Cardiovascular morbidity and mortality associated with the metabolic syndrome

Sleep Satisfaction May Modify the Association between Metabolic Syndrome and BMI, Respectively, and Occupational Stress in Japanese Office Workers

The association between obesity and psychological stress is ambiguous. The aim is to investigate the association between metabolic syndrome (MetS) and body mass index (BMI), respectively, with occupational stress among Japanese office workers. The study is a secondary analysis of the intervention group from a randomized controlled trial. There are 167 participants included in the analysis. Occupational stress is self-reported using the Brief Job Stress Questionnaire (BJSQ). BMI and the classification of MetS/pre-MetS was based on the participants’ annual health check-up data. The primary exposure is divided into three groups: no MetS, pre-MetS, and MetS in accordance with Japanese guidelines. The secondary exposure, BMI, remains as a continuous variable. Multiple linear regression is implemented. Sensitivity analyses are stratified by sleep satisfaction. Pre-MetS is significantly associated with occupational stress (7.84 points; 95% CI: 0.17, 15.51). Among participants with low sleep satisfaction, pre-MetS (14.09 points; 95% CI: 1.71, 26.48), MetS (14.72 points; 95% CI: 0.93, 28.51), and BMI (2.54 points; 95% CI: 0.05, 4.99) are all significantly associated with occupational stress. No significant associations are observed in participants with high sleep satisfaction. The findings of this study indicate that sleep satisfaction may modify the association between MetS and BMI, respectively, and occupational stress.

Factors Affecting the Health-Related Quality of Life of Cancer Survivors According to Metabolic Syndrome

BACKGROUND

Cancer survivors face an increased risk of non-cancer-related deaths, particularly associated with metabolic syndrome. With increased cancer survivors having metabolic syndrome, health-related quality of life beyond cancer diagnosis and treatment has assumed greater importance.

OBJECTIVE

This study evaluated the prevalence rate of metabolic syndrome in cancer survivors. It examined the correlation between health-related quality of life and influencing factors according to the prevalence of metabolic syndrome.

METHODS

This is a cross-sectional national study using secondary data from the 2010-2018 Korean National Health and Nutrition Examination Survey by the Korea Disease Control and Prevention Agency. We analyzed a final sample of 1293 cancer survivors using multiple regression.

RESULTS

The prevalence rate of metabolic syndrome in cancer survivors was measured at 32.1%. Cancer survivors with metabolic syndrome had a lower health-related quality of life than those without it. The difference was statistically significant. Compared with cancer survivors without metabolic syndrome, those with it experienced substantial negative effects from stress, reducing health-related quality of life. Walking and muscle-building workouts had a positive effect on stress and improved quality of life.

CONCLUSIONS

Cancer survivors' metabolic syndrome should be monitored closely. Development of a customized intervention program including stress management and physical activities improves their health-related quality of life.

IMPLICATIONS FOR PRACTICE

Stress management and physical activities increase health-related quality of life among cancer survivors with metabolic syndrome; thus, healthcare providers should implement intervention programs that promote exercise engagement and stress management for this population.

Beneficial effects of intermittent fasting: a narrative review

Caloric restriction is a popular approach to treat obesity and its associated chronic illnesses but is difficult to maintain for a long time. Intermittent fasting is an alternative and easily applicable dietary intervention for caloric restriction. Moreover, intermittent fasting has beneficial effects equivalent to those of caloric restriction in terms of body weight control, improvements in glucose homeostasis and lipid profiles, and anti-inflammatory effects. In this review, the beneficial effects of intermittent fasting are discussed.

Correlates of Metabolic Syndrome in Patients with Schizophrenia: An Exploratory Study

Metabolic syndrome (MS) is commonly reported in patients with severe mental illness including schizophrenia, but data is sparse from north-western India. The study was aimed to assess the metabolic profile in patients with schizophrenia. Patients with schizophrenia and healthy controls (N = 55 in each group) were recruited from psychiatric outpatient clinic and evaluated for the presence of metabolic syndrome using the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) criteria. Prevalence of MS was significantly greater in patient group (34.5%), compared to healthy controls (14.5%). Other 31 patients (56.4%) had one or two metabolic abnormalities. Most common metabolic abnormality was higher waist circumference in both the groups. Nearly half of the patients (56%) were obese. Greater age, weight, body mass index, and obesity were significantly associated with MS and similar variables were significant predictors of MS. MS was not associated with duration and severity of schizophrenia (PANSS score), attitude towards psychotropics (DAI-10 score), functionality (GAF score) and demographic variables. Metabolic abnormalities were significantly greater in patients with schizophrenia. It calls for comprehensive evaluation of the patients with schizophrenia, with timely management and effective prevention of metabolic problems.

Insulin: The master regulator of glucose metabolism

Insulin is the master regulator of glucose, lipid, and protein metabolism. Following ingestion of an oral glucose load or mixed meal, the plasma glucose concentration rises, insulin secretion by the beta cells is stimulated and the hyperinsulinemia, working in concert with hyperglycemia, causes: (i) suppression of endogenous (primarily reflects hepatic) glucose production, (ii) stimulation of glucose uptake by muscle, liver, and adipocytes, (iii) inhibition of lipolysis leading to a decline in plasma FFA concentration which contributes to the suppression of hepatic glucose production and augmentation of muscle glucose uptake, and (iv) vasodilation in muscle, which contributes to enhanced muscle glucose disposal. Herein, the integrated physiologic impact of insulin to maintain normal glucose homeostasis is reviewed and the molecular basis of insulin's diverse actions in muscle, liver, adipocytes, and vasculature are discussed.

Postprandial Glycemic Dips Are Associated With Metabolic Disorders and CVD Risk in Euglycemic Individuals

CONTEXT

Metabolic disorders and cardiovascular disease (CVD) threaten human health. Many studies have assessed the phenomenon of metabolic disorders and CVD in patients with diabetes. However, in euglycemic individuals, the relationships between glucose regulation, metabolism, and CVD remain unclear.

OBJECTIVE

This work aimed to explore the associations between postprandial glucose dips, metabolic disorders, and CVD risk.

METHODS

We analyzed data from the Thyroid disorders, Iodine status and Diabetes Epidemiological survey (TIDE study), which included 38 878 euglycemic individuals from all 31 provinces of mainland China. The prevalence of metabolic disorders and their related components and CVD risk were calculated according to postprandial glucose dips. Logistic regression models of quartiles of postprandial glucose dips were used to further explore whether the prevalence of these disorders was associated with postprandial glucose dips.

RESULTS

Odds ratios for the fourth vs the first quartile of glucose dips were 0.59 (95% CI, 0.55-0.63) (P < .001) for metabolic disorders, 0.48 (95% CI 0.44-0.53) (P < .001) for metabolic syndrome (MetS), and 0.54 (95% CI, 0.50-0.59) (P < .001) for hyperuricemia. The odds ratio of a 10-year CVD risk greater than 20% for the fourth vs the first glucose dip quartile was 0.67 (95% CI, 0.52-0.85) (P < .001). Models adjusted for body mass index yielded similar results.

CONCLUSION

Postprandial glucose dips are associated with metabolic disorders, MetS and its related component diseases, and CVD risk. Glucose dips may be a marker of underlying metabolic abnormalities.

Relationships between enabling services use and access to care among adults with cardiometabolic risk factors: findings from the 2014 National Health Center Patient Survey

BACKGROUND

Community health centers (CHCs) provide comprehensive primary and preventive care to medically underserved, low-income, and racially/ethnically diverse populations. CHCs also offer enabling services, non-clinical assistance to reduce barriers to healthcare due to unmet social and material needs, to improve access to healthcare and reduce health disparities. For patients with modifiable cardiometabolic risk factors, including obesity, hypertension, and diabetes, enabling services may provide additional support to improve disease management. However, little is known about the relationship between enabling services and healthcare accessibility and utilization among patients with cardiometabolic risk factors.

METHODS

This study uses data from the 2014 Health Center Patient Survey to examine the relationship between enabling services use and delayed/foregone care, routine check-ups, and emergency room visits, among adult community health center patients in the United States with cardiometabolic risk factors (N = 2358). Outcomes of enabling services users were compared to nonusers using doubly robust propensity score matching methods and generalized linear regression models.

RESULTS

Overall, enabling service users were 15.4 percentage points less likely to report delayed/foregone care and 29.4 percentage points more likely to report routine check-ups than nonusers. Enabling service users who lived in urban areas, younger and middle-aged adults, and those with two cardiometabolic risk factors were also less likely to report delayed/foregone care and/or more likely to report routine check-ups in comparison with nonusers. However, among adults with three or more cardiometabolic risk factors, enabling services use was associated with a 41.3 percentage point increase in emergency room visits and a 7.6 percentage point decrease in routine check-ups.

CONCLUSIONS

The findings highlight the value in utilizing enabling services to improve timeliness and receipt of care among CHC patients with heightened cardiometabolic risk. There is a need for targeting high-risk populations with additional enabling services to support management of multiple chronic conditions.

Soft bioelectronics for cardiac interfaces

Bioelectronics for interrogation and intervention of cardiac systems is important for the study of cardiac health and disease. Interfacing cardiac systems by using conventional rigid bioelectronics is limited by the structural and mechanical disparities between rigid electronics and soft tissues as well as their limited performance. Recently, advances in soft electronics have led to the development of high-performance soft bioelectronics, which is flexible and stretchable, capable of interfacing with cardiac systems in ways not possible with conventional rigid bioelectronics. In this review, we first review the latest developments in building flexible and stretchable bioelectronics for the epicardial interface with the heart. Next, we introduce how stretchable bioelectronics can be integrated with cardiac catheters for a minimally invasive in vivo heart interface. Then, we highlight the recent progress in the design of soft bioelectronics as a new class of biomaterials for integration with different in vitro cardiac models. In particular, we highlight how these devices unlock opportunities to interrogate the cardiac activities in the cardiac patch and cardiac organoid models. Finally, we discuss future directions and opportunities using soft bioelectronics for the study of cardiac systems.

Interaction between sodium-glucose co-transporter 2 and the sympathetic nervous system

PURPOSE OF REVIEW

Sodium-glucose co-transporter 2 (SGLT2) inhibitors have taken centre stage in research and therapeutic efforts to modulate hard clinical outcomes in patients with heightened cardiovascular and renal risk profiles. Sympathetic nervous system (SNS) activation is a prominent feature across several cardiovascular and renal disease states. This review reflects on the remarkable clinical impact of SGLT2 inhibitors on cardiorenal outcomes, and navigates the evidence for a proposed clinically relevant interaction between SGLT2 and the SNS.

RECENT FINDINGS

SGLT2 inhibitors exert several pleiotropic effects beyond glucose-lowering. These include, but are not limited to, diuresis and natriuresis, blood pressure lowering, reduction in inflammation and oxidative stress, stimulation of erythropoiesis, and improvement in cardiac energetics. Treatment with SGLT2 inhibitors is associated with significant improvement in cardiorenal outcomes irrespective of diabetes status. In addition, evidence from preclinical studies points to a strong signal of a bidirectional temporal association between SGLT2 inhibition and reduction in SNS activation.

SUMMARY

Ongoing preclinical and clinical trials aimed at unravelling the proposed interaction between SGLT and SNS will enhance our understanding of their individual and/or collective contributions to cardiovascular disease progression and guide future targeted therapeutic interventions.

YAP Targets the TGFβ Pathway to Mediate High-Fat/High-Sucrose Diet-Induced Arterial Stiffness

BACKGROUND

Metabolic syndrome is related to cardiovascular diseases, which is attributed in part, to arterial stiffness; however, the mechanisms remain unclear. The present study aimed to investigate the molecular mechanisms of metabolic syndrome-induced arterial stiffness and to identify new therapeutic targets.

METHODS

Arterial stiffness was induced by high-fat/high-sucrose diet in mice, which was quantified by Doppler ultrasound. Four-dimensional label-free quantitative proteomic analysis, affinity purification and mass spectrometry, and immunoprecipitation and GST pull-down experiments were performed to explore the mechanism of YAP (Yes-associated protein)-mediated TGF (transforming growth factor) β pathway activation.

RESULTS

YAP protein was upregulated in the aortic tunica media of mice fed a high-fat/high-sucrose diet for 2 weeks and precedes arterial stiffness. Smooth muscle cell-specific YAP knockdown attenuated high-fat/high-sucrose diet-induced arterial stiffness and activation of TGFβ-Smad2/3 signaling pathway in arteries. By contrast, Myh11Cre^ERT2-Yap^Tg mice exhibited exacerbated high-fat/high-sucrose diet-induced arterial stiffness and enhanced TGFβ-activated Smad2/3 phosphorylation in arteries. PPM1B (protein phosphatase, Mg²⁺/Mn²⁺-dependent 1B) was identified as a YAP-bound phosphatase that translocates into the nucleus to dephosphorylate Smads in response to TGFβ. This process was inhibited by YAP through removal of the K63-linked ubiquitin chain of PPM1B at K326.

CONCLUSIONS

This study provides a new mechanism by which smooth muscle cell YAP regulates the TGFβ pathway and a potential therapeutic target in metabolic syndrome-associated arterial stiffness.

Subtypes of Premorbid Metabolic Syndrome and Associated Clinical Outcomes in Older Adults

Background

Metabolic syndrome has been shown to be a risk for new onset of cardiovascular disease (CVD) and type 2 diabetes. The subclasses of metabolic syndrome and any associated adverse health outcomes remain obscure. This study aimed to explore potential subtypes of metabolic syndrome, their associations with incidental diabetes, and any Major Adverse Cardiovascular Events (MACE).

Methods

Data for the retrospective cohort study were extracted from the New Taipei City Elderly Health Examination Database in the years 2014 and 2016. Demographic data, status of metabolic syndrome, its components, and latent class analysis (LCA) were analyzed. All participants were aged 65 years and older, with those having a prior history of CVD, cerebrovascular disease, diabetes mellitus (DM), and currently taking medications for hypertension, diabetes, and dyslipidemia were excluded.

Results

A total of 4,537 senior citizens were enrolled, with 2,207 (48.6%) of them identified as men. The prevalence of both metabolic syndrome and central obesity was increased with age. A 4-latent class model was fitted for participants diagnosed with metabolic syndrome. The central obesity (ABD)+ hyperglycemia (GLU)+ reduced HDL-C (HDL)+ high Blood Pressure (BP) group displayed the highest hazard ratio (HR) for predicting the new onset of diabetes, while the ABD+HDL+BP group showed a high risk for both CVD and MACE when compared after 2 years of follow-up.

Conclusions

This epidemiological analysis demonstrated that the risks of developing new-onset diabetes, CVD, and MACE varied among the different subtypes of metabolic syndrome.

Assessing the psychosocial dimensions of frailty among older adults in Singapore: a community-based cross-sectional study

OBJECTIVE

To examine how multiple dimensions of mental and social health, in addition to physical health, were associated with frailty among older adults.

DESIGN

A door-to-door sampling household community-based survey.

SETTING

Thirty-two public housing blocks within a residential town in Singapore's central region.

PARTICIPANTS

497 residents aged 60 years or older from the public housing town.

OUTCOME MEASURES

Physical frailty was assessed using the FRAIL Scale, which stands for fatigue, resistance, ambulation, illnesses and loss of weight. Physical health was assessed by multimorbidity, physical activity and functional ability; mental illness was assessed by the General Health Questionnaire (GHQ); and social domains were assessed by the Lubben Social Network Scale, Community Integration Measure and UCLA (University of California, Los Angeles) Loneliness Scale.

RESULTS

Compared with robust (59.5%) and prefrail (32.6%) older adults, frail adults (7.9%) reported higher morbidity, lower functional ability and physical activity, higher scores on GHQ, and lower scores on all three social health scales. In multiple regression models, frailty was significantly associated with age 81-90 years (adjusted OR=2.22, 95% CI 1.23 to 3.99), having 2-3 (adjusted OR=1.56, 95% CI 1.02 to 2.38) or >3 (adjusted OR=1.83, 95% CI 1.05 to 3.18) chronic diseases, reduced ability to perform daily tasks without assistance (adjusted OR=0.41, 95% CI 0.23 to 0.73), having fallen in the past 6 months (adjusted OR=2.18, 95% CI 1.18 to 4.06), social dysfunction in GHQ (adjusted OR=1.24, 95% CI 1.08 to 1.43) and loneliness (adjusted OR=1.26, 95% CI 1.06 to 1.50). Physical activity did not remain significantly associated with frailty when mental and social health-related factors were entered in the regression.

CONCLUSION

Community intervention for frailty prevention and management needs to include mental health promotion and social engagement to increase its impact on older adults.

Joint association of meal frequency and diet quality with metabolic syndrome in Iranian adults

BACKGROUND

Metabolic syndrome (MetS) is a common complication that has been shown in various studies to be related to the frequency and timing of eating. We aimed to evaluate the relationship between meal timing and frequency with diet quality and prevalence of MetS.

STUDY DESIGN

Cross-sectional.

METHODS

We analyzed data from 850 adults (20 to 59 years) and divided the participants into different categories in terms of frequency of eating occasions (EO) (5 ≥ , 6-7 and 7 <), meal (2 ≥ and 3) and snack (2 ≥ , 3 and 4 ≤) in a day. Daily food consumption was assessed using the structured three 24-h recalls. The quality of diet we calculated using the food quality score (FQS). Metabolic syndrome was defined based on the guidelines of the national cholesterol education program adult treatment panel III (ATP III). The covariates-adjusted relationships between exposures and outcomes were investigated using a logistic regression test and two-way ANOVA.

RESULTS

The overall prevalence of MetS in participants was 34.2%. The average FQS was 28.0. Increased frequency of EOs and snacks was related to the higher prevalence of MetS ((OR, 1.72; 95% CI, 1.24, 2.37; P < 0.01) and (OR, 1.34; 95% CI, 1.07, 1.68; P, 0.01), respectively). The adjusted mean of FQS was not significantly different between the EO as well as meals and snack categories. The joint association of EO frequency and snack frequency with diet quality showed a higher chance of having MetS ( (OR, 2.36; 95% CI, 1.19, 4.66; P, 0.01 and (OR, 1.68; 95% CI, 1.06, 2.68; P,0.02), respectively). Also, we observed a higher mean of high density level cholesterol in people with the highest FQS and lowest EO frequency (P,0.02).

CONCLUSION

Our findings suggest that the EO and snack frequency may be associated with the higher chance of MetS. We also found when the frequency of EO increases, the beneficial associations of the diet quality were overshadowed. To confirm our findings, well designed randomised clinical trials are needed.

Lifetime risk of cardiovascular disease and life expectancy with and without cardiovascular disease according to changes in metabolic syndrome status

BACKGROUND AND AIMS

The relationship between dynamic changes in metabolic syndrome (MetS) status and lifetime risk of cardiovascular disease (CVD) has not been reliably quantified. This study aimed to estimate lifetime risk of CVD and life expectancy with and without CVD according to dynamic MetS status.

METHODS AND RESULTS

Dynamic changes in MetS status were assessed: MetS-free, MetS-chronic, MetS-developed, and MetS-recovery groups. We used Modified Kaplan-Meier method to estimate lifetime risk and used multistate life table method to calculate life expectancy. Participants free of CVD at index ages 35 (n = 40 168), 45 (n = 33 569), and 55 (n = 18 546) years. At index age 35 years, we recorded 1341 CVD events during a median follow-up of 6.1 years. Lifetime risk of 33.9% (95% CI: 26.9%-41.0%) in MetS-recovery group was lower than that of 39.4% (95% CI: 36.1%-42.8%) in MetS-chronic group. Lifetime risk of 37.8% (95% CI: 30.6%-45.1%) in MetS-developed group was higher than that of 26.4% (95% CI: 22.7%-30.0%) in MetS-free group. At index age 35 years, life expectancy free of CVD for MetS-recovery group (44.1 years) was higher than that for MetS-chronic group (38.8 years). Life expectancy free of CVD for MetS-developed group (41.9 years) was lower than that for MetS-free group (46.7 years).

CONCLUSIONS

Recovery from MetS was associated with decreased lifetime risk of CVD and a longer life expectancy free of CVD, whereas development of MetS was associated with increased lifetime risk of CVD and a shorter life expectancy free of CVD.

Metformin improves skeletal muscle microvascular insulin resistance in metabolic syndrome

Microvascular insulin resistance is present in metabolic syndrome and may contribute to increased cardiovascular disease risk and the impaired metabolic response to insulin observed. Metformin improves metabolic insulin resistance in humans. Its effects on macro and microvascular insulin resistance have not been defined. Eleven subjects with nondiabetic metabolic syndrome were studied four times (before and after 12 wk of treatment with placebo or metformin) using a crossover design, with an 8-wk washout interval between treatments. On each occasion, we measured three indices of large artery function [pulse wave velocity (PWV), radial pulse wave separation analysis (PWSA), brachial artery endothelial function (flow-mediated dilation-FMD)] as well as muscle microvascular perfusion [contrast-enhanced ultrasound (CEU)] before and at 120 min into a 150 min, 1 mU/min/kg euglycemic insulin clamp. Metformin decreased body mass index (BMI), fat weight, and % body fat (P < 0.05, each), however, placebo had no effect. Metformin (not placebo) improved metabolic insulin sensitivity, (clamp glucose infusion rate, P < 0.01), PWV, and FMD after insulin were unaffected by metformin treatment. PWSA improved with insulin only after metformin P < 0.01). Insulin decreased muscle microvascular blood volume measured by contrast ultrasound both before and after placebo and before metformin (P < 0.02 for each) but not after metformin. Short-term metformin treatment improves both metabolic and muscle microvascular response to insulin. Metformin's effect on microvascular insulin responsiveness may contribute to its beneficial metabolic effects. Metformin did not improve aortic stiffness or brachial artery endothelial function, but enhanced radial pulse wave properties consistent with relaxation of smaller arterioles.NEW & NOTEWORTHY Metformin, a first-line treatment for type 2 diabetes, is often used in patients with insulin resistance and metabolic syndrome. Here, we provide the first evidence for metformin improving muscle microvascular insulin sensitivity in insulin-resistant humans. Simultaneously, metformin improved muscle glucose disposal, supporting a close relationship between insulin's microvascular and its metabolic actions in muscle. Whether enhanced microvascular insulin sensitivity contributes to metformin's ability to decrease microvascular complications in diabetes remains to be resolved.

Sarcopenia Is Associated with Metabolic Syndrome in Korean Adults Aged over 50 Years: A Cross-Sectional Study

This study assessed the association between sarcopenia and metabolic syndrome in Korean adults aged over 50 years. The study obtained data from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008–2011), a cross-sectional and nationally representative survey conducted by the Korean Centers for Disease Control and Prevention. Among the 8363 participants included in this study, the prevalence rate of sarcopenia according to metabolic syndrome was stratified by sex. Crude odds ratios not adjusted for any variables were 1.827 (1.496–2.231) in males, 2.189 (1.818–2.635) in females, and 2.209 (1.766–2.331) in total participants compared with non-sarcopenia. Model 3, which was adjusted for all variables that could affect sarcopenia and metabolic syndrome, showed significant increases in the odds ratios, to 1.957 (1.587–2.413) in males, 1.779 (1.478–2.141) in females, and 1.822 (1.586–2.095) for total participants. The results suggest that the association between sarcopenia and metabolic syndrome is significant in Korean adults.

Relation between blood pressure and genito-urinary symptoms in the years across the menopausal age

OBJECTIVES

This study aimed to evaluate the relation between blood pressure (BP) or heart rate and genito-urinary symptoms in 504 women across the menopausal age (40-55 years old).

METHODS

In this multicenter, cross-sectional study, data of office systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate were related to the presence of vaginal dryness, dyspareunia, vaginal atrophy (VA), recurrent urinary infection (RUI), hot flushes (HF) or menopausal status.

RESULTS

Vaginal dryness (coefficient of linear regression β = 5.45, 95% confidence interval [CI] 2.01-8.89; p = 0.0001), VA (β = 3.79, 95% CI 0.84-6.74; p = 0.002) and RUI (β = 3.91, 95% CI 0.72-7.09; p = 0.0163) were independently related to SBP. Vaginal dryness (β = 3.28, 95% CI 0.95-5.61; p = 0.0058), and HF (β = 2.29, 95% CI 0.29-4.28; p = 0.025) were independently related to DBP. Dyspareunia (β = 2.11, 95% CI 0.50-3.72; p = 0.010) was independently related to heart rate. Hypertension was present in 17% of women. When corrected for body mass index (BMI), risk factors for hypertension were VA (OR 2.50, 95% CI 1.43-4.40; p = 0.0014), RUI (OR 1.94 95% CI 1.06-3.52; p = 0.0302) and HF (OR 2.01, 95% CI 1.15-3.50; p = 0.0141).

CONCLUSIONS

In women across the menopausal age, genito-urinary symptoms, more than HF, are associated with higher values of SBP, DBP, heart rate and hypertension.

Fat-Free Mass and Skeletal Muscle Mass Gain Are Associated with Diabetes Remission after Laparoscopic Sleeve Gastrectomy in Males but Not in Females

Besides massive body weight loss, laparoscopic sleeve gastrectomy (LSG) causes massive lean mass, including fat-free mass (FFM) and skeletal muscle mass (SM) that present higher metabolic rates in males. This study examines sex differences in FFM and SM changes of type 2 diabetes (T2D) remission at 12 months post-LSG. This cohort study recruited 119 patients (53.7% females) with T2D and obesity (body mass index 42.2 ± 7.0 kg/m²) who underwent LSG. Fat-mass (FM) loss was higher in males than in females (−12.8 ± 6.2% vs. −9.9 ± 5.0%, p = 0.02) after one-year post-operation. Regardless of the weight-loss difference, males had higher FFM and SM gain than did females (12.8 ± 8.0 vs. 9.9 ± 5.0% p = 0.02 and 6.5 ± 4.3% vs. 4.9 ± 6.2%, p = 0.03, respectively). Positive correlations of triglyceride reduction with FM loss (r = 0.47, p = 0.01) and SM gain (r = 0.44, p = 0.02) over 12 months post-operation were observed in males who achieved T2D remission. The T2D remission rate significantly increased 16% and 26% for each additional percentage of FFM and SM gain one year after LSG, which only happened in males. Increased FFM and SM were remarkably associated with T2D remission in males, but evidence lacks for females.

Cilnidipine and magnesium sulfate supplement ameliorates hyperglycemia, dyslipidemia and inhibits oxidative-stress in fructose-induced diabetic rats

The study was designed to evaluate the safety and efficacy of cilnidipine (CLN) and Mg-supplementation in fructose-induced diabetic rats. Diabetes was induced into male Wister rats by feeding fructose (10% solution) in drinking water for 8 weeks. Diabetic rats were subjected for the oral administration of CLN1 (1 mg/kg/day) and CLN10 (10 mg/kg/day), and/or methyl cellulose (0.5%) as vehicle for 28 days. After 14 days of CLN treatment, MgSO₄ (1%) was added to CLN1 and CLN10 groups for another 14 days. Age-matched healthy rats were used as normal control. After 28 days body weights were measured and organ weight to body ratio was calculated. Serum samples were analysed for fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), uric acid, lipid profiles, tri-iodothyronine (T₃) and thyroid stimulating hormone (TSH), serum glutamic pyruvic transaminase (SGPT), serum glutamic oxaloacetic transaminase (SGOT), creatine phosphokinase myocardial-band (CK-MB), creatinine, albumin, electrolytes. Oral glucose tolerance tests (OGTT), liver histopathology and in-vivo antioxidant activities were also performed. The survival rate in diabetic rats was 100% after the oral administration of CLN, Mg-supplement and/or vehicle. A significant reduction in FBS levels and improvement in OGTT were observed in CLN10, CLN1+Mg and CLN10 + Mg groups after 28 days. Further, the treatment ameliorated serum lipid profile, uric acid, and albumin levels. The groups CLN10 and CLN10 + Mg improved HbA1c, liver glycogen, creatinine, T₃, TSH levels and electrolytes in diabetic rats. Moreover, liver from CLN10 and CLN10 + Mg groups showed preservation of cellular architecture as evidenced by attenuation of inflammatory markers SGPT, SGOT and CK-MB; and the levels of superoxide dismutase (SOD), catalase (CAT), glutathione, malondialdehyde (MDA), markers of oxidative stress were significantly improved. CLN exerted prominent effects in the amelioration of hyperglycemia, dyslipidemia and reduced hepatic inflammation; and Mg-supplementation might have some beneficial effects on diabetic complications and oxidative stress in fructose-induced diabetic rats.

Sphingolipid Profiling: A Promising Tool for Stratifying the Metabolic Syndrome-Associated Risk

Metabolic syndrome (MetS) is a multicomponent risk condition that reflects the clustering of individual cardiometabolic risk factors related to abdominal obesity and insulin resistance. MetS increases the risk for cardiovascular diseases (CVD) and type 2 diabetes mellitus (T2DM). However, there still is not total clinical consensus about the definition of MetS, and its pathophysiology seems to be heterogeneous. Moreover, it remains unclear whether MetS is a single syndrome or a set of diverse clinical conditions conferring different metabolic and cardiovascular risks. Indeed, traditional biomarkers alone do not explain well such heterogeneity or the risk of associated diseases. There is thus a need to identify additional biomarkers that may contribute to a better understanding of MetS, along with more accurate prognosis of its various chronic disease risks. To fulfill this need, omics technologies may offer new insights into associations between sphingolipids and cardiometabolic diseases. Particularly, ceramides –the most widely studied sphingolipid class– have been shown to play a causative role in both T2DM and CVD. However, the involvement of simple glycosphingolipids remains controversial. This review focuses on the current understanding of MetS heterogeneity and discuss recent findings to address how sphingolipid profiling can be applied to better characterize MetS-associated risks.

Association between preventable risk factors and metabolic syndrome

The risk factors associated with metabolic syndrome (Met-S) including hypertension, hyperglycemia, central obesity, and dyslipidemia are preventable, particularly at their early stage. There are limited data available on the association between Met-S and preventable risk factors in young adults. We randomly selected 2,010 Saudis aged 18-30 years, who applied to be recruited in military colleges. All the procedures followed the guidelines of International Diabetes Federation. The results showed that out of 2,010 subjects, 4088 were affected with Met-S. The commonest risk factors were high blood sugar (63.6%), high systolic and diastolic blood pressures (63.3 and 37.3%), and high body mass index (57.5%). The prevalence of prediabetes and diabetes were 55.2 and 8.4%, respectively. Obesity, diabetes, hypertension, and hypertriglyceridemia were significantly associated with Met-S. The frequency of smoking was significantly linked with the development of Met-S. The prevalence of Met-S was found to be significantly higher in individuals with sedentary lifestyle. In conclusion, the results of this study clearly indicate that military recruits, who represent healthy young adults, are also prone to Met-S. The findings of this study will help in designing preventive measures as well as public awareness programs for controlling the high prevalence of Met-S in young adults.

Positive correlation of serum angiopoietin-like protein 3 levels with metabolic syndrome in patients with coronary artery disease

Objectives:

Angiopoietin-like protein 3 (ANGPTL3) regulates triglyceride metabolism by reversibly inhibiting the lipoprotein lipase activity. Metabolic syndrome (MetS) is an independent risk factor for further cardiovascular disease. This study evaluated the relationship between the fasting serum ANGPTL3 levels and MetS in patients with coronary artery disease (CAD).

Materials and Methods:

Fasting blood samples were obtained from 90 patients with CAD. Serum ANGPTL3 levels were measured using a commercial enzyme-linked immunosorbent assay kit. MetS and its components were defined using the diagnostic criteria of the International Diabetes Federation.

Results:

Fifty-three patients (58.9%) had MetS. The hypertension (P = 0.001), diabetes (P < 0.001), body weight (P = 0.027), body mass index (P = 0.001), waist circumference (P < 0.001), systolic blood pressure (P = 0.001), fasting glucose (P < 0.001), triglycerides (P < 0.001), blood urea nitrogen (P = 0.044), C-reactive protein (P = 0.010), insulin (P = 0.040), homeostasis model assessment of insulin resistance (P = 0.002), and ANGPTL3 level (P = 0.001) of CAD patients who had MetS were higher, and the high-density lipoprotein cholesterol (P = 0.001) and estimated glomerular filtration rate (P = 0.016) were lower. A binary logistic regression analysis of the significant variables also revealed that the ANGPTL3 level (odds ratio: 1.023, 95% confidence interval: 1.008–1.038, P = 0.002) was an independent predictor of MetS in patients with CAD.

Conclusion:

The results of our study indicated that the fasting ANGPTL3 level was positively associated with MetS among patients with CAD.

Integrative Biological Network Analysis to Identify Shared Genes in Metabolic Disorders

Identification of common molecular mechanisms in interrelated diseases is essential for better prognoses and targeted therapies. However, complexity of metabolic pathways makes it difficult to discover common disease genes underlying metabolic disorders; and it requires more sophisticated bioinformatics models that combine different types of biological data and computational methods. Accordingly, we built an integrative network analysis model to identify shared disease genes in metabolic syndrome (MS), type 2 diabetes (T2D), and coronary artery disease (CAD). We constructed weighted gene co-expression networks by combining gene expression, protein-protein interaction, and gene ontology data from multiple sources. For 90 different configurations of disease networks, we detected the significant modules by using MCL, SPICi, and Linkcomm graph clustering algorithms. We also performed a comparative evaluation on disease modules to determine the best method providing the highest biological validity. By overlapping the disease modules, we identified 22 shared genes for MS-CAD and T2D-CAD. Moreover, 19 out of these genes were directly or indirectly associated with relevant diseases in the previous medical studies. This study does not only demonstrate the performance of different biological data sources and computational methods in disease-gene discovery, but also offers potential insights into common genetic mechanisms of the metabolic disorders.

Issue of Waist Circumference for the Diagnosis of Metabolic Syndrome Regarding Arterial Stiffness: Possible Utility of a Body Shape Index in Middle-Aged Nonobese Japanese Urban Residents Receiving Health Screening

INTRODUCTION

Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. This cross-sectional study aimed to clarify whether replacing WC with "A Body Shape Index (ABSI)," an abdominal obesity index, in MetS diagnosis detects individuals with arterial stiffening assessed by cardio-ankle vascular index (CAVI).

METHODS

A retrospective cross-sectional study was conducted in 46,872 Japanese urban residents (median age 40 years) who underwent health screening. Exclusion criteria were current treatments and a past history of cardiovascular disease (CVD). The Japanese, International Diabetes Federation, and NCEP-ATPIII criteria were used to diagnose MetS. High CAVI was defined as CAVI ≥9.0.

RESULTS

CAVI correlated positively with ABSI (β = 0.127), but negatively with WC (β = -0.186), independent of age, sex, systolic blood pressure, fasting plasma glucose, and high-density lipoprotein--cholesterol. Receiver operating characteristic (ROC) analysis showed that ABSI had a stronger contribution to high CAVI (area under the ROC curve [AUC] = 0.730) than WC (AUC = 0.595) and body mass index (AUC = 0.520). ABSI ≥0.080 was defined as abdominal obesity based on the results of ROC analysis for high CAVI and estimated glomerular filtration rate <60 mL/min/1.73 m2. Logistic regression analysis revealed that replacing high WC with ABSI ≥0.080 in MetS diagnosis enhanced the detection of subjects with high CAVI.

DISCUSSION/CONCLUSION

Use of ABSI can detect subjects with arterial stiffening, which may lead to efficient stratification of CVD risk. Further studies are needed to confirm whether MetS diagnosis using ABSI predicts CVD morbidity and mortality.

Positive Association Between Nutrient Adequacy and Waist Circumference: Results of a Cross-Sectional Study

Metabolic syndrome (MetS) is a multifactorial disease with its exact causes not completely clear. Micronutrients such as vitamin A, vitamin D, zinc, and magnesium have been associated with MetS components. Our objective was to investigate the association of nutrient adequacy (NA) with MetS components. The present cross-sectional study consisted of 850 adults between 18-59 years from Tehran, Iran. Dietary intake, socio-demographic data, medical history, and anthropometric indices were collected by trained personnel. NA was calculated as the mean intake ratio to the recommended amount of 16 micronutrients. MetS were defined by the consensus of National Cholesterol Education Program-Adult Treatment Panel III criteria. The association between NA and MetS was examined using linear regression analyses after controlling potential confounders. More participants in the highest quartile were obese in terms of general obesity (p = 0004) and abdominal obesity (p = 0.003) compared with subjects in the least quartile. A significant positive correlation was found between waist circumference (WC) and NA even after controlling for all potential confounders (p < 0.001). NA was positively associated with WC among adults living in Tehran.

Lifestyle Modification in the Management of Metabolic Syndrome: Statement From Korean Society of CardioMetabolic Syndrome (KSCMS)

Metabolic syndrome (MetS) is highly prevalent and is associated with worse cardiovascular outcome. Lifestyle modification is the most effective way to reduce the incidence of cardiovascular complications caused by MetS. Here, we would like to review the effects and specific methods of the 6 lifestyle modifications (weight control, smoking cessation, alcohol drinking in moderation, diet control, exercise and physical activity, and cognitive behavioral therapy) and control of blood pressure, dyslipidemia, and blood sugar based on evidence in the management of MetS.

With the recent rapid increase in obesity worldwide, metabolic syndrome (MetS) has gained significant importance. MetS is a cluster of obesity-related cardiovascular risk factors including abdominal obesity, atherogenic dyslipidemia, high blood pressure and impaired glucose tolerance. MetS is highly prevalent and strongly associated with an increased risk of developing diabetes and cardiovascular disease, putting a great burden on human society. Therefore, it is very important to reduce MetS risk, which can improve patients’ cardiovascular prognosis. The primary and most effective strategy to control each component of MetS is lifestyle change such as losing body weight, keeping regular exercise, adopting a healthy diet, quitting smoking and alcohol drinking in moderation. Many studies have shown that lifestyle modification has improved all components of MetS, and reduces the incidence of diabetes and cardiovascular disease. Here, the Korean Society of CardioMetabolic Syndrome has summarized specific and practical methods of lifestyle modification in the management of MetS in the healthcare field.

Sleep Quality and Its Determinants Among Type 2 Diabetes Patients with Comorbid Metabolic Syndrome

PURPOSE

The prevalence of poor sleep quality in patients with diabetes was higher than the general population. This study aimed to explore risk factors for not only poor sleep quality, but also long sleep latency, short sleep duration and low sleep efficiency, in type 2 diabetes patients (T2DM) with comorbid metabolic syndrome (MS).

PATIENTS AND METHODS

A total of 281 patients aged 18-75 years were enrolled from Ningbo First Hospital during October 2021 to March 2022. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI). Sleep latency, sleep duration and sleep efficiency were obtained by a response to the questionnaire. Descriptive, independent two-sample t-test, Chi-square test and multiple logistic regression were conducted using SPSS Version 28.

RESULTS

The prevalence of poor sleep quality in T2DM with comorbid MS patients was 59.10%. The factors significantly associated with poor sleep quality were depression symptoms (OR = 3.10, 95% CI: 1.38 to 6.96, P = 0.006), poor quality of life (OR = 2.49, 95% CI: 1.24 to 4.99, P = 0.010), and age (OR = 1.07, 95% CI: 1.04 to 1.10, P < 0.001). The factor significantly associated with long sleep latency was depression symptoms (OR = 2.19, 95% CI: 1.15 to 4.16, P = 0.017). The factors significantly related to short sleep duration were depression symptoms (OR = 2.56, 95% CI: 1.31 to 5.00, P = 0.006) and age (OR = 1.05, 95% CI: 1.02 to 1.08, P = 0.002). The factor significantly related to short sleep efficiency was age (OR = 1.03, 95% CI: 1.01 to 1.06, P = 0.019).

CONCLUSION

This study found that depression symptoms, together with poor quality of life, and increasing age were associated with poor sleep quality. Symptoms of depression were related to long sleep latency and short sleep duration. The increasing age was associated with short sleep duration and low sleep efficiency.

Ventricular Dysfunction in Obese and Nonobese Rats with Metabolic Syndrome

Obesity and dyslipidemias are both signs of metabolic syndrome, usually associated with ventricular arrhythmias. Here, we tried to identify cardiac electrical alteration and biomarkers in nonobese rats with metabolic syndrome (MetS), and these findings might lead to more lethal arrhythmias than obese animals. The MetS model was developed in Wistar rats with high-sucrose diet (20%), and after twenty-eight weeks were obtained two subgroups: obese (OMetS) and nonobese (NOMetS). The electrocardiogram was used to measure the ventricular arrhythmias and changes in the heart rate variability. Also, we measured ventricular hypertrophy and its relationship with electrical activity alterations of both ventricles, using micro-electrode and voltage clamp techniques. Also, we observed alterations in the contraction force of ventricles where a transducer was used to record mechanical and electrical papillary muscle, simultaneously. Despite both subgroups presenting long QT syndrome (0.66 ± 0.05 and 0.66 ± 0.07 ms with respect to the control 0.55 ± 0.1 ms), the changes in the heart rate variability were present only in OMetS, while the NOMetS subgroup presented changes in QT interval variability (NOMetS SD = 1.8, SD2 = 2.8; SD1/SD2 = 0.75). Also, the NOMetS revealed tachycardia (10%; p < 0.05) with changes in action potential duration (63% in the right papillary and 50% in the left papillary) in the ventricular papillary which are correlated with certain alterations in the potassium currents and the force of contraction. The OMetS showed an increase in action potential duration and the force of contraction in both ventricles, which are explained as bradycardia. Our results revealed lethal arrhythmias in both MetS subgroups, irrespectively of the presence of obesity. Consequently, the NOMetS showed mechanical-electrical alterations regarding ventricle hypertrophy that should be at the NOMetS, leading to an increase of CV mortality.

Correlation between estimated glucose disposal rate and in-stent restenosis following percutaneous coronary intervention in individuals with non-ST-segment elevation acute coronary syndrome

BACKGROUND

Insulin resistance (IR) is closely associated with in-stent restenosis (ISR) following percutaneous coronary intervention (PCI). Nevertheless, the predictive power of the newly developed simple assessment method for IR, estimated glucose disposal rate (eGDR), for ISR after PCI in individuals with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) remains unclear.

METHODS

NSTE-ACS cases administered PCI in Beijing Anzhen Hospital between January and December 2015 were enrolled. The included individuals were submitted to at least one coronary angiography within 48 months after discharge. Patients were assigned to 2 groups according to ISR occurrence or absence. eGDR was derived as 21.16 - (0.09 * waist circumference [cm]) - (3.41 * hypertension) - (0.55 * glycated hemoglobin [%]). Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed for evaluating eGDR's association with ISR.

RESULTS

Based on eligibility criteria, 1218 patients were included. In multivariate logistic analysis, the odds ratios (ORs) of eGDR as a nominal variate and a continuous variate were 3.393 (confidence interval [CI] 2.099 - 5.488, P < 0.001) and 1.210 (CI 1.063 - 1.378, P = 0.004), respectively. The incremental effect of eGDR on ISR prediction based on traditional cardiovascular risk factors was reflected by ROC curve analysis (AUC: baseline model + eGDR 0.644 vs. baseline model 0.609, P for comparison=0.013), continuous net reclassification improvement (continuous-NRI) of -0.264 (p < 0.001) and integrated discrimination improvement (IDI) of 0.071 (p = 0.065).

CONCLUSION

In NSTE-ACS cases administered PCI, eGDR levels show an independent negative association with increased ISR risk.

Risk assessment of metabolic syndrome prevalence involving sedentary occupations and socioeconomic status

OBJECTIVES

To determine whether occupation type, distinguished by socioeconomic status (SES) and sedentary status, is associated with metabolic syndrome (MetS) risk.

METHODS

We analysed two data sets covering 73 506 individuals. MetS was identified according to the criteria of the modified Adult Treatment Panel III. Eight occupational categories were considered: professionals, technical workers, managers, salespeople, service staff, administrative staff, manual labourers and taxi drivers; occupations were grouped into non-sedentary; sedentary, high-SES; and sedentary, non-high-SES occupations. A multiple logistic regression was used to determine significant risk factors for MetS in three age-stratified subgroups. R software for Windows (V.3.5.1) was used for all statistical analyses.

RESULTS

MetS prevalence increased with age. Among participants aged ≤40 years, where MetS prevalence was low at 6.23%, having a non-sedentary occupation reduced MetS risk (OR=0.88, p<0.0295). Among participants aged >60 years, having a sedentary, high-SES occupation significantly increased (OR=1.39, p<0.0247) MetS risk.

CONCLUSIONS

The influence of occupation type on MetS risk differs among age groups. Non-sedentary occupations and sedentary, high-SES occupations decrease and increase MetS risk, respectively, among younger and older adults, respectively. Authorities should focus on individuals in sedentary, high-SES occupations.

Association between the frequency of toothbrushing and lifestyle in people with type 2 diabetes mellitus: at the baseline date of the Kamogawa-DM cohort study

It has been reported that oral health is associated with some co-morbid conditions, including cardiovascular disease, in people with type 2 diabetes mellitus. The present study investigated the association between the frequency of toothbrushing and lifestyle in people with type 2 diabetes mellitus. This cross-sectional study included 624 outpatients at the Kyoto Prefectural University of Medicine in Kyoto, Japan from January 2014 to January 2016. Lifestyle was evaluated using a self-administered questionnaire. The average age and hemoglobin A1c level were 67.6 ± 10.9 years and 7.2 ± 1.1%, respectively. The number of patients who brushed their teeth twice or more a day was 189 (50.3%) in men and 198 (79.8%) in women. Among men, the proportion of patients living alone was lower in those who brushed their teeth twice or more a day than those who brushed their teeth never/rarely or once a day. The logistic regression analysis, after adjusting for confounding factors, revealed that living alone (odds ratio 2.88; 95% confidence interval 1.53–5.66) was associated with the increased odds of the low frequency of toothbrushing (never/rarely or once a day) in men, but not in women. In conclusion, the results of our study suggest that living alone was associated with the low frequency of toothbrushing in people with type 2 diabetes mellitus, particularly in men.

Association of the metabolic syndrome with mortality and major adverse cardiac events: A large chronic kidney disease cohort

BACKGROUND

Metabolic syndrome with its key components insulin resistance, central obesity, dyslipidaemia, and hypertension is associated with a high risk for cardiovascular events and all-cause mortality in the general population. However, evidence that these findings apply to patients with chronic kidney disease (CKD) with moderately reduced estimated glomerular filtration rate and/or albuminuria is limited.

OBJECTIVES

We aimed to investigate the association between metabolic syndrome and its components with all-cause mortality and cardiovascular outcomes in CKD patients.

METHODS

Prospective observation of a cohort of 5110 CKD patients from the German Chronic Kidney Disease study with 3284 (64.3%) of them having a metabolic syndrome at baseline.

RESULTS

During the follow-up of 6.5 years, 605 patients died and 650 patients experienced major cardiovascular events. After extended data adjustment, patients with a metabolic syndrome had a higher risk for all-cause mortality (hazard ratio [HR] = 1.26, 95% confidence interval [CI]: 1.04-1.54) and cardiovascular events (HR = 1.48, 95% CI: 1.22-1.79). The risk increased steadily with a growing number of metabolic syndrome components (increased waist circumference, glucose, triglycerides, hypertension and decreased HDL cholesterol): HR per component = 1.09 (95% CI: 1.02-1.17) for all-cause mortality and 1.23 (95% CI: 1.15-1.32) for cardiovascular events. This resulted in hazard ratios between 1.50 and 2.50 in the case when four or five components are present. An analysis of individual components of metabolic syndrome showed that the glucose component led to the highest increase in risk for all-cause mortality (HR = 1.68, 95% CI: 1.38-2.03) and cardiovascular events (HR = 1.81, 95% CI: 1.51-2.18), followed by the HDL cholesterol and triglyceride components.

CONCLUSIONS

We observed a high prevalence of metabolic syndrome among patients with moderate CKD. Metabolic syndrome increases the risk for all-cause mortality and cardiovascular events. The glucose and lipid components seem to be the main drivers for the association with outcomes.

Nonlinear Relationship Between AST-to-ALT Ratio and the Incidence of Type 2 Diabetes Mellitus: A Follow-Up Study

Background

The aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio has been demonstrated to be associated with insulin resistance and metabolic syndrome. However, few studies have directly explored the association between the AST/ALT ratio and the incidence of type 2 diabetes mellitus (T2DM). As such, the present study aimed to investigate the relationship between the AST/ALT ratio and incident T2DM during follow-up in a population-based cohort.

Methods

This retrospective cohort analysis included 15,464 Japanese males and females without DM at baseline between 2004 and 2015. The association between AST/ALT ratio and T2DM was retrospectively examined using the Cox proportional hazard model after adjusting for multiple potential confounders.

Results

After follow-up, 373 (2.41%) patients developed T2DM. A nonlinear relationship between the AST/ALT ratio and T2DM was observed after adjusting for potential confounders. The risk for developing T2DM decreased with AST/ALT ratio up to a threshold of 0.93 (adjusted hazard ratio [HR] 0.14 [95% confidence interval (CI) = 0.02-0.90; P = 0.0385]). An AST/ALT ratio >0.93 was not associated with the risk for developing T2DM (adjusted HR = 0.67, 95% CI = 0.17-2.65; P = 0.5718).

Conclusion

The AST/ALT ratio was associated with a lower incidence of T2DM in a nonlinear pattern. The threshold AST/ALT ratio for developing T2DM was 0.93. AST/ALT levels were inversely correlated with the occurrence of T2DM when AST/ALT ratio ≤0.93.

Enhanced prediction of renal function decline by replacing waist circumference with "A Body Shape Index (ABSI)" in diagnosing metabolic syndrome: a retrospective cohort study in Japan

Background

Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is conventionally evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity.

Objective

To examine whether replacing WC with “A Body Shape Index (ABSI)”, an abdominal obesity index calculated by dividing WC by an allometric regression of weight and height, in MetS diagnosis is useful for predicting renal function decline.

Subjects/Methods

In total, 5438 Japanese urban residents (median age 48 years) who participated in a public health screening program for 4 consecutive years were enrolled. Systemic arterial stiffness was assessed by cardio-ankle vascular index (CAVI). The predictability of the new-onset renal function decline (eGFR < 60 mL/min/1.73 m²) by replacing high WC with high ABSI (ABSI ≥ 0.080) was examined using three sets of MetS diagnostic criteria: Japanese, IDF and NCEP-ATPIII.

Results

In Japanese and NCEP-ATPIII criteria, MetS diagnosed using ABSI (ABSI-MetS) was associated with significantly higher age-adjusted CAVI compared to non-MetS, whereas MetS diagnosed using WC (WC-MetS) showed no association. Kaplan–Meier analysis of the rate of new-onset renal function decline over 4 years (total 8.7%) showed remarkable higher rate in subjects with ABSI-MetS than in those without (log-rank test p < 0.001), but almost no difference between subjects with and without WC-MetS (p = 0.014–0.617). In gender-specific Cox-proportional hazards analyses including age, proteinuria, and treatments of metabolic disorders as confounders, ABSI-MetS (Japanese criteria for both sexes, IDF criteria for men) contributed independently to the new-onset renal function decline. Of these, the contribution of IDF ABSI-MetS disappeared after adjustment by high CAVI in the subsequent analysis.

Conclusion

In this study, replacing WC with ABSI in MetS diagnostic criteria more efficiently predicted subjects at risk of renal function decline and arterial stiffening.

The Contribution of Cardiac Fatty Acid Oxidation to Diabetic Cardiomyopathy Severity

Diabetes is a major risk factor for the development of cardiovascular disease via contributing and/or triggering significant cellular signaling and metabolic and structural alterations at the level of the heart and the whole body. The main cause of mortality and morbidity in diabetic patients is cardiovascular disease including diabetic cardiomyopathy. Therefore, understanding how diabetes increases the incidence of diabetic cardiomyopathy and how it mediates the major perturbations in cell signaling and energy metabolism should help in the development of therapeutics to prevent these perturbations. One of the significant metabolic alterations in diabetes is a marked increase in cardiac fatty acid oxidation rates and the domination of fatty acids as the major energy source in the heart. This increased reliance of the heart on fatty acids in the diabetic has a negative impact on cardiac function and structure through a number of mechanisms. It also has a detrimental effect on cardiac efficiency and worsens the energy status in diabetes, mainly through inhibiting cardiac glucose oxidation. Furthermore, accelerated cardiac fatty acid oxidation rates in diabetes also make the heart more vulnerable to ischemic injury. In this review, we discuss how cardiac energy metabolism is altered in diabetic cardiomyopathy and the impact of cardiac insulin resistance on the contribution of glucose and fatty acid to overall cardiac ATP production and cardiac efficiency. Furthermore, how diabetes influences the susceptibility of the myocardium to ischemia/reperfusion injury and the role of the changes in glucose and fatty acid oxidation in mediating these effects are also discussed.

Lean Yet Unhealthy: Asian American Adults Had Higher Risks for Metabolic Syndrome than Non-Hispanic White Adults with the Same Body Mass Index: Evidence from NHANES 2011-2016

(1) Background: Despite having consistently lower rates of obesity than other ethnic groups, Asian Americans (AAs) are more likely to be identified as metabolically obese, suggesting an ethnic-specific association between BMI and cardiometabolic outcomes. The goal of this study was to provide an estimate of metabolic syndrome (MetS) prevalence among AAs using national survey data and to compare this rate to that of non-Hispanic Whites (NHWs) over the BMI continuum. (2) Methods: Using the NHANES 2011-2016 data, we computed age-adjusted, gender-specific prevalence of MetS and its individual components for three BMI categories. Furthermore, we conducted multivariate binary logistic regression to examine the risk of MetS in AAs compared to NHWs, controlling for sociodemographic and lifestyle factors. The analysis sample consisted of 2121 AAs and 6318 NHWs. (3) Results: Among AAs, the prevalence of MetS and its components increased with higher BMI levels, with overall prevalence being 5.23% for BMI < 23, 38.23% for BMI of 23-27.4, and 77.68% for BMI ≥ 27.5 in men; and 18.61% for BMI < 23, 47.82% for BMI of 23-27.4, and 67.73% for BMI ≥ 27.5 in women. We also found that for those with a BMI > 23, AAs had a higher predicted risk of MetS than their NHW counterparts of the same BMI level, in both men and women. (4) Conclusions: Our findings support the use of lower BMI ranges for defining overweight and obesity in Asian populations, which would allow for earlier and more appropriate screening for MetS and may better facilitate prevention efforts.

The Impact of New-Onset Diabetes Mellitus and Hypertension on All-Cause Mortality in an Apparently Healthy Population: A Ten-Year Follow-Up Study

INTRODUCTION

The comparative effect of new-onset diabetes mellitus (DM) and hypertension (HT) on long-term mortality is a matter of debate.

MATERIALS AND METHODS

From 2007 to 2017, a 10-year longitudinal retrospective cohort study was conducted in Thailand's tertiary care setting. As baseline data, health check-up data from apparently healthy participants without underlying disease from 2007 were extracted. The vital status of all participants was determined in 2017, ten years after an initial examination. The impact of new-onset DM and HT at baseline on 10-year all-cause mortality was investigated using multivariable logistic regression analysis.

RESULTS

The prevalence of new-onset DM and HT was 6.4% and 28.8%, respectively, at baseline. Newly diagnosed diabetes increased the risk of all-cause mortality over 10 years (adjusted OR 4.77 and 95% CI 2.23-9.99). HT, on the other hand, did not increase the risk of death (adjusted OR 1.24 and 95% CI 0.65-2.35). Different HT and DM status combinations were compared to a nondiabetic, nonhypertensive reference. Individuals who were diabetic and hypertensive had a greater risk of death (adjusted OR 6.22 and 95% CI 2.22-17.00). Having DM without HT also increased the risk of death (adjusted OR 4.36 and 95% CI 1.35-12.87). However, having HT without DM did not result in a significant increase in 10-year mortality risk (adjusted OR 1.21 and 95% CI 0.57-2.56).

CONCLUSION

In an apparently healthy population, new-onset DM is more strongly associated with 10-year all-cause mortality than new-onset HT. Having both DM and HT was associated with a greater risk of death when compared to having DM or HT alone.

Multitarget molecule, PTUPB, to treat diabetic nephropathy in rats

BACKGROUND AND PURPOSE

Diabetic nephropathy is a common complications related to high morbidity and mortality in type 2 diabetes. We investigated the action of the dual modulator, PTUPB, a soluble epoxide hydrolase and cyclooxygenase-2 inhibitor against diabetic nephropathy.

EXPERIMENTAL APPROACH

Sixteen-week-old type 2 diabetic and proteinuric obese ZSF1 rats were treated with vehicle, PTUPB or enalapril for 8 weeks. Measurements were made of epoxyeicosatrienoic acids, thromboxane B2 (TBX2 ) and prostaglandin E2 (PGE2 ) in the kidney of these and lean ZSF1 rats along with their blood pressure.

KEY RESULT

Obese ZSF1 rats were diabetic with fivefold higher fasting blood glucose levels and markedly higher HbA1c levels compared with lean ZSF1 rats. PTUPB nor enalapril reduced fasting blood glucose or HbA1c but alleviated the development of diabetic nephropathy. In PTUPB-treated obese ZSF1 rats, glomerular nephrin expression was preserved. Enalapril also alleviated diabetic nephropathy. Diabetic renal injury in obese ZSF1 rats was accompanied by renal inflammation with six to sevenfold higher urinary MCP-1 (CCR2) level and renal infiltration of CD-68 positive cells. PTUPB and enalapril significantly reduced urinary MCP-1 levels and renal mRNA expression of cytokines. Both PTUPB and enalapril lowered blood pressure. PTUPB but not enalapril decreased hyperlipidaemia and liver injury in obese ZSF1 rats.

CONCLUSION AND IMPLICATIONS

Overall, the dual modulator PTUPB does not treat hyperglycaemia but can effectively alleviate hypertension, diabetic nephropathy, hyperlipidaemia and liver injury in type 2 diabetic rats. Our data further demonstrate that the renal actions of PTUPB are comparable with a current standard diabetic nephropathy treatment.

Recent Trends of Metabolic Syndrome and Its Components in Military Recruits from Saudi Arabia

Metabolic syndrome (Met-S) constitutes the risk factors and abnormalities that markedly increase the probability of developing diabetes and coronary heart disease. An early detection of Met-S, its components and risk factors can be of great help in preventing or controlling its adverse consequences. The aim of the study was to determine the prevalence of cardio-metabolic risk factors in young army recruits from Saudi Arabia. A total of 2010 Saudis aged 18-30 years were randomly selected from groups who had applied to military colleges. In addition to designed questionnaire, anthropometric measurements and blood samples were collected to measure Met-S components according to the International Diabetes Federation (IDF) criteria. Met-S prevalence was 24.3% and it was higher in older subjects than the younger ones. There were significant associations between Met-S and age, education level and marital status. The most common Met-S components were high fasting blood sugar (63.6%) followed by high blood pressure (systolic and diastolic, 63.3% and 37.3% respectively) and high body mass index (57.5%). The prevalence of pre-diabetes and diabetes were found to be 55.2% and 8.4%, respectively. Hypertriglyceridemia was found in 19.3% and low levels of high-density lipoproteins (HDL) in 11.7% of subjects. In conclusion, there is a high prevalence of Met-S in young adults of Saudi Arabia. There is a need for regular monitoring of Met-S in young populations to keep them healthy and fit for nation building. It is also important to design and launch community-based programs for educating people about the importance of physical activity, cessation of smoking and eating healthy diet in prevention of chronic diseases.

Effects of Lifestyle Intervention on Inflammatory Markers and Waist Circumference in Overweight/Obese Adults With Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Physical inactivity and an imbalanced diet could lead to some cardio metabolic risk factors.

OBJECTIVE

The objective of this meta-analysis was to investigate the effects of lifestyle modification on inflammatory indicators and waist circumference (WC) in overweight/obese subjects with metabolic syndrome (MS).

DATA SOURCES

A systematic search was conducted in PubMed, CINAHL, MEDLINE, Cochrane, Google Scholar, and Web of Science.

STUDY SELECTION

The selection criteria were randomized controlled trials (RCTs) investigating the effects of lifestyle interventions on inflammation and WC from inception to 20 December 2020. The weighted mean difference (WMD) and 95% confidence interval (CI) between interventions were computed using a random or fixed-effects model.

RESULTS

Six RCTs (including 1246 MS patients who had, on average, overweight/obesity) met all inclusion criteria. Interventions lasted 6 to 12 months (2-5 sessions per week). Lifestyle intervention significantly reduced C-reactive protein (WMD: -0.52 mg/ml, 95% CI: -0.72, -0.33), IL-6 (WMD: -0.50 pg/ml, 95% CI: -0.56, -0.45), and increased adiponectin (WMD: 0.81 µg/ml, 95% CI, 0.64, 0.98). Moreover, lifestyle modification significantly decreased WC (WMD: -3.12 cm, 95% CI, -4.61, -1.62).

CONCLUSION

Our findings provide evidence that lifestyle alterations, including physical activity and diet, can lead to significant improvement in abdominal obesity, measured by WC and some inflammation markers among overweight/obese individuals with MS. Further high-quality research is needed to clarify the mechanisms underlying the effect of such interventions on this population's inflammatory markers.

Diabetes pathogenesis and management: the endothelium comes of age

Endothelium, acting as a barrier, protects tissues against factors that provoke insulin resistance and type 2 diabetes and itself responds to the insult of insulin resistance inducers with altered function. Endothelial insulin resistance and vascular dysfunction occur early in the evolution of insulin resistance-related disease, can co-exist with and even contribute to the development of metabolic insulin resistance, and promote vascular complications in those affected. The impact of endothelial insulin resistance and vascular dysfunction varies depending on the blood vessel size and location, resulting in decreased arterial plasticity, increased atherosclerosis and vascular resistance, and decreased tissue perfusion. Women with insulin resistance and diabetes are disproportionately impacted by cardiovascular disease, likely related to differential sex-hormone endothelium effects. Thus, reducing endothelial insulin resistance and improving endothelial function in the conduit arteries may reduce atherosclerotic complications, in the resistance arteries lead to better blood pressure control, and in the microvasculature lead to less microvascular complications and more effective tissue perfusion. Multiple diabetes therapeutic modalities, including medications and exercise training, improve endothelial insulin action and vascular function. This action may delay the onset of type 2 diabetes and/or its complications, making the vascular endothelium an attractive therapeutic target for type 2 diabetes and potentially type 1 diabetes.

Metabolic syndrome among individuals living with hypertension in Accra, Ghana

Metabolic syndrome (MetS) is a major risk factor to cardiovascular diseases. In this study, we investigate the prevalence and associated risky behaviour of MetS in resource-poor urban communities in Accra, Ghana. We analysed data on 111 persons with hypertension, screened and recruited for a therapeutic lifestyle intervention program in August 2015. MetS was measured using the International Diabetes Federation (IDF) and the World Health Organization definitions. The prevalence of MetS was 58.4% and 16.8% by the IDF and WHO definitions respectively. More women (61.8%) compared to men (31.8%) had MetS (p = 0.011). Approximately 31% of the hypertensive patients were engaged in moderate-intensity physical activity; 9.0% were current smokers, 42.0% consumed excess alcohol over the past month prior to the interview and 41.0% discontinued taking their antihypertensive medications without consulting with a doctor. About 42.0% and 37.0% of respondents always consumed fruits and vegetables respectively at least two times a day. The binary logistic regression showed that compared to women, men had lower odds of consuming two or more servings of vegetable in a day (OR: 0.2; 95% CI; 0.1, 0.8). Increase in age was associated with higher odds of consuming fruits at least twice a day (1.0; 1.0, 1.1) but with lower odds of engaging in moderate intensity physical activity (0.9; 0.8, 1.0). Being married was associated with higher odds of engaging in moderate physical activity (2.8; 1.0, 8.2). Therapeutic methods essential for the management of patients with hypertension and MetS should include non-pharmacological remedies targeting the promotion of medication adherence, Dietary Approaches to Stop Hypertension (DASH) and physical activities; these are vital to changing unhealthy lifestyle which worsens the underlying pathology.

Cohort study evaluation of New Chinese Diabetes Risk Score: A new non-invasive indicator for predicting metabolic syndrome

OBJECTIVES

To investigate the association of the baseline New Chinese Diabetes Risk Score (NCDRS) with metabolic syndrome (MetS) risk and to evaluate the power of the baseline NCDRS to predict MetS based on the rural Chinese cohort study.

METHODS

Study participants were classified by baseline quartiles of NCDRS by gender. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for risk of MetS according to different diagnostic criteria. The receiver operating characteristic curve (ROC) and area under the ROC curve (AUC) were used to evaluate the power of the baseline NCDRS for predicting MetS according to different diagnostic criteria.

RESULTS

We included 7,133 participants, and 1,651 MetS cases were identified after 6 years follow-up. After adjusting for multivariable confounding factors and with NCDRS quartile 1 as the reference, with quartile 4, the risk of MetS was increased for all participants, men and women: ORs (95% CIs) 4.03 (3.23-5.02), 3.59 (2.56-5.05) and 5.71 (4.23-7.70), respectively. Similar results were found on sensitivity analysis. The baseline NCDRS was a good predictor of MetS for all participants, men and women with MetS defined according to the diagnostic criteria of the Chinese Joint Committee on the Development of Guidelines for the Prevention and Treatment of Dyslipidemia in Adults (JCDCG).

CONCLUSIONS

Our study, based on the cohort study, found that the baseline NCDRS was positively associated with risk of MetS. Furthermore, our study might provide suggestions for developing a useful and inexpensive tool for predicting MetS in the Chinese population.

Dynamic changes in metabolic health status in Chinese adults: Multiple population-based surveys in Shanghai, China

AIMS/INTRODUCTION

Metabolic syndrome (MS) has been increasing worldwide. The secular change in MS components, however, remains unclear. This study aimed to examine the dynamic change in metabolic health status in Chinese adults.

MATERIALS AND METHODS

Three population-based surveys using multistage stratified sampling were performed in Chinese aged 35-74 years in Shanghai in 2002-2003 (n = 12,302), 2009 (n = 7,400), and 2017 (n = 19,023). MS was defined according to the Adult Treatment Panel III criteria for Asian-Americans. Generalized Estimating Equations and Cochran-Armitage Trend Test was used to assess the prevalence trend over the years.

RESULTS

The prevalence of MS doubled in Chinese adults over the period (P for trend < 0.001). The largest increase occurred in younger men. Among MS components, the prevalence of high waist-circumference (HWC), high blood glucose (HBG) and high blood pressure (HBP) increased in all subjects, whereas the prevalence of high triglycerides (HTG) and low high-density lipoprotein cholesterol (LHC) increased in men but decreased in women. The increase in HBP contributed most to elevated MS, followed by HBG and HWC, resulting in the HBP-HBG-HWC the most common cluster of MS components. Metabolically unhealthy overweight also grew over the period.

CONCLUSIONS

Metabolic health status has been exacerbating in Chinese adults and may increase burden of non-communicable diseases.

Hyperechoic pancreas on ultrasonography: an analysis of its severity and clinical implications

Purpose

This study investigated risk factors for hyperechoic pancreas (HP) on ultrasonography (US) according to HP severity.

Methods

Between December 2008 and February 2014, 1,459 subjects who underwent abdominal US as part of health examinations were retrospectively included. Two radiologists assessed and categorized the severity of HP as normal, mild, moderate, and severe. Subjects were allocated to two groups as follows: fatty pancreas 1 (FP1; mild to severe HP) and fatty pancreas 2 (FP2; moderate to severe HP). Clinico-metabolic parameters such as the body mass index and blood test profile of subjects with normoglycemia and prediabetes/diabetes were compared (normal vs. FP1; normal or mild HP vs. FP2). Logistic regression analysis was used to evaluate the associations between HP, nonalcoholic fatty liver disease (NAFLD), and diabetes/prediabetes with adjustment for clinico-metabolic parameters.

Results

Of the 1,459 subjects, 71.2% and 40.4% showed HP and NAFLD on US, respectively. Normoglycemia and prediabetes/diabetes were present in 74.3% and 25.7% of subjects, respectively. Univariable analysis revealed that all the clinico-metabolic parameters were significantly associated with HP (all P<0.05). In the adjusted multivariable analysis, prediabetes/diabetes, NAFLD, age, and body mass index were significantly associated with HP with the FP1 and FP2 criteria. The independent factor with the strongest association with HP was NAFLD using the FP1 criterion (odds ratio [OR], 7.93; P<0.001) and prediabetes/diabetes using the FP2 criterion (OR, 6.96; P<0.001).

Conclusion

NAFLD and prediabetes/diabetes were associated with US-diagnosed HP. Moderate to severe HP was a better predictor of prediabetes/diabetes, suggesting that evaluating HP severity may be useful in clinical practice.

Exploring Diagnostic Biomarkers and Comorbid Pathogenesis for Osteoarthritis and Metabolic Syndrome via Bioinformatics Approach

BACKGROUND

Metabolic syndrome (MS) has grown in recognition to contribute to the pathogenesis of osteoarthritis (OA), which is the most prevalent arthritis characterized by joint dysfunction. However, the specific mechanism between OA and MS remains unclear.

METHODS

The gene expression profiles and clinical information data of OA and MS were retrieved from the Gene Expression Omnibus (GEO) database. The genes in the key module of MS were identified by weighted gene co-expression network analysis (WGCNA), which intersected with the differentially expressed genes (DEGs) between control and MS samples to obtain hub genes for MS. The potential functions and pathways of hub genes were detected through the Gene Ontology (GO) and Kyoto Encyclopedia of Gene and Genome (KEGG) analyses. The genes involved in the different KEGG pathways between the control and OA samples overlapped with the DEGs between the two groups via the Venn analysis to gain the hub genes for OA affected by MS (MOHGs). Additionally, the least absolute shrinkage and selection operator (LASSO) was performed on the MOHGs to establish a diagnostic model for each disease.

RESULTS

A total of 61 hub genes for MS were identified that significantly enriched in platelet activation, complement and coagulation cascades, and hematopoietic cell lineage. Besides, 4 candidate genes (ELOVL7, F2RL3, GP9, and ITGA2B) were screened among the 6 MOHGs to construct a diagnostic model, showing good performance for distinguishing controls from patients with MS and OA. GSEA suggested that these diagnostic genes were closely associated with immune response, adipocytokine signaling, fatty acid metabolism, cell cycle, and platelet activation.

CONCLUSION

Taken together, we identified 4 potential gene biomarkers for diagnosing MS and OA patients, providing a theoretical basis and reference for the diagnostics and treatment targets of MS and OA.

Estimation of Lifetime QALYs Based on Lifestyle Behaviors

Various lifestyle behaviors have been known to affect health-related quality of life (HRQL) and life expectancy. However, the impact on quality-adjusted life years (QALYs), which can be used for health economics, has not been clarified. The purpose of this study was to estimate the impact of lifestyle behaviors on lifetime QALYs. We first examined the relationship between lifestyle behaviors and HRQL as measured by the EQ-5D-5L among 4000 participants via a web-based survey. The results of multiple regression analysis showed that physical activity and sleep were significantly related to HRQL. Therefore, we used microsimulation to estimate QALYs from physical activity and sleep, which were determined to be significant in the regression analysis. The results showed that there was a difference of 3.6 QALYs between the recommended lifestyle scenario (23.4 QALYs; 95%CI 3.6 to 35.1) and the non-recommended lifestyle scenario (19.8 QALYs; 95%CI 3.1 to 31.6). This difference was greater in the younger age group than in the older age group. The results also indicated a large difference in QALYs between physical activity and sleep. These findings may provide a significant suggestion for future health promotion measures.

Association between nutrition labelling awareness and the metabolic syndrome: results from the Korean National Health and Nutrition Examination Survey (KNHANES) 2016-2018

Healthy dietary habits reduce the likelihood for the metabolic syndrome (MS). The present study investigated whether awareness of nutrition information is associated with a decreased likelihood for the MS after adjusting for potential confounders among Korean adults aged 20 years and older. Data were obtained from the Korean National Health and Nutrition Examination Survey 2016-2018. Of the 14 490 participants, 4001 (27·6 %) participants had the MS. In total, 3815 (26·3 %) participants checked nutritional facts and made labelling-dependent purchasing decisions (aware + consider), 7001 (48·3 %) checked nutritional facts but did not make labelling-dependent purchasing decisions or were aware of nutrition facts but did not check them when making food purchasing decisions (aware + not consider) and 3674 (25·4 %) were unaware of nutritional facts (not aware). The aware + consider group was less likely to develop the MS than other groups. The aware + not consider, and not aware groups were at higher association with the MS compared with the aware + consider group. Statistically significant associations were observed between the MS and several demographic characteristics including sex, age, household income, education level, employment status, public health insurance status, smoking status, alcohol consumption and aerobic exercise.

Nordic Walking at Maximal Fat Oxidation Intensity Decreases Circulating Asprosin and Visceral Obesity in Women With Metabolic Disorders

OBJECTIVE

Excess visceral adipose tissue is associated with insulin resistance and other metabolic disorders, including deregulation of adipokine secretion, which may be corrected by aerobic exercise training. Asprosin is a novel adipokine responsible for the regulation of appetite and the release of glucose from the liver, and its levels are pathologically elevated in obesity. The aim of the study was to evaluate the effects of 8-week Nordic walking (NW) training at maximal fat oxidation intensity (FAT max ) on changes in body mass, as well as those in insulin resistance and asprosin levels among young women with visceral obesity and metabolic disorders.

MATERIALS AND METHODS

The study was completed by 14 women (30.14 ± 3.63 years) representing low levels of physical activity, visceral obesity (waist circumference 105.50 ± 14.87 cm, BMI 33.85 ± 5.48 kg/m2) and with metabolic disorders, who for 8 weeks (three times a week, 60 min), participated in NW training at the FAT max intensity (61.92 ± 6.71% HR max , 42.33 ± 8.69% VO2max) controlled on the basis of heart rate (114.21 ± 14.10 bpm).

RESULTS

After 4 and 8 weeks of NW training, a significant decrease in the concentration of asprosin, waist and hip circumference (HC), waist-to-height ratio and body adiposity index (BAI) (p < 0.05, large effect size) were found.

CONCLUSION

The 8-week NW training at an FAT max intensity decreases the concentration of asprosin in the blood as well as visceral obesity in young women with metabolic disorders.