrome add to the evidence that adequate magnesium intake or a diet rich in magnesium may be important for maintaining good cardiometabolic health.
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Affiliation(s)
- Earl S Ford
- Centers for Disease Control and Prevention, 4770 Buford Highway, MS K66, Atlanta, GA 30341, USA.
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91
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Friedlander AH, Weinreb J, Friedlander I, Yagiela JA. Metabolic syndrome: pathogenesis, medical care and dental implications. J Am Dent Assoc 2007; 138:179-87; quiz 248. [PMID: 17272372 DOI: 10.14219/jada.archive.2007.0134] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The dental literature contains little information about metabolic syndrome (MetS) and its dental implications. TYPES OF STUDIES REVIEWED The authors conducted a MEDLINE search for the period 2000 through 2005, using the term "metabolic syndrome" to define its pathophysiology, medical treatment and dental implications. RESULTS MetS is the co-occurrence of abdominal obesity, hyper-triglyceridemia, reduced high-density lipoprotein cholesterol levels, hypertension and impaired fasting glucose, which results from consumption of a high-calorie diet and decreased levels of physical activity superimposed on the appropriate genetic setting. Components of MetS synergistically promote the development of atherosclerosis, resulting in myocardial infarction and stroke. CLINICAL IMPLICATIONS Deteriorating oral health status is associated with worsening of the atherogenic profile. Tooth loss often results in chewing difficulties because of inadequate occlusive surfaces and may lead to alterations in food selection and dietary quality. This, in turn, adversely affects body composition and nutritional status, both of which are related to vascular health. Dentists should develop treatment plans that preserve and restore the dentition, thus ensuring maximum masticatory efficiency and affording patients the optimum opportunity to consume food that will not foster atherogenesis.
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Affiliation(s)
- Arthur H Friedlander
- Graduate Medical Education, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.
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92
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Di Cianni G, Lencioni C, Volpe L, Ghio A, Cuccuru I, Pellegrini G, Benzi L, Miccoli R, Del Prato S. C-reactive protein and metabolic syndrome in women with previous gestational diabetes. Diabetes Metab Res Rev 2007; 23:135-40. [PMID: 16770838 DOI: 10.1002/dmrr.661] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND This study evaluates the presence of metabolic syndrome (MS) and its association with C-reactive protein (CRP) and other cardiovascular (CV) risk factors, in a sample of women with and without previous Gestational Diabetes (pGDM). METHODS One hundred and sixty-six women with pGDM and 98 women (controls) with uncomplicated pregnancy were studied 16 months after delivery. In all women, plasma glucose, insulin, lipid profile, serum uric acid, C-reactive protein, fibrinogen and homocysteine were measured. MS was defined according to NCEP ATPIII criteria. RESULTS MS was identified in 15 pGDM women (9%) versus 1 control (1%) (p < 0.001). The more frequent metabolic traits were abdominal obesity (36% vs 17%) and low HDL-cholesterol (34% vs 17% in pGDM women and controls, respectively; all p < 0.01). HOMA-R, LDL-cholesterol, fibrinogen, serum uric acid and CRP resulted significantly higher in pGDM women with MS as compared to those without MS after adjustment for BMI. In women with no criteria for MS, only CRP levels were found to be higher in pGDM women compared to controls (p < 0.05). Seventeen percent of pGDM women with no criteria for MS had CRP levels >or=1 mg/L (all controls showed CRP levels <1 mg/L). After a stepwise regression analysis, CRP levels were independently correlated to HOMA-R (r2 = 0.27, p < 0.001) and fibrinogen (r2 = 0.30, p < 0.001). CONCLUSIONS In our population, MS occurs in a sizable proportion of pGDM women and is associated with increased levels of CRP, fibrinogen, uric acid and LDL-cholesterol. Moreover, higher levels of CRP, a marker of chronic low-grade inflammation, are present in a subset of women with pGDM, independently of MS.
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Affiliation(s)
- G Di Cianni
- Department of Endocrinology and Metabolism, Section of Diabetes and Metabolic Diseases, University of Pisa and Azienda Ospedaliera Pisana, Pisa, Italy.
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93
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Santini F, Giannetti M, Mazzeo S, Fierabracci P, Scartabelli G, Marsili A, Valeriano R, Pucci A, Anselmino M, Zampa V, Vitti P, Pinchera A. Ultrasonographic evaluation of liver volume and the metabolic syndrome in obese women. J Endocrinol Invest 2007; 30:104-10. [PMID: 17392599 DOI: 10.1007/bf03347407] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Non-alcoholic fatty liver disease is a common finding in obese subjects, and increasing evidence has been provided suggesting that it represents the hepatic component of the metabolic syndrome. The aim of this study was to evaluate whether the extent of liver enlargement is related to the severity of the metabolic syndrome in obese women. The relationship between ultrasound- measured hepatic left lobe volume (HLLV) and various features of the metabolic syndrome was evaluated in 85 obese women. The mean+/-SD value of HLLV in obese women was 431+/-214 ml (range 46-1019 ml) while it was 187+/-31 ml (range 143-258 ml) in lean subjects. In a multiple logistic regression analysis, ultrasound-measured intra-abdominal fat was the only anthropometric measure independently associated with HLLV. A strong positive association was found between HLLV and serum liver enzymes, triglycerides, glucose, insulin, uric acid, C reactive protein, systolic and diastolic blood pressure, while a negative correlation was observed between HLLV and HDL cholesterol. The values of HLLV corresponding to the cut-off values of various risk factors for the diagnosis of the metabolic syndrome were calculated, yielding a mean value of 465 ml. In conclusion, ultrasound measurement of HLLV represents a simple, reliable and low-cost tool for the evaluation of liver involvement in the metabolic syndrome. The strong association between liver enlargement and various cardiovascular risk factors associated with insulin resistance supports the role of liver steatosis as an important link among the many facets of the metabolic syndrome in human obesity.
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Affiliation(s)
- F Santini
- Department of Endocrinology and Metabolic Diseases, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy.
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94
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Aoki F, Honda S, Kishida H, Kitano M, Arai N, Tanaka H, Yokota S, Nakagawa K, Asakura T, Nakai Y, Mae T. Suppression by licorice flavonoids of abdominal fat accumulation and body weight gain in high-fat diet-induced obese C57BL/6J mice. Biosci Biotechnol Biochem 2007; 71:206-14. [PMID: 17213668 DOI: 10.1271/bbb.60463] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We applied licorice flavonoid oil (LFO) to high-fat diet-induced obese C57BL/6J mice and investigated its effect. LFO contains hydrophobic flavonoids obtained from licorice by extraction with ethanol. The oil is a mixture of medium-chain triglycerides, having glabridin, a major flavonoid of licorice, concentrated to 1.2% (w/w). Obese mice were fed on a high-fat diet containing LFO at 0 (control), 0.5%, 1.0%, or 2.0% for 8 weeks. Compared with mice in the control group, those in the 1% and 2% LFO groups efficiently reduced the weight of abdominal white adipose tissues and body weight gain. A histological examination revealed that the adipocytes became smaller and the fatty degenerative state of the hepatocytes was improved in the 2% LFO group. A DNA microarray analysis of the liver showed up-regulation of those genes for beta-oxidation and down-regulation of those for fatty acid synthesis in the 2% LFO group. These findings suggest that LFO prevented and ameliorated diet-induced obesity via the regulation of lipid metabolism-related gene expression in the liver.
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Affiliation(s)
- Fumiki Aoki
- Functional Food Ingredients Division, Kaneka Corporation, Japan
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95
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González-Sánchez JL, Martínez-Larrad MT, Sáez ME, Zabena C, Martínez-Calatrava MJ, Serrano-Ríos M. Endothelial Nitric Oxide Synthase Haplotypes Are Associated with Features of Metabolic Syndrome. Clin Chem 2007; 53:91-7. [PMID: 17110473 DOI: 10.1373/clinchem.2006.075176] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Abstract
Background: The metabolic syndrome, a cluster of several metabolic disorders, is increasingly being recognized as a risk factor for cardiovascular disease. Endothelium-derived nitric oxide facilitates skeletal muscle glucose uptake, and data from animal models indicate that endothelial nitric oxide synthase (eNOS) gene–null mice present with a phenotype of insulin resistance, hypertension, and hypertriglyceridemia, much like that observed in humans with metabolic syndrome. We used haplotype tagging single nucleotide polymorphisms (htSNPs) to investigate the role of genetic variation in the eNOS gene (NOS3) in metabolic syndrome in humans.
Methods: We recruited 738 unrelated persons from a cross-sectional population-based epidemiological survey in the province of Segovia in Central Spain (Castille). Metabolic syndrome was defined according to the recently modified National Cholesterol Education Program Adult Treatment Panel III guidelines.
Results: Haplotype analysis showed a statistically significant association between some NOS3 gene variants and features of metabolic syndrome. Relative to the most common haplotype, 121, the haplotype 212 was associated with an increased odds ratio (OR) for metabolic syndrome [OR = 1.81, 95% confidence interval (CI) 1.15–2.84], and for decreased HDL-cholesterol concentrations (OR 1.52, 95% CI 1.01–2.29), and with increased mean values for the homeostasis model assessment of insulin resistance (P = 0.043), and triglycerides (P = 0.026).
Conclusions: Our results suggest that genetic variation at the eNOS locus is associated with features of metabolic syndrome, and might represent a new genetic susceptibility component for insulin resistance, hypertriglyceridemia, and low HDL-cholesterol concentrations.
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96
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Joo S, Lee S, Choi HA, Kim J, Kim E, Kimm K, Kim J, Shin C. Habitual snoring is associated with elevated hemoglobin A1clevels in non-obese middle-aged adults. J Sleep Res 2006; 15:437-44. [PMID: 17118101 DOI: 10.1111/j.1365-2869.2006.00556.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Hemoglobin A(1c) (HbA(1c)) is an indicator of long-term glycemic control. The purpose of this study was to determine whether habitual snoring is associated with increased HbA(1c) levels in non-obese and normoglycemic middle-aged men and women. A total of 6981 subjects (3362 men and 3619 women) aged 40-69 years from the Korean Health and Genome Study were examined for the study. Each participant received a comprehensive physical examination as well as a set of questions pertaining to demographic characteristics and snoring frequency. Habitual snoring was defined as a snoring frequency of > or = 4 days week(-1). After adjusting for age, abdominal obesity, and other confounding covariates, male habitual snorers showed a 1.69-fold excess [95% confidence interval (CI) 1.30-2.19] odds of having a high HbA(1c) level. Similarly, premenopausal women with habitual snoring had a 2.31 times (95% CI 1.22-4.39) significantly higher odds of having elevated HbA(1c)levels compared with non-snorers. This association was not found in postmenopausal women. Multivariate analysis revealed that male habitual snorers aged 40-50 had a 2.08-fold excess (95% CI 1.40-3.09) risk of having an elevated HbA(1c) level. In male habitual snores over 50, the strength of association was attenuated. Our findings based on cross-sectional data support a hypothesis that habitual snoring is associated with impaired glucose tolerance even in non-obese and normoglycemic men and premenopausal women. However, as waist circumference as an index of abdominal obesity (visceral adiposity) in the present study may only partially represent the effect of visceral fat, there may be a residual confounding from visceral obesity in our result. Longitudinal follow-up studies are necessary to confirm the association between sleep-disordered breathing and impaired glucose tolerance and to examine the causal relationship in a healthy population without obesity and diabetes.
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Affiliation(s)
- Soonjae Joo
- Institute of Human Genomic Study, Korea University Medical Science Research Center, Seoul, Korea
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97
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Abstract
Pre-eclampsia is a common and potentially dangerous disorder of human pregnancy. The maternal syndrome of hypertension, proteinuria and oedema is part of a severe systemic inflammatory response that includes leukocyte and endothelial cell activation. Although the origins of pre-eclampsia remain unclear, a major cause is the failure to develop an adequate blood supply to the placenta, leading to placental oxidative stress. This results in the excess release of placental factors, such as syncytiotrophoblast debris or soluble fms-like tyrosine kinase-1 (sFlt-1), the soluble receptor for vascular endothelial growth factor (VEGF), into the maternal circulation, where they trigger an inflammatory response and endothelial dysfunction. Alternatively, pre-eclampsia can develop in the presence of a normal placenta in women that are susceptible to systemic inflammation, such as with chronic cardiovascular disease or diabetes. While clinical management of pre-eclampsia does not currently include anti-inflammatory agents, current research is focusing on ways to reduce inflammation and oxidative stress.
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Affiliation(s)
- A M Borzychowski
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford OX3 9DU, UK.
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98
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Di Bello V, Santini F, Di Cori A, Pucci A, Palagi C, Delle Donne MG, Fierabracci P, Marsili A, Talini E, Giannetti M, Biadi O, Balbarini A, Mariani M, Pinchera A. Obesity cardiomyopathy: is it a reality? An ultrasonic tissue characterization study. J Am Soc Echocardiogr 2006; 19:1063-71. [PMID: 16880104 DOI: 10.1016/j.echo.2006.03.033] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2005] [Indexed: 12/26/2022]
Abstract
Obesity is a well-established risk factor for congestive heart failure. Evidence has been provided indicating that insulin resistance could be the mediator between obesity and congestive heart failure, but the pathogenic mechanisms leading to myocardial alterations remain unclear. The aim of this study was to investigate, by ultrasonic integrated backscatter (IBS) analysis, subclinical alterations of left ventricular (LV) structure and function in severe obesity. Sixty consecutive, severely obese people, who were otherwise healthy (15 men, 45 women; mean age +/- SD = 31.8 +/- 7 years), were enrolled. A total of 48 sex- and age-matched nonobese healthy participants were recruited as control subjects. All participants underwent conventional 2-dimensional color Doppler echocardiography, pulsed wave Doppler tissue imaging at mitral annulus level, and IBS. The homeostasis model assessment insulin resistance index was used to assess insulin resistance; the index values in the obese group were significantly higher (mean +/- SD = 4.9 +/- 1.4) than in the control group (0.92 +/- 0.5, P < .0001). Obese patients had a greater LV mass index by height (58.5 +/- 14 g/m(2.7)) than did control subjects (37 +/- 8 g/m(2.7), P < .0001) because of compensation response to volume overload caused by a greater cardiac output (P < .02). Preload reserve was increased in obese patients, as demonstrated by the significant increase in left atrial dimension (P < .0001). This volumetric increase activated the Frank-Starling mechanism, and determined a significantly higher LV ejection fraction (P < .03) in obese patients as compared with control subjects. A slightly reduced LV diastolic function was demonstrated in obese patients (transmitral early to late peak diastolic transmitral flow velocities ratio = 1.1 +/- 0.7) as compared with control subjects (1.5 +/- 0.5, P < .02). Pulsed wave Doppler tissue imaging showed an impairment of diastolic LV longitudinal function and increased LV diastolic filling pressure. The IBS values at septum level, indexed by pericardium interface, were significantly higher for septum in the obese group (57.8 +/- 8%) than in the control group (42.3 +/- 9%, P < .0001). Additional IBS alterations were observed in the obese group, with a significantly lower cyclic variation index both at septum (P < .0001) and at posterior wall (P < .001) levels. A significant association was found between insulin resistance index and both the IBS index of myocardial reflectivity at septum level (expression of increased myocardial collagen content) or LV mass. In conclusion, this study demonstrates that obese patients exhibit myocardial structural and functional alterations related to insulin resistance and to LV volume overload, which could be considered the very early stage of incipient obesity cardiomyopathy.
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99
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Twedell D. Metabolic syndrome. J Contin Educ Nurs 2006; 37:150-1. [PMID: 16892664 DOI: 10.3928/00220124-20060701-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Diane Twedell
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
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100
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Grallert H, Huth C, Kolz M, Meisinger C, Herder C, Strassburger K, Giani G, Wichmann HE, Adamski J, Illig T, Rathmann W. IL-6 promoter polymorphisms and quantitative traits related to the metabolic syndrome in KORA S4. Exp Gerontol 2006; 41:737-45. [PMID: 16797905 DOI: 10.1016/j.exger.2006.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2006] [Revised: 04/28/2006] [Accepted: 05/02/2006] [Indexed: 01/09/2023]
Abstract
Interleukin-6 (IL-6) is a pleiotropic cytokine which has been proposed as "cytokine for gerontologists" and linked to age-related metabolic disturbances such as the metabolic syndrome or type 2 diabetes. Polymorphisms located in the promoter region of IL-6 have been reported to be involved in the regulation of IL-6 transcription. This study investigates whether IL-6 promoter variants -174 G/C and -573 G/C are associated with quantitative traits related to the metabolic syndrome (International Diabetes Federation criteria) in a population of normoglycemic subjects (n=878) from the latest KORA survey (KORA S4). Genotyping was performed using MALDI-TOF MS. Besides lower height (p=0.01) the -174 CC genotype was independently associated with lower waist (p=0.002) and hip (p=0.01) circumferences in men. Furthermore, the -174 CC genotype was associated with BMI (p=0.004) when adjusted for waist and hip circumference. The present study does not suggest associations with further components of the metabolic syndrome. The association with height seems to be the central factor indicating an influence of IL-6 on growth through impaired bone metabolism. However, the complex relationships need further investigation.
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Affiliation(s)
- Harald Grallert
- GSF National Research Center for Environment and Health, Institute of Epidemiology, Germany
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