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Lim AMW, Lim EU, Chen PL, Fann CSJ. Unsupervised clustering identified clinically relevant metabolic syndrome endotypes in UK and Taiwan Biobanks. iScience 2024; 27:109815. [PMID: 39040048 PMCID: PMC11260869 DOI: 10.1016/j.isci.2024.109815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/02/2024] [Accepted: 04/23/2024] [Indexed: 07/24/2024] Open
Abstract
Metabolic syndrome (MetS) is a collection of cardiovascular risk factors; however, the high prevalence and heterogeneity impede effective clinical management. We conducted unsupervised clustering on individuals from UK Biobank to reveal endotypes. Five MetS subgroups were identified: Cluster 1 (C1): non-descriptive, Cluster 2 (C2): hypertensive, Cluster 3 (C3): obese, Cluster 4 (C4): lipodystrophy-like, and Cluster 5 (C5): hyperglycemic. For all of the endotypes, we identified the corresponding cardiometabolic traits and their associations with clinical outcomes. Genome-wide association studies (GWASs) were conducted to identify associated genotypic traits. We then determined endotype-specific genotypic traits and constructed polygenic risk score (PRS) models specific to each endotype. GWAS of each MetS clusters revealed different genotypic traits. C1 GWAS revealed novel findings of TRIM63, MYBPC3, MYLPF, and RAPSN. Intriguingly, C1, C3, and C4 were associated with genes highly expressed in brain tissues. MetS clusters with comparable phenotypic and genotypic traits were identified in Taiwan Biobank.
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Affiliation(s)
- Aylwin Ming Wee Lim
- Taiwan International Graduate Program in Molecular Medicine, National Yang Ming Chiao Tung University and Academia Sinica, Taipei 112304, Taiwan
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
- ASUS Intelligent Cloud Services (AICS), Taipei 112, Taiwan
| | - Evan Unit Lim
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
- College of Computing, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Pei-Lung Chen
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10617, Taiwan
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Cathy Shen Jang Fann
- Taiwan International Graduate Program in Molecular Medicine, National Yang Ming Chiao Tung University and Academia Sinica, Taipei 112304, Taiwan
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan
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Corona DG, Vena W, Pizzocaro A, Rastrelli G, Sparano C, Sforza A, Vignozzi L, Maggi M. Metabolic syndrome and erectile dysfunction: a systematic review and meta-analysis study. J Endocrinol Invest 2023; 46:2195-2211. [PMID: 37515706 DOI: 10.1007/s40618-023-02136-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/09/2023] [Indexed: 07/31/2023]
Abstract
PURPOSE The clinical significance of metabolic syndrome (MetS) versus its single components in erectile dysfunction (ED) is conflicting. Thus, the purpose is to analyze the available evidence on the relationship between MetS-along with its components-and ED. METHODS All prospective and retrospective observational studies reporting information on ED and MetS were included. In addition, we here reanalyzed preclinical and clinical data obtained from a previously published animal model of MetS and from a consecutive series of more than 2697 men (mean age: 52.7 ± 12), respectively. RESULTS Data derived from this meta-analysis showed that MetS was associated with an up to fourfold increased risk of ED when either unadjusted or adjusted data were considered. Meta-regression analysis, performed using unadjusted statistics, showed that the MetS-related risk of ED was closely associated with all the MetS components. These associations were confirmed when unadjusted analyses from clinical models were considered. However, fully adjusted data showed that MetS-associated ED was more often due to morbidities included (or not) in the algorithm than to the MetS diagnostic category itself. MetS is also associated with low testosterone, but its contribution to MetS-associated ED-as derived from preclinical and clinical models-although independent, is marginal. CONCLUSIONS The results of our analysis suggest that MetS is a useless diagnostic category for studying ED. However, treating the individual MetS components is important, because they play a pivotal role in determining ED.
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Affiliation(s)
- D G Corona
- Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy.
| | - W Vena
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - A Pizzocaro
- Unit of Endocrinology, Diabetology and Medical Andrology, IRCSS, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - C Sparano
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - A Sforza
- Endocrinology Unit, Azienda AUSL Bologna, Largo Nigrisoli 2, 40133, Bologna, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - M Maggi
- Endocrinology Unit, "Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Loracher C, Märkl B, Loracher A. The impact of progredient vessel and tissue stiffening for the development of metabolic syndrome. Pflugers Arch 2022; 474:1323-1326. [PMID: 36151345 DOI: 10.1007/s00424-022-02749-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/28/2022]
Abstract
Established risk factors for the metabolic syndrome as diabetes and arterial hypertension are believed to be the cause of arteriosclerosis and subsequently following diseases like coronary heart disease, apoplexy, or chronic renal failure. Based on broad evidence from the already available experimental literature and clinical experience, an alternative hypothesis is presented that puts an increased vessel and organ stiffness to the beginning of the pathophysiological scenario. The stiffness itself is caused by a persistent activation of mechano-sensitive cation channels like the epithelial/endothelial sodium channel. A further enhancement takes place by proteins like JACD and RhoA coupled phospholipase C coupled G-protein receptors and integrins. A self-enhancing positive feedback loop by activation of YAP/TAZ signaling is a further central pillar of this theory. Further investigations are necessary to verify this hypothesis. If this hypothesis could be confirmed fundamental changes regarding the pharmacologic therapy of the diseases that are currently summarizes as metabolic syndrome would be the consequence.
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Affiliation(s)
- Clemens Loracher
- General Pathology and Molecular Diagnostics, Medical Faculty, University Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany.
| | - Bruno Märkl
- General Pathology and Molecular Diagnostics, Medical Faculty, University Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany
| | - Alois Loracher
- General Pathology and Molecular Diagnostics, Medical Faculty, University Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany
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Ticagrelor alleviates high-carbohydrate intake induced altered electrical activity of ventricular cardiomyocytes by regulating sarcoplasmic reticulum-mitochondria miscommunication. Mol Cell Biochem 2021; 476:3827-3844. [PMID: 34114148 DOI: 10.1007/s11010-021-04205-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/03/2021] [Indexed: 12/17/2022]
Abstract
Metabolic syndrome (MetS) is associated with additional cardiovascular risk in mammalians while there are relationships between hyperglycemia-associated cardiovascular dysfunction and increased platelet P2Y12 receptor activation. Although P2Y12 receptor antagonist ticagrelor (Tica) plays roles in reduction of cardiovascular events, its beneficial mechanism remains poorly understood. Therefore, we aimed to clarify whether Tica can exert a direct protective effect in ventricular cardiomyocytes from high-carbohydrate diet-induced MetS rats, at least, through affecting sarcoplasmic reticulum (SR)-mitochondria (Mit) miscommunication. Tica treatment of MetS rats (150 mg/kg/day for 15 days) significantly reversed the altered parameters of action potentials by reversing sarcolemmal ionic currents carried by voltage-dependent Na+ and K+ channels, and Na+/Ca2+-exchanger in the cells, expressed P2Y12 receptors. The increased basal-cytosolic Ca2+ level and depressed SR Ca2+ load were also reversed in Tica-treated cells, at most, though recoveries in the phosphorylation levels of ryanodine receptors and phospholamban. Moreover, there were marked recoveries in Mit structure and function (including increases in both autophagosomes and fragmentations) together with recoveries in Mit proteins and the factors associated with Ca2+ transfer between SR-Mit. There were further significant recoveries in markers of both ER stress and oxidative stress. Taken into consideration the Tica-induced prevention of ER stress and mitochondrial dysfunction, our data provided an important document on the pleiotropic effects of Tica in the electrical activity of the cardiomyocytes from MetS rats. This protective effect seems through recoveries in SR-Mit miscommunication besides modulation of different sarcolemmal ion-channel activities, independent of P2Y12 receptor antagonism.
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Abstract
Although the first description of a syndrome defined by the co-existence of atherogenic and diabetogenic metabolic abnormalities is debated in the literature, it was Gerald Reaven who proposed, in his landmark 1988 Banting award lecture, that a significant proportion of individuals (with diabetes or not) were characterised by insulin resistance causing prejudice to cardiovascular health. However, Reaven was influenced by seminal observations made more than 50 years earlier by Himsworth who proposed that there were two forms of diabetes (insulin resistant v. insulin sensitive). Reaven went further in proposing the theory that insulin resistance was the most prevalent cause of CVD associated with metabolic abnormalities that he named syndrome X. Because there was a syndrome X documented in cardiology, the term evolved to insulin resistance syndrome. As Reaven could also find insulin-resistant individuals in non-obese subjects, he did not include obesity as a feature of syndrome X. Imaging studies then revealed that excess adipose tissue in the abdominal cavity, a condition described as visceral obesity, was the form of overweight/obesity associated with insulin resistance and its related abnormalities. As obesity risk assessment and management remain largely based on body weight (BMI) and weight loss, it is proposed that our clinical approaches and public health messages should be revisited. First, patients should be educated about the importance of monitoring their waistline as a crude index of abdominal adiposity. Secondly, public health approaches focussing on 'lifestyle vital signs' including achieving healthy waistlines rather than healthy body weights should be developed.
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Governa P, Baini G, Borgonetti V, Cettolin G, Giachetti D, Magnano AR, Miraldi E, Biagi M. Phytotherapy in the Management of Diabetes: A Review. Molecules 2018; 23:E105. [PMID: 29300317 PMCID: PMC6017385 DOI: 10.3390/molecules23010105] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 12/30/2017] [Accepted: 01/01/2018] [Indexed: 01/25/2023] Open
Abstract
Phytotherapy has long been a source of medicinal products and over the years there have been many attempts to use herbal medicines for the treatment of diabetes. Several medicinal plants and their preparations have been demonstrated to act at key points of glucidic metabolism. The most common mechanisms of action found include the inhibition of α-glucosidase and of AGE formation, the increase of GLUT-4 and PPARs expression and antioxidant activity. Despite the large amount of literature available, the actual clinical effectiveness of medicinal plants in controlling diabetes-related symptoms remains controversial and there is a crucial need for stronger evidence-based data. In this review, an overview of the medicinal plants, which use in the management of diabetes is supported by authoritative monographs, is provided. References to some species which are currently under increasing clinical investigation are also reported.
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Affiliation(s)
- Paolo Governa
- Department of Physical Sciences, Earth and Environment, University of Siena, Via Laterina 8, 53100 Siena, Italy.
- Italian Society of Phytotherapy, Via Laterina 8, 53100 Siena, Italy.
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy.
| | - Giulia Baini
- Department of Physical Sciences, Earth and Environment, University of Siena, Via Laterina 8, 53100 Siena, Italy.
- Italian Society of Phytotherapy, Via Laterina 8, 53100 Siena, Italy.
| | - Vittoria Borgonetti
- Department of Physical Sciences, Earth and Environment, University of Siena, Via Laterina 8, 53100 Siena, Italy.
- Italian Society of Phytotherapy, Via Laterina 8, 53100 Siena, Italy.
| | - Giulia Cettolin
- Department of Physical Sciences, Earth and Environment, University of Siena, Via Laterina 8, 53100 Siena, Italy.
- Italian Society of Phytotherapy, Via Laterina 8, 53100 Siena, Italy.
| | - Daniela Giachetti
- Department of Physical Sciences, Earth and Environment, University of Siena, Via Laterina 8, 53100 Siena, Italy.
- Italian Society of Phytotherapy, Via Laterina 8, 53100 Siena, Italy.
| | - Anna Rosa Magnano
- Department of Physical Sciences, Earth and Environment, University of Siena, Via Laterina 8, 53100 Siena, Italy.
- Italian Society of Phytotherapy, Via Laterina 8, 53100 Siena, Italy.
| | - Elisabetta Miraldi
- Department of Physical Sciences, Earth and Environment, University of Siena, Via Laterina 8, 53100 Siena, Italy.
- Italian Society of Phytotherapy, Via Laterina 8, 53100 Siena, Italy.
| | - Marco Biagi
- Department of Physical Sciences, Earth and Environment, University of Siena, Via Laterina 8, 53100 Siena, Italy.
- Italian Society of Phytotherapy, Via Laterina 8, 53100 Siena, Italy.
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Montano D. Association Between Socioeconomic Determinants and the Metabolic Syndrome in the German Health Interview and Examination Survey for Adults (DEGS1) - A Mediation Analysis. Rev Diabet Stud 2017; 14:279-294. [PMID: 29145538 PMCID: PMC6115006 DOI: 10.1900/rds.2017.14.279] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/23/2017] [Accepted: 08/01/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Metabolic syndrome and different socioeconomic characteristics including education and occupational status have been found to be associated in previous research. Nonetheless, theoretical models defining core variables and causal processes accounting for these associations are lacking. OBJECTIVES The main objectives of the present investigation are (1) to present a theoretical model integrating physiological, biochemical, and psychosocial factors determining metabolic syndrome prevalence and (2) to corroborate the hypothesis that socioeconomic determinants are (partially) mediated by health-related behaviors, health risks, and dietary habits. METHODS The research hypothesis is tested with cross-sectional data from the German Health Interview and Examination Survey for Adults (DEGS1) conducted from 2008 to 2011 (n = 7,987) by means of multivariate regression models which appropriately take into account the stochastic dependence of metabolic syndrome components. RESULTS The results suggest that the metabolic syndrome is less frequent among individuals with a higher educational level and those who have a partner. These associations may point to protective effects of social support, self-efficacy, and other socio-psychological constructs in relation to metabolic syndrome incidence. Furthermore, frequent consumption of wine, muesli, fruits, and raw vegetables are associated with lower prevalence rates of metabolic syndrome components. The associations of occupational status, income, and employment are partially mediated by health-related behavior, physiological and psychosocial factors, and dietary habits. Sensitivity analyses have suggested that even small changes in the distribution of potential risk and protective factors may reduce the prevalence of metabolic syndrome components. CONCLUSIONS Healthrelated behavior (smoking, physical activity) and physiological and psychosocial factors mediate the association between socioeconomic characteristics and metabolic syndrome prevalence. However, metabolic syndrome components were much less frequent among individuals with a higher educational level, higher income and occupational status, and those having a life partner.
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Affiliation(s)
- Diego Montano
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany
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Jeejeebhoy K, Dhaliwal R, Heyland DK, Leung R, Day AG, Brauer P, Royall D, Tremblay A, Mutch DM, Pliamm L, Rhéaume C, Klein D. Family physician-led, team-based, lifestyle intervention in patients with metabolic syndrome: results of a multicentre feasibility project. CMAJ Open 2017; 5:E229-E236. [PMID: 28401139 PMCID: PMC5378505 DOI: 10.9778/cmajo.20160101] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a medical condition with major complications and health care costs. Previous research has shown that diet and exercise can improve and reverse this condition. The goal of this study was to test the feasibility and effectiveness of implementing the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program into diverse family medicine practices to improve MetS. METHODS In this longitudinal before-after study, 305 adult patients with MetS were recruited from 3 diverse family medicine team-based organizations to the CHANGE personalized diet and exercise program. Participants were followed for 12 months. Primary outcomes included feasibility and reversal of MetS. Secondary outcomes included improvement in MetS components, changes in diet quality, aerobic fitness and cardiovascular risk. RESULTS Participants attended 76% and 90% of the kinesiologist and dietitian visits, respectively. At 12 months, 19% of patients (95% confidence interval [CI] 14%-24%) showed reversal of MetS, VO2max increased by 16% (95% CI 13%-18%), and Healthy Eating Index and Mediterranean Diet Scores improved by 9.6% (95% CI 7.6%-11.6%) and 1.4% (1.1%-1.6%), respectively. In addition, the Prospective Cardiovascular Munster (PROCAM) 10-year risk of acute coronary event decreased by 1.4%, from a baseline of 8.6%. INTERPRETATION A team-based program led by the family physician that educates patients about the risks of MetS, and with a dietitian and kinesiologist, empowers them to undertake an individualized supervised program of diet modification and exercise, is feasible, improves aerobic capacity and diet quality, reverses MetS and improves MetS components at 12 months.
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Affiliation(s)
- Khursheed Jeejeebhoy
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
| | - Rupinder Dhaliwal
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
| | - Daren K Heyland
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
| | - Roger Leung
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
| | - Andrew G Day
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
| | - Paula Brauer
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
| | - Dawna Royall
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
| | - Angelo Tremblay
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
| | - David M Mutch
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
| | - Lew Pliamm
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
| | - Caroline Rhéaume
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
| | - Doug Klein
- Metabolic Syndrome Canada is a not-for-profit charitable organization that funded the current study. Daren Heyland received grant funds from Metabolic Syndrome Canada for program development, study coordination and data analyses. Rupinder Dhaliwal, Andrew Day and Roger Leung were paid for their work on the study by Kingston General Hospital and Queen's University from this grant. Rupinder Dhaliwal became an employee of Metabolic Syndrome Canada after the completion of study enrolment. Lew Pliamm, Caroline Rhéuame and Doug Klein received grants as participating sites for patient enrolment and data collection from Metabolic Syndrome Canada. Paula Brauer, Dawna Royall, David Mutch and Angelo Tremblay received grants for program development from Metabolic Syndrome Canada. Khursheed Jeejeebhoy is on the board of directors for Metabolic Syndrome Canada and will be involved in discussions about fundraising for this nonprofit organization
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Norberg M, Stenlund H, Lindahl B, Boman K, Weinehall L. Contribution of Swedish moist snuff to the metabolic syndrome: A wolf in sheep's clothing? Scand J Public Health 2016; 34:576-83. [PMID: 17132590 DOI: 10.1080/14034940600665143] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Aim: Combined effects of genetic and environmental factors underlie the clustering of cardiovascular risk factors in the metabolic syndrome (MetSy). The aim was to investigate associations between several lifestyle factors and MetSy, with a focus on the possible role of smokeless tobacco in the form of Swedish moist snuff (snus). Methods: A population-based longitudinal cohort study within the Västerbotten Intervention Programme in Northern Sweden. All inhabitants at the ages of 30, 40, 50, and 60 are invited to participate in a health survey that includes a questionnaire on psychosocial conditions and lifestyle and measurement of biological variables. Individuals examined in 1990—94 (n=24,230) and who also returned for follow-up after 10 years were included (total of 16,492 individuals: 46.6% men and 53.4% women). Regression analyses were performed. MetSy was the outcome and analyses were adjusted for age, sex, alcohol abuse, and family history of CVD and diabetes. Results: Ten-year development of MetSy was associated with high-dose consumption of snus at baseline (OR 1.6 [95% CI 1.26—2.15]), low education (2.2 [1.92—2.63]), physical inactivity (1.5 [1.22—1.73]) and former smoking (1.2 [1.06—1.38]). Snus was associated with separate components of MetSy, including triglycerides (1.6, 1.30—1.95), obesity (1.7 [1.36—2.18]) but not hypertension, dysglycemia and low HDL cholesterol. Conclusions: MetSy is independently associated with high consumption of snus, even when controlling for smoking status. The finding is of public health interest in societies with widespread use of snus. More research is needed to better understand the mechanisms underlying this effect.
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Affiliation(s)
- Margareta Norberg
- Epidemiology and Public Health Sciences, Umeå University, Umeå, Sweden.
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Giuffrida FMA. The quest for a metabolic theory of everything. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2016; 60:187-9. [PMID: 27355854 PMCID: PMC10522303 DOI: 10.1590/2359-3997000000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 05/22/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Fernando M. A. Giuffrida
- Departamento de Ciências da VidaUniversidade do Estado da BahiaSalvadorBrasilDepartamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Brasil.
- Universidade Federal de São PauloSão PauloBrasilPrograma de Pós-Graduação em Endocrinologia, Disciplina de Endocrinologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brasil.
- Centro de Diabetes e Endocrinologia do Estado da BahiaSalvadorBrasilCentro de Diabetes e Endocrinologia do Estado da Bahia (CEDEBA), Salvador, Brasil
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11
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Malayala SV, Raza A. Health behavior and perceptions among African American women with metabolic syndrome. J Community Hosp Intern Med Perspect 2016; 6:30559. [PMID: 26908390 PMCID: PMC4763556 DOI: 10.3402/jchimp.v6.30559] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 01/16/2016] [Accepted: 01/21/2016] [Indexed: 11/26/2022] Open
Abstract
Background Metabolic syndrome is a cluster of different risk factors (abdominal obesity, insulin resistance, high blood pressure, and high cholesterol) that predispose to the development of cardiovascular diseases. African American women (AAW) are easily predisposed to metabolic syndrome due to higher levels of insulin resistance. Various sociodemographic factors further contribute to higher prevalence. Aim This study evaluates the current prevalence of metabolic syndrome in AAW and identifies the related sociodemographic risk factors. Methods The study utilized 2007–11 National Health and Nutrition Examination Survey (NHANES) data sets from the Centers for Disease Control (CDC). The sample was divided into two groups: AAW with and without metabolic syndrome. Sociodemographic, physical examination, laboratory parameters, and health perceptions were compared between the two groups. Results Out of the available sample of 30,442 individuals, 1918 (6.4%) met the inclusion criteria (AAW, age>20, non-pregnant women). The prevalence of metabolic syndrome was 47%. Older age, lower education level, low socioeconomic status, unmarried status, low physical activity level, and smoking were associated with higher prevalence of metabolic syndrome (p<0.001). The prevalence of borderline hypertension, hypertension, diabetes, stroke, and cardiovascular diseases was significantly higher in AAW with metabolic syndrome (p<0.001). Conclusion In spite of the focus on prevention of cardiovascular risk factors and elimination of ethnic and gender disparities, metabolic syndrome is still widely prevalent in AAW and poses a threat to the goals of Healthy People 2020.
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Affiliation(s)
- Srikrishna Varun Malayala
- Department of Internal Medicine, University at Buffalo/Sisters of Charity Hospital - Catholic Health System, Buffalo, NY, USA;
| | - Ambreen Raza
- Department of Internal Medicine, University at Buffalo/Sisters of Charity Hospital - Catholic Health System, Buffalo, NY, USA
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Metabolic Syndrome in South African Patients with Severe Mental Illness: Prevalence and Associated Risk Factors. PLoS One 2016; 11:e0149209. [PMID: 26882230 PMCID: PMC4755575 DOI: 10.1371/journal.pone.0149209] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 01/28/2016] [Indexed: 01/16/2023] Open
Abstract
Background There is a surge of cardiovascular disease (CVD) in Africa. CVD is the leading cause of mortality among patients with severe mental illness (SMI) in developed countries, with little evidence from the African context. Objective To determine the prevalence and risk factors for MetS among South African patients with SMI. Method In a cross sectional study, individuals with SMI treated with antipsychotics and a control group without a mental illness, matched for age, gender and ethnicity were evaluated for MetS using the 2009 Joint Interim statement (JIS) criteria. Results Of the 276 study group subjects, 65.9% were male, 84.1% black African, 9.1% white, 5.4% of Indian descent and 1.5% coloured (mixed race) with a mean age of 34.7 years (±12.5). Schizophrenia was the most common diagnosis (73.2%) and 40% were taking first generation antipsychotics. The prevalence of MetS was 23.2% (M: 15.4%, F: 38.3%) in the study group and 19.9% (M: 11.9%, F: 36.3%) in the control group (p = 0.4). MetS prevalence was significantly higher in study subjects over 55 years compared to controls (p = 0.03). Increased waist circumference (p< 0.001) and low high density lipoprotein (HDL) cholesterol (p = 0.003) were significantly more prevalent in study subjects compared to controls. In study subjects, risk factors associated with MetS included age (OR: 1.09, 95% CI 1.06–1.12, p < 0.001), female gender (OR: 2.19, 95% CI 1.06–4.55, p = 0.035) and Indian descent (OR: 5.84, 95% CI 1.66–20.52, p = 0.006) but not class of antipsychotic (p = 0.26). Conclusion The overall MetS prevalence was not increased in patients with SMI compared to controls; however, the higher prevalence of the individual components (HDL cholesterol and waist circumference) suggests an increased risk for CVD, especially in patients over 55 years.
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Vancampfort D, Stubbs B, Probst M, De Hert M, Schuch FB, Mugisha J, Ward PB, Rosenbaum S. Physical activity as a vital sign in patients with schizophrenia: Evidence and clinical recommendations. Schizophr Res 2016; 170:336-40. [PMID: 26782636 DOI: 10.1016/j.schres.2016.01.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 12/01/2015] [Accepted: 01/01/2016] [Indexed: 12/21/2022]
Abstract
AIM This study investigated whether in patients with schizophrenia the Physical Activity Vital Sign (PAVS) assessment can identify those at higher risk of cardio-metabolic abnormalities. METHODS One hundred patients with schizophrenia completed the PAVS-questions exploring whether they adhered to the general physical activity recommendations, underwent a full-fasting metabolic screening, and performed a six-minute walk test (6 MWT). RESULTS Those who do not adhere to the health recommendations according to the PAVS (n=61) were significantly older (37.1±11.3 versus 32.5±8.5 years, P=0.033) and more likely to be women (30/36 versus 31/64, P<0.001). Patients who do not meet the physical activity recommendations have a higher BMI (27.0±6.4 versus 23.3±3.1, P=0.017) performed worse on the 6MWT (531.1±84.2 m versus 657.0±98.2 m, P<0.001) and are at a significantly higher risk for cardio-metabolic diseases. Relative risks ranged from 1.07 (0.84-1.36) for having dyslipidemia to 4.65 (1.77-12.17) for having hypertension. CONCLUSIONS PAVS-baseline assessment should be included in the routine assessment of people with schizophrenia.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven - University of Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, Z.org UPC Leuven, campus Kortenberg, Kortenberg, Belgium.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom
| | - Michel Probst
- KU Leuven - University of Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Marc De Hert
- KU Leuven - University of Leuven, Z.org UPC Leuven, campus Kortenberg, Kortenberg, Belgium
| | - Felipe B Schuch
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil; Programa de Pos Graduacaoem Ciencias Medicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - James Mugisha
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
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14
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Vidula H, Liu K, Criqui MH, Szklo M, Allison M, Sibley C, Ouyang P, Tracy RP, Chan C, McDermott MM. Metabolic syndrome and incident peripheral artery disease - the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 2015; 243:198-203. [PMID: 26398292 DOI: 10.1016/j.atherosclerosis.2015.08.044] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 08/16/2015] [Accepted: 08/31/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We evaluated whether metabolic syndrome (MetS) is associated with an increased incidence of lower extremity peripheral artery disease (PAD) in community dwelling people free of clinical cardiovascular disease at baseline. We assessed whether higher levels of inflammatory biomarkers may mediate the association of MetS with incident PAD. METHODS MetS was defined at baseline as the presence of three or more of the following components: elevated waist circumference, triglycerides ≥150 mg/dL, reduced high-density lipoprotein (HDL) cholesterol, blood pressure ≥130/85 mm Hg or taking blood pressure medication, and fasting glucose ≥100 mg/dL and <126 mg/dL. People with diabetes were excluded. Incident New PAD was defined among people with a normal ankle brachial index (ABI) at baseline (i.e. baseline ABI of 0.90 to 1.40) and consisted of one of the following outcomes during 3-year follow-up: ABI decline to < 0.90 combined with a decline ≥0.15 or medical record confirmed PAD outcome. Multivariable Poisson regression was used to estimate the association between MetS and incident PAD. RESULTS Among 4817 participants without PAD at baseline, 1382 (29%) had MetS. Adjusting for age, sex, race, smoking, physical activity, low-density lipoprotein cholesterol, baseline ABI, and other confounders, 23/1382 (1.7%) people with MetS developed PAD vs. 30/3435 (0.87%) people without MetS (risk ratio = 1.78 [95% Confidence Interval (CI), 1.04 to 2.82], P = 0.031). Adjusting for C-reactive protein, fibrinogen, or interleukin-6 did not attenuate this association. CONCLUSION People free of clinical cardiovascular disease with MetS are at increased risk for PAD. Our findings suggest that this association is not mediated by inflammation.
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Affiliation(s)
- Himabindu Vidula
- University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA
| | - Kiang Liu
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA; Department of Medicine, Northwestern University Feinberg School of Medicine, 750 N Lake Shore Drive, 10th Floor, Chicago, IL 60611, USA
| | - Michael H Criqui
- Department of Family and Preventive Medicine, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Moyses Szklo
- Department of Epidemiology, John Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - Matthew Allison
- Department of Family and Preventive Medicine, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Christopher Sibley
- Knight Cardiovascular Institute, Oregon Health and Science University, 3181 South West Sam Jackson Park Road, Portland, OR 97239, USA
| | - Pamela Ouyang
- Department of Medicine, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD 21224, USA
| | - Russell P Tracy
- Departments of Pathology and Biochemistry, University of Vermont College of Medicine, 89 Beaumont Avenue, Burlington, VT 05405, USA
| | - Cheeling Chan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA
| | - Mary M McDermott
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA; Department of Medicine, Northwestern University Feinberg School of Medicine, 750 N Lake Shore Drive, 10th Floor, Chicago, IL 60611, USA.
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15
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Ryoo JH, Chun H, Lee HS, Suh E, Choi JM, Kim MG, Shin H, Park SK, Oh CM, Ko TS. Clinical associations between metabolic syndrome and the development of microalbuminuria in Korean men. Diabetes Res Clin Pract 2015; 107:407-14. [PMID: 25638455 DOI: 10.1016/j.diabres.2014.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 10/07/2014] [Accepted: 12/25/2014] [Indexed: 11/15/2022]
Abstract
AIMS There have been several studies on the association between metabolic syndrome (MetS) and microalbuminuria. However, none has examined whether MetS is associated with the prospective development of microalbuminuria. Accordingly, we performed a prospective study to evaluate the longitudinal effects of baseline number of MetS traits on the development of microalbuminuria in Korean men. METHODS 1649 Korean men without microalbuminuria in 2005 were included and followed prospectively until 2010 with the endpoint being the development of microalbuminuria. MetS was defined according to the joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. Microalbuminuria was evaluated by urine albumin creatinine ratio (UACR). Risk estimations for development of microalbuminuria were analyzed according to the number of MetS traits using multivariate adjusted Cox proportional hazards model. RESULTS During 5611.8 person-years of follow-up (median 3.40±1.46 years), microalbuminuria developed in 91 (5.5%) participants between 2006 and 2010. After adjusting for multiple covariates, the hazard ratios (95% confidence interval) for development of microalbuminuria comparing 1, 2 and 3-5 MetS traits vs 0 were 2.57 (0.97-6.82), 2.94 (1.09-7.98) and 3.85 (1.37-10.86), respectively. CONCLUSIONS The number of MetS traits independently associated with the future development of microalbuminuria during the 5-year follow-up period, and MetS per se was an independent risk factor for microalbuminuria.
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Affiliation(s)
- Jae-Hong Ryoo
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hyejin Chun
- Health Promotion Center, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Hong-Soo Lee
- Department of Family Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Eunkyung Suh
- Department of Family Medicine, CHAUM, CHA University School of Medicine, Pocheon, Republic of Korea
| | - Joong-Myung Choi
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Min-Gi Kim
- Department of Occupational and Environmental Medicine, Dongguk University, Gyeongju Hospital, Seoul, Republic of Korea
| | - HoCheol Shin
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Sung Keun Park
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea; Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea.
| | - Chang-Mo Oh
- Korea Institute of Drug Safety and Risk Management, Seoul, Republic of Korea
| | - Taeg Su Ko
- Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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16
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Rutter MK, Sullivan LM, Fox CS, Wilson PW, Nathan DM, Vasan RS, D'Agostino RB, Meigs JB. Baseline levels, and changes over time in body mass index and fasting insulin, and their relationship to change in metabolic trait clustering. Metab Syndr Relat Disord 2014; 12:372-80. [PMID: 25007010 PMCID: PMC4209491 DOI: 10.1089/met.2013.0148] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Multiple abnormal metabolic traits are found together or "cluster" within individuals more often than is predicted by chance. The individual and combined role of adiposity and insulin resistance (IR) on metabolic trait clustering is uncertain. We tested the hypothesis that change in trait clustering is a function of both baseline level and change in these measures. METHODS In 2616 nondiabetic Framingham Offspring Study participants, body mass index (BMI) and fasting insulin were related to a within-person 7-year change in a trait score of 0-4 Adult Treatment Panel III metabolic syndrome traits (hypertension, high triglycerides, low high-density lipoprotein cholesterol, hyperglycemia). RESULTS At baseline assessment, mean trait score was 1.4 traits, and 7-year mean (SEM) change in trait score was +0.25 (0.02) traits, P<0.0001. In models with BMI predictors only, for every quintile difference in baseline BMI, the 7-year trait score increase was 0.14 traits, and for every quintile increase in BMI during 7-year follow-up, the trait score increased by 0.3 traits. Baseline level and change in fasting insulin were similarly related to trait score change. In models adjusted for age-sex-baseline cluster score, 7-year change in trait score was significantly related to both a 1-quintile difference in baseline BMI (0.07 traits) and fasting insulin (0.18 traits), and to both a 1-quintile 7-year increase in BMI (0.21 traits) and fasting insulin (0.18 traits). CONCLUSIONS Change in metabolic trait clustering was significantly associated with baseline levels and changes in both BMI and fasting insulin, highlighting the importance of both obesity and IR in the clustering of metabolic traits.
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Affiliation(s)
- Martin K Rutter
- The Endocrinology and Diabetes Research Group, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, and Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Lisa M. Sullivan
- Department of Biostatistics, Boston University, Boston, Massachusetts
| | - Caroline S. Fox
- Harvard Medical School, Boston, Massachusetts
- National Heart, Lung, and Blood Institute and Framingham (Mass) Heart Study, Framingham, Massachusetts
- Department of Endocrinology and Metabolism, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - David M. Nathan
- Harvard Medical School, Boston, Massachusetts
- General Medicine Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Ramachandran S. Vasan
- National Heart, Lung, and Blood Institute and Framingham (Mass) Heart Study, Framingham, Massachusetts
- Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts
| | - Ralph B. D'Agostino
- Department of Mathematics and Statistics/Consulting Unit, Boston University, Boston, Massachusetts
| | - James B. Meigs
- Harvard Medical School, Boston, Massachusetts
- General Medicine Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
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17
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He D, Xi B, Xue J, Huai P, Zhang M, Li J. Association between leisure time physical activity and metabolic syndrome: a meta-analysis of prospective cohort studies. Endocrine 2014; 46:231-40. [PMID: 24287790 DOI: 10.1007/s12020-013-0110-0] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 10/30/2013] [Indexed: 01/17/2023]
Abstract
A great number of prospective studies have investigated the relationship between leisure time physical activity (LTPA) and metabolic syndrome (MetS) risk. However, the results have been inconsistent. The aim of this study was to clarify the relationship between LTPA and MetS risk. Literature databases were searched including PubMed and Embase up to June 2013. A total of 17 studies, including 64,353 participants and 11,271 incident cases, were included in the meta-analysis. A high level of LTPA was statistically associated with decreased risk of MetS [high vs. low: relative risk (RR) = 0.80, 95 % confidence interval (CI) 0.75-0.85], whereas a moderate level of LTPA was weakly associated with decreased risk of MetS (moderate vs. low: RR = 0.95, 95 % CI 0.91-1.00). Subgroup analyses indicated that the association between a moderate level of LTPA and decreased risk of MetS was only significant in men (moderate vs. low: RR = 0.88, 95 % CI 0.81-0.97) and in studies with more than a 10-year follow-up period (moderate vs. low: RR = 0.90, 95 % CI 0.84-0.97). A high level of LTPA was statistically associated with decreased risk of MetS in each subgroup. A higher level of LTPA is associated with a lower risk of MetS. These findings could have public health implications with regard to prevention of MetS through lifestyle interventions.
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Affiliation(s)
- Dan He
- Department of Maternal and Child Health Care, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, People's Republic of China
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Black RNA, Ennis CN, Young IS, Hunter SJ, Atkinson AB, Bell PM. The peroxisome proliferator-activated receptor alpha agonist fenofibrate has no effect on insulin sensitivity compared to atorvastatin in type 2 diabetes mellitus; a randomised, double-blind controlled trial. J Diabetes Complications 2014; 28:323-7. [PMID: 24560135 DOI: 10.1016/j.jdiacomp.2014.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 12/02/2013] [Accepted: 01/02/2014] [Indexed: 11/28/2022]
Abstract
AIMS Assess insulin sensitivity after treatment with a selective PPAR-alpha agonist compared to an HMG CoA reductase inhibitor in human subjects with type 2 diabetes mellitus. METHODS Thirteen subjects with Type 2 diabetes mellitus were studied in a double-blind crossover design with 4-week placebo run-in and washout and 12-week treatment periods, randomised to micronised fenofibrate 267 mg or atorvastatin 10mg daily followed by the alternate drug in the second period. Insulin resistance was measured using the isoglycaemic hyperinsulinaemic clamp method with isotope dilution. RESULTS Weight, physical activity and other medications did not change. Total cholesterol (mean +/- standard error) was 4.60+/-0.21 versus 3.9+/-0.22 mmol/L after fenofibrate and atorvastatin respectively, p<0.05. LDL was 2.70+/-0.19 versus 1.95+/-0.23 mmol/L, p<0.05 and triglyceride 1.64+/-0.23 versus 1.84+/-0.26 mmol/L, p<0.05. Insulin-stimulated whole-body glucose disposal (35.4+/-3.1 versus 33.2+/-3.0 μmol/kg/min) and nadir endogenous glucose production (6.2+/-1.4 versus 7.0+/-1.1 μmol/kg/min) revealed no significant differences in effects of the treatments. CONCLUSIONS In human subjects with Type 2 diabetes mellitus there were characteristic differences in lipid profile changes but no difference in insulin sensitivity after treatment with micronised fenofibrate compared to atorvastatin. This study finds no evidence of increased insulin sensitivity using this selective PPAR-alpha agonist over a commonly used statin at these doses.
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Affiliation(s)
- R Neil A Black
- Regional Centre for Endocrinology & Diabetes, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, UK.
| | - Cieran N Ennis
- Regional Centre for Endocrinology & Diabetes, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, UK
| | - Ian S Young
- Nutrition and Metabolism Group, The Queen's University of Belfast, Belfast, UK
| | - Steven J Hunter
- Regional Centre for Endocrinology & Diabetes, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, UK
| | - A Brew Atkinson
- Regional Centre for Endocrinology & Diabetes, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, UK
| | - Patrick M Bell
- Regional Centre for Endocrinology & Diabetes, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, UK
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19
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Verkest KR. Is the metabolic syndrome a useful clinical concept in dogs? A review of the evidence. Vet J 2014; 199:24-30. [DOI: 10.1016/j.tvjl.2013.09.057] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 09/08/2013] [Accepted: 09/22/2013] [Indexed: 02/08/2023]
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20
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Huo D, Tao L, Li X, Wang W, Wang Z, Chen D, Zhu H, Yang X, Luo Y, Guo X. Association of blood pressure with development of metabolic syndrome components: a five-year Retrospective Cohort study in Beijing. BMC Public Health 2013; 13:912. [PMID: 24088273 PMCID: PMC3850729 DOI: 10.1186/1471-2458-13-912] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 09/25/2013] [Indexed: 12/28/2022] Open
Abstract
Background Raised blood pressure (BP) is associated with the incidence of metabolic syndrome (MetS). It is unknown if subjects with different BP levels may develop certain components of MetS over time. We investigated the incidence of MetS relative to different levels of BP over a 5-year period in a Chinese population in Tongren Hospital, Beijing. Methods During the period of 2006–2011, we recruited 2,781 participants with no MetS, or self-reported type 2 diabetes, dyslipidemia, hypertension, or cardiovascular disease at baseline. Association rule was used to identify the transitions of MetS components over time. Results The incidence of MetS at follow-up was 9.74% for men and 3.21% for women in the group with optimal BP; 10.29% and 7.22%, respectively, in the group with normal BP; 10.49% and 10.84%, respectively, in the group with high-normal BP; and 14.48% and 23.21%, respectively in the group with high BP. The most common transition was from healthy to healthy in the groups with optimal or normal BP (17.9–49.3%), whereas in the high-normal BP group, 16.9-22.1% of subjects with raised BP returned to healthy status or stayed unchanged, while 13.8-21.4% of people with high BP tended to develop raised fasting glucose levels. Conclusions The incidence of MetS increased in parallel with the increase in BP. People with optimal and normal BP levels were less susceptible to developing MetS over time, whereas abnormal BP seemed to be a pre-existing phase of MetS. High-normal BP was a crucial status for MetS prevention.
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Affiliation(s)
- Da Huo
- School of Public Health, Capital Medical University, No, 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing 100069, China.
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Tsatsoulis A, Mantzaris MD, Bellou S, Andrikoula M. Insulin resistance: an adaptive mechanism becomes maladaptive in the current environment - an evolutionary perspective. Metabolism 2013; 62:622-33. [PMID: 23260798 DOI: 10.1016/j.metabol.2012.11.004] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 11/08/2012] [Accepted: 11/14/2012] [Indexed: 01/07/2023]
Abstract
Human survival has relied upon the ability to withstand starvation through energy storage, the capacity to fight off infection by a proinflammatory immune response, and the ability to cope with physical stressors by an adaptive stress response. Energy storage, mainly as glycogen in liver and triglycerides in adipose tissue, is regulated by the anabolic actions of insulin. On the other hand, mobilization of stored energy during infection, trauma or stress is served by the temporary inhibition of insulin action (insulin resistance) in target tissues by proinflammatory cytokines and stress hormones. In the current environment, high energy intake, low physical activity, and chronic stress favor the storage of surplus fat in adipose tissue depots that far exceeds their storage capacity and liporegulation. Lipid overload in central fat depots initiates an inflammatory response and adipocyte dysfunction with resultant low-grade systemic inflammation and lipid overflow to peripheral tissues. In turn, proinflammatory cytokines and non-oxidized lipid metabolites, accumulated in liver and muscle cells, activate the mechanism of insulin resistance as would occur in the case of infection or stress. The same factors together with the ensuing insulin resistance further contribute to pancreatic β-cell dysfunction and ultimately to type 2 diabetes and cardiovascular disease. The present review supports the hypothesis that insulin resistance evolved as a physiological adaptive mechanism in human survival and that the same mechanism is inappropriately activated on a chronic basis in the current environment, leading to the manifestations of the metabolic syndrome.
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Affiliation(s)
- Agathocles Tsatsoulis
- Department of Endocrinology, Medical School, University of Ioannina, 45110 Ioannina, Greece.
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Nazzaro P, Schirosi G, Mezzapesa D, Petruzzellis M, Pascazio L, Serio G, De Benedittis L, Federico F. Effect of clustering of metabolic syndrome factors on capillary and cerebrovascular impairment. Eur J Intern Med 2013; 24:183-8. [PMID: 23041467 DOI: 10.1016/j.ejim.2012.08.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 08/24/2012] [Accepted: 08/27/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Hypertension and metabolic disorders, attended by impaired microcirculation, represent major risk factors for cerebrovascular impairment, as well as being individual components of the metabolic syndrome (MetS). Aim of the study was to establish whether mild hypertensives, aged ≤65years, may be affected by progressive microvascular damage impairing cerebrovascular perfusion, related to a progressive clustering of MetS components. METHODS Twenty-two normotensives with no MetS component (NTN-0), 29 hypertensives with no (HTN-0), 30 with one (HTN-1), 29 with two (HTN-2), 27 with three (HTN-3), 25 with all four (HTN-4) MetS components, were recruited. The study required office and twenty-four hour ambulatory blood pressure monitoring and video capillaroscopy. Functional (fCD), anatomical (aCD) and recruited (RECR) phalangeal skin capillarity were assessed. Cerebral vasodilatory reserve was measured by the breath-holding index (BHI), using transcranial Doppler, in HTN-1 and HTN-2 with MetS. RESULTS The fCD and aCD were reduced in hypertensives and progressively reduced in those with MetS, while RECR was also impaired. BHI was lower in HTN-2 than in HTN-1 (p<0.001). BHI was correlated with fCD in HTN-1 (.396, p: .046), HNT-2 (.497, p: .011), and with aCD in HTN-2 (.494, p: .012), by partial Pearson test. DISCUSSION The findings show that hypertensives exhibit an increasing microvascular rarefaction with MetS progression and that an impaired cerebral perfusion occurs when the MetS is established. The data underline the importance of preventing MetS in mild hypertensives, as it causes microvascular damage and impairs cerebral arterial perfusion.
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Affiliation(s)
- Pietro Nazzaro
- Department of Neurosciences, Division of Neurology-Stroke Unit, Hypertension, Italy.
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Jääskeläinen P, Magnussen CG, Pahkala K, Mikkilä V, Kähönen M, Sabin MA, Fogelholm M, Hutri-Kähönen N, Taittonen L, Telama R, Laitinen T, Jokinen E, Lehtimäki T, Viikari JSA, Raitakari OT, Juonala M. Childhood nutrition in predicting metabolic syndrome in adults: the cardiovascular risk in Young Finns Study. Diabetes Care 2012; 35:1937-43. [PMID: 22815293 PMCID: PMC3425009 DOI: 10.2337/dc12-0019] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Our aim was to study the associations of childhood lifestyle factors (the frequency of consumption of vegetables, fruit, fish, and meat, butter use on bread, and physical activity) with the metabolic syndrome (MetS) in adulthood. RESEARCH DESIGN AND METHODS The study cohort consisted of 2,128 individuals, 3-18 years of age at the baseline, with a follow-up time of 27 years. We used the average of lifestyle factor measurements taken in 1980, 1983, and 1986 in the analyses. Childhood dietary factors and physical activity were assessed by self-reported questionnaires, and a harmonized definition of MetS was used as the adult outcome. RESULTS Childhood vegetable consumption frequency was inversely associated with adult MetS (odds ratio [OR] 0.86 [95% CI 0.77-0.97], P = 0.02) in a multivariable analysis adjusted with age, sex, childhood metabolic risk factors (lipids, systolic blood pressure, insulin, BMI, and C-reactive protein), family history of type 2 diabetes and hypertension, and socioeconomic status. The association remained even after adjustment for adulthood vegetable consumption. Associations with the other childhood lifestyle factors were not found. Of the individual components of MetS, decreased frequency of childhood vegetable consumption predicted high blood pressure (0.88 [0.80-0.98], P = 0.01) and a high triglyceride value (0.88 [0.79-0.99], P = 0.03) after adjustment for the above-mentioned risk factors. CONCLUSIONS Childhood vegetable consumption frequency is inversely associated with MetS in adulthood. Our findings suggest that a higher intake of vegetables in childhood may have a protective effect on MetS in adulthood.
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Abdominal obesity and cardiovascular disease: is inflammation the missing link? Can J Cardiol 2012; 28:642-52. [PMID: 22889821 DOI: 10.1016/j.cjca.2012.06.004] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 06/06/2012] [Accepted: 06/06/2012] [Indexed: 02/08/2023] Open
Abstract
It is well established that cardiovascular disease has an inflammatory component. The present narrative review explores the role of adipose tissue distribution, morphology, and function as potential mediators of the link between inflammation and cardiovascular disease. Evidence that abdominal obesity is a key driving force behind a constellation of atherothrombotic inflammatory abnormalities linked to insulin resistance and often referred to as the metabolic syndrome is also reviewed. It is also proposed that the amount of visceral adipose tissue and the liver fat content are important factors responsible for the link between abdominal obesity and features of the metabolic syndrome. It is suggested that the inflammatory profile associated with excess visceral adipose tissue/liver fat may be a consequence of the relative inability of subcutaneous adipose tissue to expand through hyperplasia and to act as a protective metabolic sink storing the chronic energy surplus resulting from a positive energy balance (overnutrition or lack of physical activity or both). In this model, the inflammatory profile often observed among sedentary overweight/obese individuals with an excess of visceral adipose tissue/liver fat may be a consequence of a more primary defect in subcutaneous adipose tissue. On that basis, it is proposed that therapeutic strategies relieving the stress for storage of a chronic energy surplus in the subcutaneous adipose tissue (reduced caloric intake, increase in energy expenditure, pharmacotherapy) should induce a substantial loss of visceral adipose tissue and of ectopic fat depots such as the liver, thereby substantially reducing inflammation.
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Krentz AJ. Type 2 diabetes or …? Still looking for a better name. Diabetes Res Clin Pract 2012; 96:259-60. [PMID: 22560792 DOI: 10.1016/j.diabres.2012.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 12/19/2011] [Accepted: 02/27/2012] [Indexed: 10/28/2022]
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Taberner R. Multiplatform Application to Determine Presence of Metabolic Syndrome and Cardiovascular Risk in Patients With Psoriasis. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2011.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Vakil KP, Malhotra S, Sawada S, Campbell SR, Sayfo S, Kamalesh M. Waist circumference and metabolic syndrome: the risk for silent coronary artery disease in males. Metab Syndr Relat Disord 2012; 10:225-31. [PMID: 22324791 DOI: 10.1089/met.2011.0099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Waist circumference (WC) is a component used to define metabolic syndrome. However, its role as an independent predictor of silent coronary artery disease (CAD), above its contribution to metabolic syndrome, remains unknown. METHODS Male veterans without known CAD, undergoing cardiac stress testing for indications other than typical angina or its equivalent, were evaluated for the presence of silent CAD. High WC and metabolic syndrome were defined per the revised National Cholesterol Education Program (NCEP-R) and the International Diabetes Federation (IDF) criteria. RESULTS Data on 1,071 patients (age 61±11 years) were analyzed retrospectively. On multivariable logistic regression analysis [odds ratio (OR), 95% confidence interval (CI), P value), a WC ≥94 cm (1.42, 1.04-1.93; P=0.026), metabolic syndrome by NCEP-R (1.73, 1.29-2.33; P<0.0001), and metabolic syndrome by IDF (1.57, 1.17-2.11; P=0.003) were independent predictors of silent CAD. When comparing patients meeting criteria for metabolic syndrome defined by either NCEP-R or IDF, the prevalence of silent CAD was not statistically different (P=0.86). The prevalence of silent CAD associated with a high WC was not inferior to that seen between silent CAD and metabolic syndrome as defined by either criterion. Last, among patients with metabolic syndrome defined by NCEP-R, those with a high WC as a defining component of metabolic syndrome had a higher prevalence of silent CAD (30% vs. 20%; P=0.026). CONCLUSION A WC ≥94 cm in males is independently associated with an increased prevalence of silent CAD. In patients with metabolic syndrome, this prevalence is increased by the presence of high WC.
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Affiliation(s)
- Kairav P Vakil
- Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Taberner R. [Multiplatform application to determine presence of metabolic syndrome and cardiovascular risk in patients with psoriasis]. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:111-9. [PMID: 22284865 DOI: 10.1016/j.ad.2011.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 10/30/2011] [Accepted: 11/15/2011] [Indexed: 01/21/2023] Open
Abstract
Traditionally, psoriasis was considered to be a purely cutaneous disease affecting otherwise healthy patients (except for joint involvement). Recent studies have, however, shown a relationship between psoriasis and cardiovascular disease, with increased mortality in patients who have severe forms of psoriasis. Dermatologists are thus in a position to play an important role in identifying patients at greater risk of cardiovascular disease and detecting potential risk factors that are, for the most part, manageable and avoidable. To this end, we designed a multiplatform application that provides a simple and intuitive tool to determine body mass index, whether or not metabolic syndrome is present, and cardiovascular risk. The application runs on iOS, Android, and the webpage of the Psoriasis Group of the Spanish Academy of Dermatology and Venereology (AEDV).
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Affiliation(s)
- R Taberner
- Hospital Son Llàtzer, Servicio de Dermatología, Palma de Mallorca, España.
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Weng C, Yuan H, Tang X, Huang Z, Yang K, Chen W, Yang P, Chen Z, Chen F. Age- and gender dependent association between components of metabolic syndrome and subclinical arterial stiffness in a Chinese population. Int J Med Sci 2012; 9:730-7. [PMID: 23091411 PMCID: PMC3477683 DOI: 10.7150/ijms.4752] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Accepted: 10/12/2012] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The aim of this study was to estimate the relationship between arterial stiffness and components of metabolic syndrome (MetS) in different age- and gender groups. METHODS A total of 12,900 Chinese adults aged 20-79 years were recruited and stratified on the basis of gender and age. All participants underwent the measurement of waist circumference, blood pressure (BP), brachial-ankle pulse wave velocity (baPWV; an indicator of arterial stiffness), and blood chemistry. Multiple linear regression analysis was performed to evaluate the relationship between baPWV and above variables, to determine the relative influence of each component of MetS on baPWV. RESULTS The prevalence of metabolic disorders except for low high-density lipoprotein cholesterol (HDL-C) was much higher in men than in women. All participants with MetS or any component of MetS except for low HDL-C had higher baPWV. BP was positively correlated with baPWV in all groups, while HDL-C was not correlated with baPWV in any groups. In addition, fasting glucose was related to baPWV in middle-aged adults and the elderly. Waist circumference had a positive association with baPWV in middle-aged adults and young men, triglyceride levels showed a significant correlation with baPWV in middle-aged women and young men. Of the MetS components, elevated BP was the strongest predictor of baPWV. CONCLUSION The prevalence of metabolic disorders and the association between baPWV and metabolic variables are dependent on age and gender. Different components of MetS exert distinct impacts on the baPWV in different age- and gender groups, with BP being the strongest predictor. It is suggested that age and gender should be taken into accounted in the management of MetS aiming to reduce subsequent complications.
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Affiliation(s)
- Chunyan Weng
- Department of Cardiology, the Third Xiangya Hospital, Central South University, Changsha 410013, China
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Abstract
South Asia is home to one of the largest population of people with metabolic syndrome (MetS). The prevalence of MetS in South Asians varies according to region, extent of urbanization, lifestyle patterns, and socioeconomic/cultural factors. Recent data show that about one-third of the urban population in large cities in India has the MetS. All classical risk factors comprising the MetS are prevalent in Asian Indians residing in India. The higher risk in this ethnic population necessitated a lowering of the cut-off values of the risk factors to identify and intervene for the MetS to prevent diabetes and cardiovascular disease. Some pharmacological and nonpharmacological interventions are underway in MetS to assess the efficacy in preventing the diabetes and cardiovascular disease in this ethnic population.
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Affiliation(s)
- Kaushik Pandit
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Soumik Goswami
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Sujoy Ghosh
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Pradip Mukhopadhyay
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
| | - Subhankar Chowdhury
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research and SSKM Hospital, Kolkata, India
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Gender differences in the prevalence of metabolic syndrome in 50-year-old Swedish men and women with hypertension born in 1953. J Hum Hypertens 2011; 27:56-61. [PMID: 22129609 DOI: 10.1038/jhh.2011.106] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To investigate potential gender differences in the role of hypertension as a risk factor for metabolic syndrome (MetS) we used a random population sample of 50-year-old men (n=595) and women (n=667; all born in 1953) who were examined in 2003-2004. Systolic (SBP) and diastolic (DBP) blood pressure values were dichotomized at ≥ 140 mm Hg and ≥ 90 mm Hg, respectively. MetS was defined using NCEP (National Cholesterol Education Programme) and IDF (International Diabetes Federation) criteria. MetS was more prevalent in men than in women (NCEP 16% versus 10%, P=0.003; IDF 26% versus 16%, P=0.000) and systolic hypertension was more common in men than in women (high SBP 24% versus 18%, P=0.003; high DBP 29% versus 24%, P=0.074). Women with high SBP had about a seven-fold increased NCEP risk compared with normotensive women (odds ratio (OR) 6.91, confidence interval (CI) 2.90-16.42), whereas high SBP in men was associated with about a three-fold increased NCEP risk (OR 2.72, CI 1.69-4.38). A similar pattern was observed for the IDF criterion of MetS. All interaction terms (sex × hypertension) were significant at P<0.01. At middle age, despite that fewer women had hypertension or MetS than men, hypertension carries a relatively greater risk for MetS in women than in men.
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Bendriss L, Lebbaq A, Jallal H, Mrani S, Khatouri A. [Usefulness of microalbuminuria in the metabolic syndrome as a predictor of cardiovascular disease. Prospective study about 78 cases]. Ann Cardiol Angeiol (Paris) 2011; 61:15-9. [PMID: 21679922 DOI: 10.1016/j.ancard.2011.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 04/28/2011] [Indexed: 11/18/2022]
Abstract
AIM Increased urinary albumin-excretion is a cardiovascular risk factor. The metabolic syndrome is associated with an increased risk of chronic kidney disease, cardiovascular disease and mortality. The aim of this prospective study was to explore the combined associations of microalbuminuria and metabolic syndrome with the risk of incident cardiovascular disease. METHODS The present study involved 78 patients with metabolic syndrome between May 1 and July 30 in 2009 from cardiology clinic of military hospital in Marrakech. They were followed for 1 year. The metabolic syndrome was defined according to the criteria of International Diabetes Federation (IDF). Microalbuminuria was defined as a urinary albumin excretion of 30 to 300mg/d. RESULTS The mean age was 56 years old. The prevalence of microalbuminuria was 38%. There was a significantly positive correlation between the number of components of the metabolic syndrome and the corresponding prevalence of microalbuminuria. Incidence rates of cardiovascular events were higher in the positive microalbuminuria group than the group without microalbuminuria, the difference was significant for composite criteria but not for each one probably because of the small size of effective and limited duration. CONCLUSIONS There is a strong relationship between microalbuminuria and the metabolic syndrome. Microalbuminuria accounts for the increased risk of cardiovascular disease in patients with metabolic syndrome.
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Affiliation(s)
- L Bendriss
- Cardiology clinic of military hospital, Marrakech, Morocco.
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Wen CP, Chan HT, Tsai MK, Cheng TYD, Chung WSI, Chang YC, Hsu HL, Tsai SP, Tsao CK, Man Wai JP, Hsu CC. Attributable mortality burden of metabolic syndrome: comparison with its individual components. ACTA ACUST UNITED AC 2011; 18:561-73. [DOI: 10.1177/1741826710389422] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Chi-Pang Wen
- China Medical University Hospital, Taichung, Taiwan
- Division of Health Policy Research and Development, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | | | | | | | - Wen-Shen I Chung
- Division of Health Policy Research and Development, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Yen-Chen Chang
- Division of Health Policy Research and Development, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Hui-Ling Hsu
- Division of Health Policy Research and Development, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Shan-Pou Tsai
- University of Texas School of Public Health, Houston, USA
| | | | - Jackson Pui Man Wai
- Laboratory for Exercise Physiology Research, Institute of Sport Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Chih-Cheng Hsu
- Division of Health Policy Research and Development, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
- Department of Health Services Administration, China Medical University and Hospital, Taichung, Taiwan
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DE Hert M, Correll CU, Bobes J, Cetkovich-Bakmas M, Cohen D, Asai I, Detraux J, Gautam S, Möller HJ, Ndetei DM, Newcomer JW, Uwakwe R, Leucht S. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry 2011; 10:52-77. [PMID: 21379357 PMCID: PMC3048500 DOI: 10.1002/j.2051-5545.2011.tb00014.x] [Citation(s) in RCA: 1450] [Impact Index Per Article: 111.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The lifespan of people with severe mental illness (SMI) is shorter compared to the general population. This excess mortality is mainly due to physical illness. We report prevalence rates of different physical illnesses as well as important individual lifestyle choices, side effects of psychotropic treatment and disparities in health care access, utilization and provision that contribute to these poor physical health outcomes. We searched MEDLINE (1966 - August 2010) combining the MeSH terms of schizophrenia, bipolar disorder and major depressive disorder with the different MeSH terms of general physical disease categories to select pertinent reviews and additional relevant studies through cross-referencing to identify prevalence figures and factors contributing to the excess morbidity and mortality rates. Nutritional and metabolic diseases, cardiovascular diseases, viral diseases, respiratory tract diseases, musculoskeletal diseases, sexual dysfunction, pregnancy complications, stomatognathic diseases, and possibly obesity-related cancers are, compared to the general population, more prevalent among people with SMI. It seems that lifestyle as well as treatment specific factors account for much of the increased risk for most of these physical diseases. Moreover, there is sufficient evidence that people with SMI are less likely to receive standard levels of care for most of these diseases. Lifestyle factors, relatively easy to measure, are barely considered for screening; baseline testing of numerous important physical parameters is insufficiently performed. Besides modifiable lifestyle factors and side effects of psychotropic medications, access to and quality of health care remains to be improved for individuals with SMI.
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Ghezzi AC, Cambri LT, Ribeiro C, Botezelli JD, Mello MAR. Impact of early fructose intake on metabolic profile and aerobic capacity of rats. Lipids Health Dis 2011; 10:3. [PMID: 21223589 PMCID: PMC3024237 DOI: 10.1186/1476-511x-10-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Accepted: 01/11/2011] [Indexed: 02/01/2023] Open
Abstract
Background Metabolic syndrome is a disease that today affects millions of people around the world. Therefore, it is of great interest to implement more effective procedures for preventing and treating this disease. In search of a suitable experimental model to study the role of exercise in prevention and treatment of metabolic syndrome, this study examined the metabolic profile and the aerobic capacity of rats kept early in life on a fructose-rich diet, a substrate that has been associated with metabolic syndrome. Methods We used adult female Wistar rats fed during pregnancy and lactation with two diets: balanced or fructose-rich 60%. During breastfeeding, the pups were distributed in small (4/mother) or adequate (8/mother) litters. At 90 days of age, they were analyzed with respect to: glucose tolerance, peripheral insulin sensitivity, aerobic capacity and serum glucose, insulin, triglycerides, total cholesterol, LDL cholesterol and HDL cholesterol concentrations as well as measures of glycogen synthesis and glucose oxidation by the soleus muscle. Results It was found that the fructose rich diet led the animals to insulin resistance. The fructose fed rats kept in small litters also showed dyslipidemia, with increased serum concentrations of total cholesterol and triglycerides. Conclusion Neither the aerobic capacity nor the glucose oxidation rates by the skeletal muscle were altered by fructose-rich diet, indicating that the animal model evaluated is potentially interesting for the study of the role of exercise in metabolic syndrome.
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Affiliation(s)
- Ana C Ghezzi
- UNESP Department of Physical Education, São Paulo State University, Av: 24-A, 1515 Bela Vista Zip code: 13506-900 Rio Claro, São Paulo, Brazil.
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Beavers KM, Nicklas BJ. Effects of lifestyle interventions on inflammatory markers in the metabolic syndrome. Front Biosci (Schol Ed) 2011; 3:168-77. [PMID: 21196367 PMCID: PMC3665333 DOI: 10.2741/s142] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors which places individuals at increased risk for cardiovascular morbidity and mortality. In addition to obesity and insulin resistance, inflammation is emerging as a potential etiologic factor of the syndrome. One hypothesis suggests that obesity contributes to insulin resistance through increased production of adipose-derived inflammatory cytokines. Currently, lifestyle change is the first line of treatment for MetS. Only recently, however, have studies begun exploring the effect of lifestyle interventions on the mediation of inflammation in individuals with MetS. This review summarizes the strongest evidence (i.e. randomized controlled trial data) for a role of lifestyle interventions (diet and/or exercise) on the improvement of inflammatory biomarkers in people with MetS. Of six studies assessed, lifestyle interventions were consistently successful at improving the inflammatory and metabolic profiles. Interestingly, improvements in the inflammatory profile were found to be largely independent of obesity. Data currently suggest that alterations in dietary composition may be the most effective lifestyle change, although there is a need for more research in this area.
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Affiliation(s)
- Kristen M Beavers
- J. Paul Sticht Center on Aging, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest, University School of Medicine, Winston-Salem, North Carolina 27157, USA.
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Abstract
Information bias might be present in any study, including randomized trials, because the values of variables of interest are unknown, and researchers have to rely on substitute variables, the values of which provide information on the unknown true values. We used causal directed acyclic graphs to extend previous work on information bias. First, we show that measurement is a complex causal process that has two components, ie, imprinting and synthesizing. Second, we explain how the unknown values of a variable may be imputed from other variables, and present examples of valid and invalid substitutions for a variable of interest. Finally, and most importantly, we describe a previously unrecognized bias, which may be viewed as antithetical to information bias. This bias arises whenever a variable does not exist in the physical world, yet researchers obtain “information” on its nonexistent values and estimate nonexistent causal parameters. According to our thesis, the scientific literature contains many articles that are affected by such bias.
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Affiliation(s)
- Eyal Shahar
- Division of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health
| | - Doron J Shahar
- Departments of Physics and Mathematics, College of Science, The University of Arizona, Tucson, AZ, USA
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Shahar E. Metabolic syndrome? A critical look from the viewpoints of causal diagrams and statistics. J Cardiovasc Med (Hagerstown) 2010; 11:772-9. [DOI: 10.2459/jcm.0b013e32833b9088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
The metabolic syndrome is one of several patterns of risk for atherosclerotic cardiovascular disease. Although the concept of the metabolic syndrome has been known for 2 centuries or more, it is only recently that its individual components have been proposed. Visceral obesity is a central component but other major facets such as hypertension, dyslipidemia, or dysglycemia are often present. These components are well-established cardiovascular risk factors and therefore grouping them under a single entity, namely the metabolic syndrome, has questioned its clinical usefulness and its ability to predict cardiovascular disease. Depending on what criteria are used, the prevalence of this syndrome may be as much as 40% in those aged 60 years and older. Heredity, environmental factors, personal lifestyle habits and behavior, and clinical comorbidities all seem to be associated with the metabolic syndrome. In addition, hypogonadism in men and hypovitaminosis D are age-related issues associated with the metabolic syndrome. In ageing individuals the existence of the metabolic syndrome as a distinct entity is questioned although some studies report an association with diabetes mellitus, physical impairments, and cognitive dysfunction. Further studies that explore these factors over time are needed but for now, treatment remains focused on individual components and not on the syndrome as a whole.
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Sadikot SM. WITHDRAWN: Is it "science"… or is it "turf" guarding? Diabetes Metab Syndr 2010:S1871-4021(10)00043-3. [PMID: 25376593 DOI: 10.1016/j.dsx.2010.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Is it “science” … or is it “turf” guarding? Diabetes Metab Syndr 2010. [DOI: 10.1016/j.dsx.2010.05.022] [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: 11/23/2022]
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Sadikot S, Hermans M. Here we go again … The metabolic syndrome revisited! Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2010. [DOI: 10.1016/j.dsx.2010.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Wajchenberg BL, Nery M, Cunha MR, Silva MERD. Adipose tissue at the crossroads in the development of the metabolic syndrome, inflammation and atherosclerosis. ACTA ACUST UNITED AC 2010; 53:145-50. [PMID: 19466206 DOI: 10.1590/s0004-27302009000200005] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Accepted: 02/17/2009] [Indexed: 02/05/2023]
Abstract
The authors analyze insulin resistance, the metabolic syndrome and endothelial dysfunction as consequence of a common antecedent, a low grade inflammation, indicating that in obesity there is a chronically activated inflammatory state of the adipose tissue. Furthermore, the inflammatory signaling is discussed according to the adipose tissue depot, visceral or subcutaneous.
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Affiliation(s)
- Bernardo Léo Wajchenberg
- Serviço de Endocrinologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Arnaldo 455, São Paulo, SP, Brazil.
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44
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Janiszewski PM, Ross R. The utility of physical activity in the management of global cardiometabolic risk. Obesity (Silver Spring) 2009; 17 Suppl 3:S3-S14. [PMID: 19927143 DOI: 10.1038/oby.2009.382] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Major health organizations promote the adoption of a healthy lifestyle, composed of sufficient daily physical activity and a balanced diet for the prevention and management of type 2 diabetes (T2D) and cardiovascular disease risk. In particular, it is recommended that adults accumulate 30 min of moderate-intensity aerobic physical activity on most days of the week. Despite these recommendations, a physically active lifestyle is seldom adopted, and the majority of the North American population remains sedentary. Although the optimal strategy for promoting physical activity in today's environment remains elusive, the evidence for the utility of physical activity in the management of risk factors for T2D and cardiovascular disease is overwhelming. This review examines the influence of aerobic-type physical activity on components of global cardiometabolic risk, that is, the traditional and emerging risk factors for cardiovascular disease and T2D, including visceral obesity, insulin resistance, hypertension, atherogenic dyslipidemia, thrombosis, inflammation, and cardiorespiratory fitness. Where possible, specific consideration is given to the independent effects of an acute bout of physical activity vs. chronic physical activity with weight loss vs. chronic physical activity without weight loss.
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Affiliation(s)
- Peter M Janiszewski
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
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Thivel D, Malina RM, Isacco L, Aucouturier J, Meyer M, Duché P. Metabolic Syndrome in Obese Children and Adolescents: Dichotomous or Continuous? Metab Syndr Relat Disord 2009; 7:549-55. [DOI: 10.1089/met.2008.0085] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- David Thivel
- Laboratory of Exercise Physiology, Bâtiment de Biologie B, Complexe Universitaire des Cézeaux, Aubière, France
| | - Robert M. Malina
- University of Texas at Austin and Tarleton State University, Stephenville, Texas
| | - Laurie Isacco
- Laboratory of Exercise Physiology, Bâtiment de Biologie B, Complexe Universitaire des Cézeaux, Aubière, France
| | - Julien Aucouturier
- Laboratory of Exercise Physiology, Bâtiment de Biologie B, Complexe Universitaire des Cézeaux, Aubière, France
| | - Martine Meyer
- Pediatrics Department, Hotel Dieu, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Pascale Duché
- Laboratory of Exercise Physiology, Bâtiment de Biologie B, Complexe Universitaire des Cézeaux, Aubière, France
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46
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Sadikot S. Will we now play harmonious melodies or will the cacophony start again? Diabetes Metab Syndr 2009. [DOI: 10.1016/j.dsx.2009.11.001] [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: 10/20/2022]
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47
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Noto D, Niglio T, Cefalù AB, Martino E, Fayer F, Mina M, Valenti V, Notarbartolo A, Averna M, Martino F. Obesity and the metabolic syndrome in a student cohort from Southern Italy. Nutr Metab Cardiovasc Dis 2009; 19:620-625. [PMID: 19261454 DOI: 10.1016/j.numecd.2008.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Revised: 11/06/2008] [Accepted: 12/02/2008] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM Cardiovascular (CV) risk factors present in childhood predict future CV events. Few data regarding the metabolic syndrome (MS) prevalence are available in adolescents from Mediterranean areas where obesity is becoming a social emergency. This study presents data of MS prevalence in a student cohort from southern Italy. METHODS AND RESULTS 1629 students between 7 and 14 years of age underwent anthropometric measurements and a blood sample was obtained to assess biochemical parameters. MS risk factors were calculated based on age and gender adjusted percentiles of parameter distributions. MS prevalence rate was 0.022 using paediatric, age-adjusted criteria; the rate increased to 0.029 using a 90th percentile criteria for fasting blood glucose instead of >100mg/dL. Using the criteria issued by the International Diabetes Federation the MS prevalence rate dropped to 0.005. The exploratory factor analysis identified four factors: age/fat related, lipids, blood pressure and blood glucose. Family history of type 2 diabetes mellitus was associated with triglyceride [OR=1.55 (1.0-2.3)] and BMI [OR=1.71 (1.2-2.4)] but not to blood glucose by logistic regression analysis. CONCLUSIONS In a student cohort from Southern Italy, obesity is associated with the features of MS.
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Affiliation(s)
- D Noto
- Department of Clinical Medicine and Emerging Diseases, University of Palermo, Palermo, Italy
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48
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Zhang Y, Hong J, Gu W, Gui M, Chen Y, Zhang Y, Chi Z, Wang W, Li X, Ning G. Impact of the metabolic syndrome and its individual components on risk and severity of coronary heart disease. Endocrine 2009; 36:233-8. [PMID: 19618299 DOI: 10.1007/s12020-009-9214-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Revised: 05/18/2009] [Accepted: 06/04/2009] [Indexed: 11/28/2022]
Abstract
The clinical use of criteria for metabolic syndrome (MetS) and its individual components with respect to risk prediction of coronary heart disease (CHD) remains uncertain. In this study, we investigated whether and to what extent MetS and its individual components were related to risk for CHD. A total of 1,028 subjects, who had undergone coronary angiography or were diagnosed as acute myocardial infarction, were selected according to inclusion criteria. MetS was diagnosed with National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) criteria. CHD was diagnosed with clinical data and confirmed by coronary angiography. The severity of coronary atherosclerosis was estimated by CHD Gensini cumulative index. All the patients were aged 33-87 years. The results showed that the age- and sex-adjusted odds ratios (ORs) for CHD in different individual components of MetS were as follows: low-high density lipoprotein (low-HDL), 3.15 (1.94-5.12); high-fasting plasma glucose (high-FPG), 2.26 (1.63-3.69); high-blood pressure (high-BP), 2.13 (1.38-3.29); high-triglycerides (high-TG), 1.55 (1.13-2.11); all P < 0.05, whereas high-body mass index (high-BMI), 0.75 (0.55-1.03) and high-waist circumference, 0.75 (0.51-1.10), both P > 0.05. Among all the components, the triad of low-HDL, high-FPG, and high-BP had the highest OR for CHD: 4.28 (3.12-5.87) (P < 0.001). MetS subjects had significant increases in number of disease vessel and CHD Gensini index (P < 0.001). When individual components of MetS were considered separately, groups with low-HDL, or high-FPG, or high-BP had significant increases in number of disease vessel and Gensini index (all P < 0.001). In conclusion, our present results demonstrated that individual components of MetS and their various combinations may have different contributions to CHD and the severity of coronary artery stenosis. Clinical focus should remain on establishing optimum-risk algorithms for CHD.
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Affiliation(s)
- Yifei Zhang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrinology and Metabolism, Endocrine and Metabolic E-Institutes of Shanghai Universities (EISU) and Key Laboratory for Endocrinology and Metabolism of Chinese Health Ministry, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, People's Republic of China
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Zuo H, Shi Z, Hu X, Wu M, Guo Z, Hussain A. Prevalence of metabolic syndrome and factors associated with its components in Chinese adults. Metabolism 2009; 58:1102-8. [PMID: 19481771 DOI: 10.1016/j.metabol.2009.04.008] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 03/24/2009] [Accepted: 04/09/2009] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to assess the prevalence of metabolic syndrome (MetS) and its components among middle-aged and elderly adults in Jiangsu province, China. Moreover, factors associated with MetS were also assessed. A population-based cross-sectional survey was conducted with 4 randomly selected areas including both urban and rural areas from Jiangsu province, China. After the procedure, 3914 adults aged 35 to 74 years were included in the study. Metabolic syndrome was defined by the modified National Cholesterol Education Program Adult Treatment Panel III report. Data were collected by interviewer-administered questionnaire, biophysical assessment, and biochemical examination. Crude and age-standardized prevalence of MetS was 31.5% and 30.5%, respectively. Prevalence rate increased significantly with age in female but not in male subjects, whereas this was true for both sexes with increased body mass index. High blood pressure was the most prevalent component of MetS (45.2%), followed by elevated triglycerides (40.1%) and low high-density lipoprotein cholesterol (40.1%). Multivariate ordinal regression analysis revealed that women had significantly higher risk of MetS than men (odds ratio = 1.72, P < .001). Older age, living in urban area, income, family history of diabetes, and family history of hypertension were positively associated with MetS risk. However, higher education and tea drinking everyday were found to be negatively associated with MetS (P < .05). Moreover, substantial agreement (kappa = 0.79) was found between the International Diabetes Federation and modified Adult Treatment Panel III criteria among 3 comparisons of MetS definitions. Metabolic syndrome was highly prevalent in middle-aged and elderly Chinese population in Jiangsu province. Community-based strategies for diet and lifestyle modifications are strongly suggested, especially in women and the elderly.
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Affiliation(s)
- Hui Zuo
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210009, China.
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50
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Koskinen J, Kähönen M, Viikari JSA, Taittonen L, Laitinen T, Rönnemaa T, Lehtimäki T, Hutri-Kähönen N, Pietikäinen M, Jokinen E, Helenius H, Mattsson N, Raitakari OT, Juonala M. Conventional cardiovascular risk factors and metabolic syndrome in predicting carotid intima-media thickness progression in young adults: the cardiovascular risk in young Finns study. Circulation 2009; 120:229-36. [PMID: 19581494 DOI: 10.1161/circulationaha.108.845065] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Conventional risk factors and metabolic syndrome (MetS) are cross-sectionally associated with subclinical atherosclerosis in young adults. We evaluated the relations of conventional risk factors and MetS to the 6-year progression of carotid intima-media thickness (IMT) in a population of young adults. RESULTS AND METHODS The study included 1809 subjects (aged 32+/-5 years) who had IMT measured in 2001 and 2007. Risk factor measurements included low-density lipoprotein cholesterol, body mass index, C-reactive protein, smoking, and family history of coronary disease in addition to MetS components. We used European Group for the Study of Insulin Resistance, revised National Cholesterol Education Program, and International Diabetes Federation definitions to diagnose MetS in 2001. Waist circumference (P<0.0001), low-density lipoprotein cholesterol (P=0.01), and insulin (P=0.003) were directly associated with IMT progression in a multivariable model adjusted for age, sex, and baseline IMT (model R(2)=24%). When the MetS/European Group for the Study of Insulin Resistance definition was included in the model, it was directly associated with IMT progression (P=0.03), but its inclusion did not improve the model's predictive value. IMT increased 79+/-7 mum (mean+/-SEM) in subjects with MetS according to the MetS/European Group for the Study of Insulin Resistance definition and 42+/-2 mum in subjects without MetS (P<0.0001). In addition, the number of MetS components was linearly associated with IMT progression (P<0.0001). Similar results were seen with MetS/revised National Cholesterol Education Program and MetS/International Diabetes Federation definitions. CONCLUSIONS Obesity, high low-density lipoprotein cholesterol, and high insulin level predicted IMT progression in young adults. All MetS definitions identified young adults with accelerated IMT progression, but we found no evidence that MetS would predict IMT progression more than expected from the sum of its risk components.
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Affiliation(s)
- Juha Koskinen
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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