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Graby J, Khavandi A, Gillison F, Smith T, Murphy D, Peacock O, McLeod H, Dastidar A, Antoniades C, Thompson D, Rodrigues JCL. 'Super Rehab': can we achieve coronary artery disease regression? A feasibility study protocol. BMJ Open 2023; 13:e080735. [PMID: 38086597 PMCID: PMC10729239 DOI: 10.1136/bmjopen-2023-080735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Patients diagnosed with coronary artery disease (CAD) are currently treated with medications and lifestyle advice to reduce the likelihood of disease progression and risk of future major adverse cardiovascular events (MACE). Where obstructive disease is diagnosed, revascularisation may be considered to treat refractory symptoms. However, many patients with coexistent cardiovascular risk factors, particularly those with metabolic syndrome (MetS), remain at heightened risk of future MACE despite current management.Cardiac rehabilitation is offered to patients post-revascularisation, however, there is no definitive evidence demonstrating its benefit in a primary prevention setting. We propose that an intensive lifestyle intervention (Super Rehab, SR) incorporating high-intensity exercise, diet and behavioural change techniques may improve symptoms, outcomes, and enable CAD regression.This study aims to examine the feasibility of delivering a multicentre randomised controlled trial (RCT) testing SR for patients with CAD, in a primary prevention setting. METHODS AND ANALYSIS This is a multicentre randomised controlled feasibility study of SR versus usual care in patients with CAD. The study aims to recruit 50 participants aged 18-75 across two centres. Feasibility will be assessed against rates of recruitment, retention and, in the intervention arm, attendance and adherence to SR. Qualitative interviews will explore trial experiences of study participants and practitioners. Variance of change in CAD across both arms of the study (assessed with serial CT coronary angiography) will inform the design and power of a future, multi-centre RCT. ETHICS AND DISSEMINATION Ethics approval was granted by South West-Frenchay Research Ethics Committee (reference: 21/SW/0153, 18 January 2022). Study findings will be disseminated via presentations to relevant stakeholders, national and international conferences and open-access peer-reviewed research publications. TRIAL REGISTRATION NUMBER ISRCTN14603929.
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Affiliation(s)
- John Graby
- Cardiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
- Health, University of Bath, Bath, UK
| | - Ali Khavandi
- Cardiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | | | | | - David Murphy
- Cardiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
- Health, University of Bath, Bath, UK
| | | | | | | | - Charalambos Antoniades
- Acute Multidisciplinary Imaging & Interventional Centre, University of Oxford, John Radcliffe Hospital, Oxford, UK
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Wilken MR, Lambert MNT, Christensen CB, Jeppesen PB. Effects of Anthocyanin-rich Berries on the Risk of Metabolic Syndrome: A Systematic Review and Meta-analysis. Rev Diabet Stud 2022; 18:42-57. [PMID: 35300756 PMCID: PMC9382680 DOI: 10.1900/rds.2022.18.42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE: Metabolic syndrome (MetS) can lead to fatal complications, including cardiovascular disease. Emerging evidence suggests has emerged that increased fruit and vegetable intake and decreased intake of saturated fats, simple sugars, and processed foods can improve cardiovascular
health. Anthocyanins (color pigments) have anti-inflammatory and antioxidant capacities but are of low bioavailability. In this systematic review and metaanalysis, we investigate the possible beneficial effects of the intake of berries high in anthocyanins on MetS risk factors. We also investigate
the influences of high-density lipoprotein (HDL), lowdensity lipoprotein (LDL), triglycerides (TG), and total cholesterol (TC). METHODS: We identified 2,274 articles from PUBMED and EMBASE following a search input designed to include studies of interest of these, 21 met inclusion criteria.
RESULTS: The studies showed an overall reduction in low-density lipoprotein (p=0.04). Increases in HDL were found with cranberry and freeze-dried berry intake during a 4-6-week intervention. No statistically significant findings were detected for fasting glucose, Hb1Ac, insulin levels,
blood pressure, oxidized LDL (OX-LDL), BMI, and overall HDL. CONCLUSIONS: We conclude from this systematic review and meta-analysis that increased berry intake improves MetS key risk factors and reduces the risk of cardiovascular disease. Pronounced effects were apparent for concentrated
berry products, such as freeze-dried strawberries.
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Affiliation(s)
- Mikkel Roulund Wilken
- Department of Clinical Medicine. Aarhus University Hospital. Aarhus University. Palle Juul-Jensens. Boulevard 165. Aarhus N. Denmark
| | - Max Norman Tandrup Lambert
- Department of Clinical Medicine. Aarhus University Hospital. Aarhus University. Palle Juul-Jensens. Boulevard 165. Aarhus N. Denmark
| | - Christine Bodelund Christensen
- Department of Clinical Medicine. Aarhus University Hospital. Aarhus University. Palle Juul-Jensens. Boulevard 165. Aarhus N. Denmark
| | - Per Bendix Jeppesen
- Department of Clinical Medicine. Aarhus University Hospital. Aarhus University. Palle Juul-Jensens. Boulevard 165. Aarhus N. Denmark
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Li X, Zhai Y, Zhao J, He H, Li Y, Liu Y, Feng A, Li L, Huang T, Xu A, Lyu J. Impact of Metabolic Syndrome and It's Components on Prognosis in Patients With Cardiovascular Diseases: A Meta-Analysis. Front Cardiovasc Med 2021; 8:704145. [PMID: 34336959 PMCID: PMC8319572 DOI: 10.3389/fcvm.2021.704145] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/21/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Patients with metabolic syndrome (MetS) have a higher risk of developing cardiovascular diseases (CVD). However, controversy exists about the impact of MetS on the prognosis of patients with CVD. Methods: Pubmed, Cochrane library, and EMBASE databases were searched. Cohort Studies and randomized controlled trials post hoc analyses that evaluated the impact of MetS on prognosis in patients (≥18 years) with CVD were included. Relative risk (RR), hazard rate (HR) and 95% confidence intervals (CIs) were calculated for each individual study by random-effect model. Subgroup analysis and meta-regression analysis was performed to explore the heterogeneity. Results: 55 studies with 16,2450 patients were included. Compared to patients without MetS, the MetS was associated with higher all-cause death [RR, 1.220, 95% CI (1.103 to 1.349), P, 0.000], CV death [RR, 1.360, 95% CI (1.152 to 1.606), P, 0.000], Myocardial Infarction [RR, 1.460, 95% CI (1.242 to 1.716), P, 0.000], stroke [RR, 1.435, 95% CI (1.131 to 1.820), P, 0.000]. Lower high-density lipoproteins (40/50) significantly increased the risk of all-cause death and CV death. Elevated fasting plasma glucose (FPG) (>100 mg/dl) was associated with an increased risk of all-cause death, while a higher body mass index (BMI>25 kg/m2) was related to a reduced risk of all-cause death. Conclusions: MetS increased the risk of cardiovascular-related adverse events among patients with CVD. For MetS components, there was an increased risk in people with low HDL-C and FPG>100 mg/dl. Positive measures should be implemented timely for patients with CVD after the diagnosis of MetS, strengthen the prevention and treatment of hyperglycemia and hyperlipidemia.
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Affiliation(s)
- Xiao Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Department of Clinical Medicine, Qinghai Institute of Health Sciences, Xining, China
| | - Yajing Zhai
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | - Jiaguo Zhao
- Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin, China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuanjie Li
- Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yue Liu
- Xiyuan Hospital of China Academy of Chinese Medicinal Sciences, Beijing, China
| | - Aozi Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Tao Huang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Anding Xu
- Department of Neurology, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Kazlauskienė L, Butnorienė J, Norkus A. Metabolic syndrome related to cardiovascular events in a 10-year prospective study. Diabetol Metab Syndr 2015; 7:102. [PMID: 26594246 PMCID: PMC4653909 DOI: 10.1186/s13098-015-0096-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 11/02/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) becomes a serious society health problem. The main risk factors of MetS are related to the increased risk of cardiovascular diseases, appearance of stroke, type 2 diabetes mellitus and the growing risk of mortality. MetS stimulates the appearance of early atherosclerosis, its progress and accelerates the frequency of cardiovascular complications related to atherosclerosis and diabetes mellitus. OBJECTIVE To evaluate the risk of cardiovascular events (myocardial infarction, stroke) among the individuals with MetS in a 10 year prospective study; to identify MetS components that determine risk and character of cardiovascular events. METHODS The study design was prospective. It was started in 2003 to assess the risk factors, clinical components, diagnostic criteria of MetS. At the second stage in 2013 the individuals were repeatedly invited to evaluate cardiovascular pathology that was confirmed by cardiologist and neurologist. The 45 years old and older citizens of Lithuanian district participated in the study. 1115 individuals (562 men and 553 women) were randomly selected in 2003. 538 respondents: 278 (51.70 %) men and 260 (48.30 %) women participated in the repeated study in 2013. RESULTS During the study myocardial infarction (MI) was confirmed to 7.43 % individuals taken part in the study, stroke-to 4.28 % individuals. The odds' ratio (OR) of MI between individuals with MetS and without MetS was 1.80 (95 % CI 1.67-1.97), p < 0.05. The OR of stroke for individuals with MetS and without MetS was 2.05 (95 % CI 1.21-2.54), p < 0.05. The OR of MI between men with abdominal obesity and identified MetS was 3.12 (95 % CI 2.77-3.53), p < 0.05. The OR of stroke between men with low level of high density lipoprotein cholesterol and identified MetS was 4.98 (95 % CI 4.40-5.65), p < 0.05. The OR of stroke between men with hypertriglyceridemia and identified MetS was 8.43 (95 % CI 7.45-9.54), p < 0.05. CONCLUSIONS Individuals with identified MetS have 1.80 and 2.05 times higher statistically significant probability, respectively, for MI and stroke events, than individuals without MetS. Separate components or MetS increase risk of cardiovascular events in men: abdominal obesity increases risk of MI, and low level of high density lipoprotein cholesterol and hypertriglyceridemia increase risk of stroke.
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Affiliation(s)
- Laura Kazlauskienė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveniu 2, 50009 Kaunas, Lithuania
| | - Jūratė Butnorienė
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveniu 2, 50009 Kaunas, Lithuania
| | - Antanas Norkus
- Institute of Endocrinology, Lithuanian University of Health Sciences, Eiveniu 2, 50009 Kaunas, Lithuania
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Fang NN, Sui DX, Yu JG, Gong HP, Zhong M, Zhang Y, Zhang W. Strain/strain rate imaging of impaired left atrial function in patients with metabolic syndrome. Hypertens Res 2015; 38:758-64. [PMID: 26178155 DOI: 10.1038/hr.2015.76] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 03/16/2015] [Accepted: 04/20/2015] [Indexed: 12/22/2022]
Abstract
Left ventricular (LV) dysfunction has been demonstrated in patients with metabolic syndrome (MetS). However, alterations in left atrial (LA) function in MetS are unknown. We aimed to use strain/strain rate (SR) imaging to investigate the effect of MetS on LA function. A total of 177 MetS patients and 156 normal subjects underwent echocardiography. Strain and SR tissue Doppler imaging values were used to evaluate LA function. Partial correlation and multiple stepwise regression analyses were used to determine the risk factors for impaired LA function. Compared with the controls, the MetS patients showed significantly lower levels of mean strain, mean peak systolic SR and mean peak early diastolic SR (P<0.001 for all), with no difference in the mean peak late diastolic SR. Central obesity, hypertension, dyslipidemia and LV diastolic abnormality were independent risk factors for impaired LA function. LA function was impaired in patients with MetS as a result of metabolic disturbance and LV diastolic abnormality. SR imaging is reliable in assessing LA function in MetS patients.
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Affiliation(s)
- Ning-Ning Fang
- The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Department of Cardiology, Qilu Hospital, Shandong University, Jinan, China.,Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, China
| | - Dong-Xin Sui
- The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Department of Cardiology, Qilu Hospital, Shandong University, Jinan, China.,Department of Respiration, the Second Hospital of Shandong University, Jinan, China
| | - Jin-Gui Yu
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, China
| | - Hui-Ping Gong
- Department of Cardiology, the Second Hospital of Shandong University, Jinan, China
| | - Ming Zhong
- The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Department of Cardiology, Qilu Hospital, Shandong University, Jinan, China
| | - Yun Zhang
- The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Department of Cardiology, Qilu Hospital, Shandong University, Jinan, China
| | - Wei Zhang
- The Key Laboratory of Cardiovascular Remodelling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Department of Cardiology, Qilu Hospital, Shandong University, Jinan, China
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Zhang JW, He LJ, Cao SJ, Yang Q, Yang SW, Zhou YJ. Association of serum uric acid and coronary artery disease in premenopausal women. PLoS One 2014; 9:e106130. [PMID: 25184207 PMCID: PMC4153543 DOI: 10.1371/journal.pone.0106130] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 08/02/2014] [Indexed: 02/07/2023] Open
Abstract
Objective To date, no study in the published literature has investigated the role of various serum uric acid (SUA) concentrations in the development of angiographically-proven coronary artery disease (CAD) in premenopausal women. Therefore, the aim of this study was to investigate the role SUA levels may play in the prevalence, severity, and prognosis of CAD in premenopausal women. Methods This cross-sectional retrospective study included 607 premenopausal women who had undergone coronary angiography. The CAD diagnosis was based upon stenosis affecting ≥50% of the luminal diameter. Association of the SUA levels with CAD prevalence, severity, and clinical outcomes were assessed by statistical analysis. Results In total, 369 (60.8%) of the patients were diagnosed with CAD. The CAD patients had significantly higher SUA levels than those without CAD (5.3±1.9 vs. 4.8±1.7 mg/dL, P = 0.001). The SUA levels were found to be significantly associated with CAD prevalence (P = 0.013). Patients with higher levels of SUA also showed increased rates of multivessel disease and composite end-points, such as major adverse cardiac events. Furthermore, multivariate analysis identified abnormally high levels of uric acid (hyperuricemia) as an independent risk factor for CAD (OR 1.51 (1.11–2.53), P<0.05). Conclusions The SUA levels are significantly associated with the prevalence of CAD. The SUA levels may be a predictor for incidence of major cardiovascular events in premenopausal women.
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Affiliation(s)
- Jian-wei Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China
| | - Ling-jie He
- Department of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shu-jun Cao
- Department of Cardiology, Beijing Daxing Hospital, Capital Medical University, Beijing, China
| | - Qing Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China
| | - Shi-wei Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China
| | - Yu-jie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China
- * E-mail:
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Zhou F, Zhang H, Yao W, Mei H, Xu D, Sheng Y, Yang R, Kong X, Wang L, Zou J, Yang Z, Li X. Relationship between brachial-ankle pulse wave velocity and metabolic syndrome components in a Chinese population. J Biomed Res 2014; 28:262-8. [PMID: 25050109 PMCID: PMC4102839 DOI: 10.7555/jbr.28.20130160] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 12/02/2013] [Accepted: 03/16/2014] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to assess the relationship between arterial stiffness, as measured by brachial-ankle pulse wave velocity (baPWV), and the presence of the metabolic syndrome (MS) in a Chinese population. A total of 4,445 subjects were enrolled. The prevalence of MS in our study population was 21.7%, 17.2% and 25.6% for the general population, males and females, respectively. With adjustments for age, gender, cigarette smoking, heart rate, total cholesterol, low-density lipoprotein (LDL) cholesterol, and the use of anti-hypertensive drug, the stepwise regression analysis showed that baPWV had a significant relationship with components of MS, including systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.001), glucose (P < 0.001), high-density lipoprotein (HDL) cholesterol (P = 0.04), and triglycerides (P < 0.001), but no relationship with waist circumference (P = 0.25). With an increase in the number of the MS components, baPWV increased significantly both in women and men. This study indicated that the MS is indeed a risk factor for arterial stiffness. Monitoring of baPWV in patients with MS may help in identifying persons at high risk for cardiovascular disease.
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Affiliation(s)
- Fang Zhou
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Haifeng Zhang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wenming Yao
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hongbin Mei
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Dongjie Xu
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yanhui Sheng
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Rong Yang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xiangqing Kong
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Liansheng Wang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Jiangang Zou
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhijian Yang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xinli Li
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Yuan Y, Ikram MK, Vingerling JR, Jiang S, Lin H, Liu M, Ren L, Gao X. Retinal vascular caliber and metabolic syndrome in a Chinese population. Intern Med J 2014; 42:1014-22. [PMID: 21395957 DOI: 10.1111/j.1445-5994.2011.02470.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Microvascular changes have been associated with the metabolic syndrome. METHODS We included 869 participants aged ≥ 40 years from the High-risk for Diabetes Changfeng Study, who had gradable fundus photographs. On digital photographs sum retinal arteriolar and venular calibers were measured with a semi-automated system. Metabolic syndrome was defined according to the International Diabetes Federation consensus. RESULTS A total of 286 (32.9%) participants was diagnosed with metabolic syndrome. Participants with narrower retinal arteriolar caliber were more often diagnosed with metabolic syndrome (odds ratio 1.78, 95% confidence interval 1.02 – 3.10; lowest vs highest quintile). Additionally adjusting for age, gender, education, smoking and weekly activity, and adding arteriolar and venular caliber simultaneously in the same models did not alter these associations. In the component analyses, participants with narrower retinal arteriolar caliber were more likely to have central obesity, dyslipidaemia or raised blood pressure, and less likely to have raised fasting plasma glucose. The association between wider venular caliber and metabolic syndrome was less pronounced and non-significant (odds ratio 1.34; 95% confidence interval 0.79 – 2.38; highest vs lowest quintile). CONCLUSION Retinal arteriolar narrowing and, to a lesser extent, retinal venular dilatation were associated with metabolic syndrome in this Chinese population. These vascular changes, although small in magnitude, may still be important in the pathophysiological mechanisms involved in the metabolic syndrome.
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Relationship Between Metabolic Scores, Systemic Inflammation, Renal Function, and High-risk Peripheral Arterial Disease. INT J GERONTOL 2013. [DOI: 10.1016/j.ijge.2012.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Timóteo AT, Mota Carmo M, Cruz Ferreira R. Does metabolic syndrome predict significant angiographic coronary artery disease? REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.repce.2012.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Timóteo AT, Mota Carmo M, Cruz Ferreira R. Does metabolic syndrome predict significant angiographic coronary artery disease? Rev Port Cardiol 2012; 31:769-78. [PMID: 23158962 DOI: 10.1016/j.repc.2012.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 03/01/2012] [Accepted: 03/08/2012] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Metabolic syndrome (MS) is an independent predictor of acute cardiovascular events. However, few studies have addressed the relationship between MS and stable angiographic coronary artery disease (CAD), which has a different pathophysiological mechanism. We aimed to study the independent predictors for significant CAD, and to analyze the impact of MS (by the AHA/NHLBI definition) on CAD. METHODS We prospectively included 300 patients, mean age 64±9 years, 59% male, admitted for elective coronary angiography (suspected ischemic heart disease), excluding patients with known cardiac disease. All patients underwent assessment of demographic, anthropometric, and laboratory data and risk factors, and subsequently underwent coronary angiography. RESULTS In the study population, 23.0% were diabetic, 40.5% had MS (and no diabetes) and 36.7% had neither diagnosis. Significant CAD was present in 51.3% of patients. CAD patients were older and more frequently male and diabetic, with increased triglycerides and glucose and lower HDL cholesterol. Abdominal obesity was also less prevalent. MS was not associated with the presence of CAD (OR 0.94, 95% CI 0.59-1.48, p=0.778). Of the MS components, the most important predictors of CAD were increased glucose and triglycerides. Abdominal obesity was associated with a lower risk of CAD. In a multivariate logistic regression model for CAD, independent predictors of CAD were age, male gender, glucose and triglycerides. Body mass index had a protective effect. CONCLUSIONS Although MS is associated with cardiovascular events, the same was not found for stable angiographically proven CAD. Age, gender, diabetes and triglycerides are the most influential factors for CAD, with abdominal obesity as a protective factor.
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Affiliation(s)
- Ana Teresa Timóteo
- Cardiology Department, Santa Marta Hospital, Centro Hospitalar Lisboa Central, EPE, Lisboa, Portugal.
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A sequential two meal challenge reveals abnormalities in postprandial TAG but not glucose in men with increasing numbers of metabolic syndrome components. Atherosclerosis 2012; 220:237-43. [DOI: 10.1016/j.atherosclerosis.2011.09.047] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 09/15/2011] [Accepted: 09/26/2011] [Indexed: 11/20/2022]
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Sung KCC, Seo MHH, Rhee EJJ, Wilson AM. Elevated fasting insulin predicts the future incidence of metabolic syndrome: a 5-year follow-up study. Cardiovasc Diabetol 2011; 10:108. [PMID: 22129309 PMCID: PMC3275515 DOI: 10.1186/1475-2840-10-108] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 11/30/2011] [Indexed: 01/08/2023] Open
Abstract
Background There is controversy about the specific pathophysiology of metabolic syndrome (MS) but several authors have argued that hyperinsulinemia is a key feature of the cluster. We aimed to assess whether the baseline insulin levels could predict the development of MS in a well characterised cohort of otherwise healthy adults who were followed over a five year period. Methods We identified 2, 350 Koreans subjects who did not have MS in 2003 and who were followed up in 2008. The subjects were divided into 4 groups according to the baseline quartiles of fasting insulin, and the predictors of the incidence of MS were analyzed using multivariate regression analysis. Results Over the follow up period, 8.5% of the cohort developed MS. However, 16.4% of the subjects in the highest quartile of the insulin levels developed MS. In a model that included gender, age, the smoking status, the exercise level, alcohol consumption and the systolic blood pressure, the subjects in the highest quartile of the insulin levels had more than a 5 times greater risk of developing MS compared that of the subjects in the lowest quartile. This predictive importance remained significant even after correcting for all the individual features of MS. Conclusions These data suggest that high baseline fasting insulin levels are independent determinants for the future development of MS.
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Affiliation(s)
- Ki-Chul C Sung
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Beckie TM, Beckstead JW, Groer MW. The association between variants on chromosome 9p21 and inflammatory biomarkers in ethnically diverse women with coronary heart disease: a pilot study. Biol Res Nurs 2011; 13:306-19. [PMID: 21705410 DOI: 10.1177/1099800411403469] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The most consistently replicated genetic variants associated with coronary heart disease (CHD) in populations of European descent have been found on chromosome 9p21. Yet there is little known about these associations in ethnic groups of African ancestry. These disease-associated variants are located in a genomic region of unknown function. The purpose of this exploratory study was to examine the allelic frequencies and haplotype structure of single nucleotide polymorphisms (SNPs) for Black and White women with CHD. The authors also sought to explore the relationship between these genetic variants and biomarkers of inflammation. METHODS Using polymerase chain reaction amplification, the authors genotyped 8 SNPs in a 58-kilobase region of chromosome 9p21 in a cohort of women with CHD (n = 91). The authors examined the interethnic relationship between the SNPs and four inflammatory biomarkers (C-reactive protein, intercellular adhesion molecule-1, interleukin-6, and tumor necrosis factor-alpha) using analysis of variance (ANOVA). RESULTS We found considerable interethnic allelic and haplotype diversity across the 9p21 locus, with only two SNPs in perfect linkage disequilibrium (LD) in both races. A pair of high- and low-risk haplotypes was most common in White women, while about 41% of Blacks carried the risk alleles for three of the eight SNPs the authors examined. The interethnic associations between the SNP genotypes and inflammatory markers were divergent in both direction and magnitude. CONCLUSIONS Our results lend support for the importance of ancestry-specific allelic context when examining variants on chromosome 9p21. Additional work is needed to elucidate the genetic contribution to inflammatory biomarkers for diverse racial groups.
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Luan FL, Langewisch E, Ojo A. Metabolic syndrome and new onset diabetes after transplantation in kidney transplant recipients. Clin Transplant 2011; 24:778-83. [PMID: 20047609 DOI: 10.1111/j.1399-0012.2009.01194.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Metabolic syndrome (MS) and new onset diabetes after transplant (NODAT) are common in kidney transplant patients. We studied the relationship between the two conditions and their impact on metabolic and cardiovascular risk profiles. METHODS All non-diabetic patients transplanted between 1999 and 2005 who were followed up to 2006 were included. MS and NODAT were determined. Kaplan-Meier survival and various regression analyses were performed to determine the clinical correlates for both conditions and their association with various cardiovascular risk factors. RESULTS Among 591 patients, 314 (53.1%) had MS and 90 (15.2%) developed NODAT. The two conditions were highly associated with each other as 84 patients with NODAT also had MS (14.2%). Elevated body mass index and fasting glucose levels at transplant were risk factors for both conditions, whereas weight gain after transplant was associated only with MS. African American, old age, and hypertension-related ESRD were risk factors for NODAT. Finally, the presence of MS was associated with reduced kidney function and elevated uric acid levels, whereas the presence of NODAT with elevated pulse pressure. CONCLUSIONS MS and NODAT are highly prevalent and significantly associated with impaired metabolic and cardiovascular risk profiles. Early identification of such conditions may facilitate targeted therapeutic intervention.
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Affiliation(s)
- Fu L Luan
- Internal Medicine, Division of Nephrology, University of Michigan Taubman Center, East Medical Center Drive, Ann Arbor, MI, USA.
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16
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KAWAMIYA TOSHIKI, KATO KIMIHIKO, HORIBE HIDEKI, YOKOI KIYOSHI, OGURI MITSUTOSHI, YOSHIDA TETSURO, FUJIMAKI TETSUO, WATANABE SACHIRO, SATOH KEI, AOYAGI YUKITOSHI, NOZAWA YOSHINORI, MUROHARA TOYOAKI, YAMADA YOSHIJI. Association of genetic variants with myocardial infarction in Japanese individuals with or without metabolic syndrome. Exp Ther Med 2010; 1:969-975. [PMID: 22993627 PMCID: PMC3446751 DOI: 10.3892/etm.2010.147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 08/09/2010] [Indexed: 02/06/2023] Open
Abstract
The etiology of metabolic syndrome (MetS) is highly complex, with both genetic and environmental factors being thought to play an important role. Although MetS has been recognized as a risk factor for myocardial infarction (MI), the genetic risk for MI in individuals with or without MetS has remained uncharacterized. We examined a possible association of genetic variants with MI in individuals with or without MetS separately. The study population comprised 4,424 individuals, including 1,918 individuals with MetS (903 subjects with MI and 1,015 controls) and 2,506 individuals without MetS (499 subjects with MI and 2,007 controls). The 150 polymorphisms examined in the present study were selected by genome-wide association studies of MI and ischemic stroke with the use of Affymetrix GeneChip Human Mapping 500K Array Set. Initial screening by the Chi-square test revealed that the C→T polymorphism (rs1794429) of LRPAP1, the A→G polymorphism (rs12373237) of LAMA3 and the A→G polymorphism (rs3782257) of NCOR2 were significantly (false discovery rate of <0.05) associated with MI for individuals with MetS, and that the C→G polymorphism (rs13051704) of TFF1 was significantly related to MI for individuals without MetS. Subsequent multivariable logistic analysis with adjustment for covariates revealed that rs1794429 of LRPAP1 (recessive model; P=0.0218; odds ratio=0.71) and rs3782257 of NCOR2 (dominant model; P=0.0057; odds ratio=1.94) were significantly associated with MI among individuals with MetS, and that rs13051704 of TFF1 (additive model; P=0.0100; odds ratio=0.55) was significantly associated with MI among individuals without MetS. The genetic variants that confer susceptibility to MI differ between individuals with or without MetS. Stratification of subjects according to the presence or absence of MetS may thus be important for personalized prevention of MI based on genetic information.
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Affiliation(s)
- TOSHIKI KAWAMIYA
- Department of Cardiovascular Medicine, Gifu Prefectural Tajimi Hospital, Tajimi
| | - KIMIHIKO KATO
- Meito Hospital, Nagoya, and Life Science Research Center and
| | - HIDEKI HORIBE
- Department of Cardiovascular Medicine, Gifu Prefectural Tajimi Hospital, Tajimi
| | - KIYOSHI YOKOI
- Department of Cardiovascular Medicine, Gifu Prefectural Tajimi Hospital, Tajimi
| | - MITSUTOSHI OGURI
- Department of Cardiology, Japanese Red Cross Nagoya First Hospital
| | - TETSURO YOSHIDA
- Department of Cardiovascular Medicine, Inabe General Hospital, Inabe
| | - TETSUO FUJIMAKI
- Department of Cardiovascular Medicine, Inabe General Hospital, Inabe
| | - SACHIRO WATANABE
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu
| | - KEI SATOH
- Department of Vascular Biology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki
| | - YUKITOSHI AOYAGI
- Department of Genomics for Longevity and Health, Tokyo Metropolitan Institute of Gerontology, Tokyo
| | - YOSHINORI NOZAWA
- Gifu International Institute of Biotechnology and Tokai Gakuin University, Kakamigahara,
Japan
| | - TOYOAKI MUROHARA
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya
| | - YOSHIJI YAMADA
- Department of Human Functional Genomics, Life Science Research Center, Mie University, Tsu
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Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, Rinfret S, Schiffrin EL, Eisenberg MJ. The Metabolic Syndrome and Cardiovascular Risk. J Am Coll Cardiol 2010; 56:1113-32. [PMID: 20863953 DOI: 10.1016/j.jacc.2010.05.034] [Citation(s) in RCA: 1825] [Impact Index Per Article: 130.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 05/10/2010] [Accepted: 05/13/2010] [Indexed: 11/16/2022]
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The influence of cardiac rehabilitation on inflammation and metabolic syndrome in women with coronary heart disease. J Cardiovasc Nurs 2010; 25:52-60. [PMID: 19935427 DOI: 10.1097/jcn.0b013e3181b7e500] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) and increased inflammatory markers, both predictors of future cardiovascular events, are more prevalent in women with coronary heart disease (CHD). The influence of cardiac rehabilitation (CR) on MetS and inflammatory biomarkers is not well characterized for women. PURPOSE : The purpose of this article was to examine the effects of a 12-week behaviorally enhanced CR exclusively for women compared with traditional CR on components of the MetS and inflammatory markers in women with CHD. METHODS The randomized clinical trial used 2 treatment groups, both receiving a comprehensive 12-week CR program, with 1 group receiving a motivationally enhanced intervention exclusively for women. A subset of 91 women (mean age, 61.6 years) from the parent study provided serum samples to examine the effects of CR on high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and intercellular adhesion molecule-1 (ICAM-1). RESULTS After CR, the total sample of women demonstrated significant reductions in hsCRP (P =.002), IL-6 (P <.001), TNF-alpha (P =.010), and ICAM-1 (P =.016). Women in the gender-tailored CR program significantly improved all biomarker levels compared with baseline (P <.05 for all), whereas those in the traditional group improved only hsCRP (P <.05) and IL-6 (P <.05) levels. The combined study group demonstrated improvements in several components of MetS (triglycerides, waist circumference, and systolic blood pressure) but not in others (high-density lipoprotein cholesterol, fasting glucose, and diastolic blood pressure). CONCLUSION Cardiac rehabilitation promotes greater improvements in inflammatory biomarkers than in components of MetS for women with CHD. Improvements in body composition or weight may not be a precondition for the benefits of exercise because of loss of abdominal fat. Examining components of MetS as continuous variables is recommended to prevent lost information inherent in dichotomization.
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Morrison JA, Glueck CJ, Horn PS, Yeramaneni S, Wang P. Pediatric triglycerides predict cardiovascular disease events in the fourth to fifth decade of life. Metabolism 2009; 58:1277-84. [PMID: 19501856 PMCID: PMC2774112 DOI: 10.1016/j.metabol.2009.04.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Revised: 04/14/2009] [Accepted: 04/16/2009] [Indexed: 11/19/2022]
Abstract
To assess relationships between pediatric lipids and subsequent cardiovascular disease (CVD) in the fourth to fifth decades, we conducted 22- to 31-year follow-up studies (1998-2003) in former schoolchildren first studied in 1973-1976. The follow-up included 53% of eligible former subjects. We compared pediatric and adult body mass (in kilograms per square meter) and lipids in 19 cases with at least 1 CVD event and in 789 CVD event-free subjects. Mean +/- SD age was 12.3 +/- 3.3 years at entry and 38.5 +/- 3.8 years at follow-up. Mean age at the first CVD event was 37.1 +/- 4.9 years. The major novel finding of our study was that childhood triglycerides (TG) were consistently and independently associated with young adult CVD. The distributions of both childhood and adult TG were shifted to higher levels in the cases than controls. Of the 19 cases, 7 (37%) had childhood TG greater than the pediatric 95th percentile (153 mg/dL); and 6 of these 7 had high TG (>/=150 mg/dL) at adult follow-up. Overall, 61% of cases had high TG as adults. After adjusting for age, sex, and race, by analysis of variance, cases had higher TG levels both in childhood and in young adulthood. A bootstrapping method and the Cox proportional hazard analysis were used to predict CVD in the cohort with explanatory variables sex; race; childhood body mass index, low-density lipoprotein, log high-density lipoprotein cholesterol, and log TG; and adult cigarette smoking and type 2 diabetes mellitus. Childhood TG level was a significant, independent explanatory variable for young adult CVD hazard (hazard ratio, 5.35; 95% confidence interval, 1.69-20.0 for each 1-unit increase in natural logarithm scale) along with adult type 2 diabetes mellitus (hazard ratio, 19.4; 95% confidence interval, 4.24-114.2). Pediatric hypertriglyceridemia appears to be a significant, independent, potentially reversible correlate of young adult CVD.
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Affiliation(s)
- John A Morrison
- Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
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Can AS, Ozbayrakçi S, Palaoğlu KE, Bersot TP. Comparison between Turkish Cardiovascular Risk Platform and United States National Cholesterol Education Program Adult Treatment Panel III definitions of the metabolic syndrome in Turkish adults. JOURNAL OF THE CARDIOMETABOLIC SYNDROME 2009; 4:26-32. [PMID: 19245513 DOI: 10.1111/j.1559-4572.2008.00032.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The Turkish Cardiovascular Risk Platform (TCRP) calls for the diagnosis of the metabolic syndrome (MS) if insulin resistance, impaired fasting glucose, impaired glucose tolerance, or diabetes mellitus and >or=2 other established criteria are present. TCRP defines insulin resistance as a homeostasis model assessment >2.7. The aim of this cross-sectional study was to compare TCRP guidelines with the United States National Cholesterol Education Program Adult Treatment Panel III (NCEP) definition of MS in Turkish adults (N=1690). The age- and sex-adjusted prevalence of MS was 25% with the TCRP and 40% for the NCEP definition. Patients with MS identified by the NCEP definition but not by the TCRP definition had lower body mass index and less insulin resistance, but had a similarly adverse cardiovascular risk factor profile to those with TCRP-identified MS, with high blood pressure, waist circumference, triglycerides, and total cholesterol/high-density lipoprotein cholesterol ratio. Other national health organizations should avoid using homeostasis model assessment as a prerequisite for diagnosing MS. Modification of the NCEP definition would be more appropriate for ethnic groups with different body sizes.
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Affiliation(s)
- Ahmet Selçuk Can
- From the Department of Medicine, Faculty of Medicine, Istanbul Science University, Istanbul, Turkey
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Tommasino A, Burzotta F, Trani C, Giammarinaro M, Schiavoni G. Metabolic syndrome is a poor predictor of outcome after coronary interventions in high-risk patients. Hypertens Res 2008; 31:2097; author reply 2097-8. [PMID: 19098382 DOI: 10.1291/hypres.31.2097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sattar N, McConnachie A, Shaper AG, Blauw GJ, Buckley BM, de Craen AJ, Ford I, Forouhi NG, Freeman DJ, Jukema JW, Lennon L, Macfarlane PW, Murphy MB, Packard CJ, Stott DJ, Westendorp RG, Whincup PH, Shepherd J, Wannamethee SG. Can metabolic syndrome usefully predict cardiovascular disease and diabetes? Outcome data from two prospective studies. Lancet 2008; 371:1927-35. [PMID: 18501419 DOI: 10.1016/s0140-6736(08)60602-9] [Citation(s) in RCA: 361] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Clinical use of criteria for metabolic syndrome to simultaneously predict risk of cardiovascular disease and diabetes remains uncertain. We investigated to what extent metabolic syndrome and its individual components were related to risk for these two diseases in elderly populations. METHODS We related metabolic syndrome (defined on the basis of criteria from the Third Report of the National Cholesterol Education Program) and its five individual components to the risk of events of incident cardiovascular disease and type 2 diabetes in 4812 non-diabetic individuals aged 70-82 years from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). We corroborated these data in a second prospective study (the British Regional Heart Study [BRHS]) of 2737 non-diabetic men aged 60-79 years. FINDINGS In PROSPER, 772 cases of incident cardiovascular disease and 287 of diabetes occurred over 3.2 years. Metabolic syndrome was not associated with increased risk of cardiovascular disease in those without baseline disease (hazard ratio 1.07 [95% CI 0.86-1.32]) but was associated with increased risk of diabetes (4.41 [3.33-5.84]) as was each of its components, particularly fasting glucose (18.4 [13.9-24.5]). Results were similar in participants with existing cardiovascular disease. In BRHS, 440 cases of incident cardiovascular disease and 105 of diabetes occurred over 7 years. Metabolic syndrome was modestly associated with incident cardiovascular disease (relative risk 1.27 [1.04-1.56]) despite strong association with diabetes (7.47 [4.90-11.46]). In both studies, body-mass index or waist circumference, triglyceride, and glucose cutoff points were not associated with risk of cardiovascular disease, but all five components were associated with risk of new-onset diabetes. INTERPRETATION Metabolic syndrome and its components are associated with type 2 diabetes but have weak or no association with vascular risk in elderly populations, suggesting that attempts to define criteria that simultaneously predict risk for both cardiovascular disease and diabetes are unhelpful. Clinical focus should remain on establishing optimum risk algorithms for each disease.
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Affiliation(s)
- Naveed Sattar
- Faculty of Medicine, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
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Dominiczak MH. Hyperlipidaemia and cardiovascular disease: nonfasting triglycerides gain momentum--but nothing changes on the metabolic syndrome front. Curr Opin Lipidol 2008; 19:326-7. [PMID: 18460927 DOI: 10.1097/mol.0b013e3282feec44] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tommasino A, Burzotta F, Trani C, Giammarinaro M, Schiavoni G. Impact of metabolic syndrome on angiographic and clinical outcome after stenting. Am J Cardiol 2008; 101:1679. [PMID: 18489952 DOI: 10.1016/j.amjcard.2008.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2007] [Revised: 01/11/2008] [Accepted: 01/16/2008] [Indexed: 11/19/2022]
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Connelly JJ, Shah SH, Doss JF, Gadson S, Nelson S, Crosslin DR, Hale AB, Lou X, Wang T, Haynes C, Seo D, Crossman DC, Mooser V, Granger CB, Jones CJH, Kraus WE, Hauser ER, Gregory SG. Genetic and functional association of FAM5C with myocardial infarction. BMC MEDICAL GENETICS 2008; 9:33. [PMID: 18430236 PMCID: PMC2383879 DOI: 10.1186/1471-2350-9-33] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Accepted: 04/22/2008] [Indexed: 12/18/2022]
Abstract
Background We previously identified a 40 Mb region of linkage on chromosome 1q in our early onset coronary artery disease (CAD) genome-wide linkage scan (GENECARD) with modest evidence for linkage (n = 420, LOD 0.95). When the data are stratified by acute coronary syndrome (ACS), this modest maximum in the overall group became a well-defined LOD peak (maximum LOD of 2.17, D1S1589/D1S518). This peak overlaps a recently identified inflammatory biomarker (MCP-1) linkage region from the Framingham Heart Study (maximum LOD of 4.27, D1S1589) and a region of linkage to metabolic syndrome from the IRAS study (maximum LOD of 2.59, D1S1589/D1S518). The overlap of genetic screens in independent data sets provides evidence for the existence of a gene or genes for CAD in this region. Methods A peak-wide association screen (457 SNPs) was conducted of a region 1 LOD score down from the peak marker (168–198 Mb) in a linkage peak for acute coronary syndrome (ACS) on chromosome 1, within a family-based early onset coronary artery disease (CAD) sample (GENECARD). Results Polymorphisms were identified within the 'family with sequence similarity 5, member C' gene (FAM5C) that show genetic linkage to and are associated with myocardial infarction (MI) in GENECARD. The association was confirmed in an independent CAD case-control sample (CATHGEN) and strong association with MI was identified with single nucleotide polymorphisms (SNPs) in the 3' end of FAM5C. FAM5C genotypes were also correlated with expression of the gene in human aorta. Expression levels of FAM5C decreased with increasing passage of proliferating aortic smooth muscle cells (SMC) suggesting a role for this molecule in smooth muscle cell proliferation and senescence. Conclusion These data implicate FAM5C alleles in the risk of myocardial infarction and suggest further functional studies of FAM5C are required to identify the gene's contribution to atherosclerosis.
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Affiliation(s)
- Jessica J Connelly
- Department of Medicine and Center for Human Genetics, Duke University Medical Center, Durham, NC, USA.
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Vlek ALM, van der Graaf Y, Spiering W, Visseren FLJ. Effect of metabolic syndrome or type II diabetes mellitus on the occurrence of recurrent vascular events in hypertensive patients. J Hum Hypertens 2008; 22:358-65. [PMID: 18273039 DOI: 10.1038/jhh.2008.5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Patients with hypertension and manifest vascular disease are at high risk for recurrent cardiovascular diseases. It is unknown if the metabolic syndrome further increases the risk in these patients. This study aims to quantify the effect of metabolic syndrome and type II diabetes on cardiovascular events in hypertensive patients with vascular disease. A total of 2,196 hypertensive patients with vascular disease (cerebrovascular disease (34%), coronary heart disease (50%), peripheral arterial disease (28%), abdominal aortic aneurysm (13%)) from the Second Manifestations of Arterial Disease study were followed for up to 10 years (mean 3.9 years) for death, stroke and myocardial infarction. Age and sex adjusted hazard ratios (HR) were calculated for hypertensive patients with metabolic syndrome but without diabetes (n=775) and for hypertensive patients with type II diabetes (n=381), compared to merely hypertensive patients (n=1,040). Forty-nine percent had metabolic syndrome (NCEP ATPIII definition) and 17% had type II diabetes. Metabolic syndrome predicted vascular death (HR 1.41, 95% confidence interval (CI) 1.01-1.98), stroke (HR 1.36, 95% CI 0.85-2.16) and myocardial infarction (HR 1.40, 95% CI 0.97-2.01). Type II diabetes accounted for even higher risks of vascular end points (HR 1.41-1.64). The effect of metabolic syndrome on future events could not be explained by the presence of type II diabetes. Even in high-risk patients with hypertension and vascular disease, presence of metabolic syndrome or type II diabetes identifies patients at high risk for future cardiovascular events. Identifying metabolic syndrome patients may direct therapy focusing on treatment of insulin resistance by reducing weight and increasing physical activity.
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Affiliation(s)
- A L M Vlek
- Julius Center for Health Sciences and Primary Care, Department of Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands
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Janero DR, Makriyannis A. Targeted modulators of the endogenous cannabinoid system: future medications to treat addiction disorders and obesity. Curr Psychiatry Rep 2007; 9:365-73. [PMID: 17915075 DOI: 10.1007/s11920-007-0047-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The endogenous endocannabinoid system encompasses a family of natural signaling lipids ("endocannabinoids") functionally related to (9)-tetrahydrocannabinol, the psychoactive ingredient of marijuana (cannabis), along with proteins that modulate the endocannabinoids, including enzymes, transporters, and receptors. The endocannabinoid system's ubiquitous regulatory actions in health and disease underscore its importance to mammalian (patho)physiology and suggest discrete targets through which it may be modulated for therapeutic gain. Medications based on the endocannabinoid system are an important focus of contemporary translational research, particularly with respect to substance abuse and obesity, two prevalent disorders with a pathogenic component of endocannabinoid system hyperactivity. Pressing health care needs have made the rational design of targeted CB1 cannabinoid-receptor modulators a promising route to future medications with significant therapeutic impact against psychobehavioral and metabolic disturbances having a reward-supported appetitive component.
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Affiliation(s)
- David R Janero
- Center for Drug Discovery, Northeastern University, 116 Mugar Hall, 360 Huntington Avenue, Boston, MA 02115-5000, USA.
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