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Skåra KH, Hernáez Á, Næss Ø, Fraser A, Lawlor DA, Burgess S, Brumpton BM, Magnus MC. Cardiovascular disease risk factors and infertility: multivariable analyses and one-sample Mendelian randomization analyses in the Trøndelag Health Study. Hum Reprod Open 2024; 2024:hoae033. [PMID: 38911051 PMCID: PMC11190059 DOI: 10.1093/hropen/hoae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 05/03/2024] [Indexed: 06/25/2024] Open
Abstract
STUDY QUESTION Are cardiovascular disease (CVD) risk factors causally associated with higher risk of infertility among women and men? SUMMARY ANSWER We found evidence to support a causal relationship between smoking initiation and history of infertility in women. WHAT IS KNOWN ALREADY Several CVD risk factors are associated with history of infertility. Previous studies using Mendelian randomization (MR) further support a causal relationship between BMI and infertility in women. STUDY DESIGN SIZE DURATION We used data from the Trøndelag Health Study (HUNT) in Norway, a prospective population-based cohort study, including 26 811 women and 15 598 men participating in three survey collections in 1995-1997 (HUNT2), 2006-2008 (HUNT3), and 2017-2019 (HUNT4). PARTICIPANTS/MATERIALS SETTING METHODS Our outcome was women's self-reported history of infertility, defined as ever having tried to conceive for 12 months or more or having used ART. We assigned the history of infertility reported by women to their male partners; therefore, the measure of infertility was on the couple level. We used both conventional multivariable analyses and one-sample MR analyses to evaluate the association between female and male CVD risk factors (including BMI, blood pressure, lipid profile measurements, and smoking behaviours) and history of infertility in women and men, separately. MAIN RESULTS AND THE ROLE OF CHANCE A total of 4702 women (18%) and 2508 men (16%) were classified with a history of infertility. We found a higher risk of infertility among female smokers compared to non-smokers in both multivariable and MR analyses (odds ratio (OR) in multivariable analysis, 1.20; 95% CI, 1.12-1.28; OR in MR analysis, 1.13; CI, 1.02-1.26), and potentially for higher BMI (OR in multivariable analysis, 1.13; CI, 1.09-1.18; OR in MR analysis, 1.11, CI, 0.92-1.34). In multivariable analysis in women, we also found evidence of associations between triglyceride levels, high-density lipoprotein cholesterol, lifetime smoking index, and smoking intensity with higher risk of infertility. However, these results were not consistent in MR analyses. We found no robust or consistent associations between male CVD risk factors and infertility. LIMITATIONS REASONS FOR CAUTION Our main limitation was that the CVD risk factors measured might not adequately capture the relevant time periods for when couples were trying to conceive. Additionally, we did not have information on causes of infertility in either women or men. WIDER IMPLICATIONS OF THE FINDINGS Women with infertility could have a worse CVD risk factor profile and thus public health interventions aimed at reducing the impact of some CVD risk factors, such as smoking and BMI, could reduce the burden of infertility. However, additional MR studies of the relationship between CVD risk factors and infertility with a larger sample size would be of value. STUDY FUNDING/COMPETING INTERESTS The study was supported by a grant from the European Research Council under the European Union's Horizon 2020 research and innovation program (grant agreements no. 947684). This research was also supported by the Research Council of Norway through its Centres of Excellence funding scheme (project no. 262700) and partly funded by the Research Council of Norway, project: Women's fertility-an essential component of health and well-being (project no. 320656). D.A.L. and A.F. work in a unit that is supported by the University of Bristol and the UK Medical Research Council (MC_UU_00011/6). D.A.L.'s contribution to the article is supported by the European Research Council (101021566), the British Heart Foundation (CH/F/20/90003 and AA/18/7/34219). S.B.'s contribution to the article is supported by the Wellcome Trust (225790/Z/22/Z). B.M.B. is funded by The Liaison Committee for education, research and innovation in Central Norway; and the Joint Research Committee between St. Olavs Hospital and the Faculty of Medicine and Health Sciences, NTNU. The genotyping in HUNT was financed by the National Institute of Health (NIH); University of Michigan; The Research Council of Norway; The Liaison Committee for education, research and innovation in Central Norway; and the Joint Research Committee between St. Olavs Hospital and the Faculty of Medicine and Health Sciences, NTNU. None of the funding organizations influenced the study design, reporting, or interpretation of results. The views expressed in the present article are those of the authors and not necessarily any acknowledged funding organization. D.A.L. reports grants from Medtronic Ltd and Roche Diagnostics outside the submitted work. The other authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Karoline H Skåra
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Álvaro Hernáez
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Consorcio CIBER, M.P. Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
- Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain
| | - Øyvind Næss
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Stephen Burgess
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Ben M Brumpton
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Levanger, Norway
- HUNT Research Centre, Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Levanger, Norway
- Clinic of Medicine, St Olavs Hospital, Trondheim University, Trondheim, Norway
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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Musazadeh V, Abbasi S, Kavyani Z, Moridpour AH, Safarzadeh D, Moradi Z, Bahadori F, Faghfouri AH. The effect of curcumin supplementation on circulating adiponectin and leptin concentration in adults: a GRADE-assessed systematic review and meta-analysis of randomised controlled trials. Br J Nutr 2024; 131:964-973. [PMID: 37980942 DOI: 10.1017/s0007114523002428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Curcumin is a phytocompound found in the root of turmeric, a common herbal ingredient in many Asian cuisines. The compound contains anti-inflammatory activity, which is mediated through an upregulation of adiponectin and reduction of leptin. Results of randomised controlled trials (RCT) have shown that the effects of curcumin on adipokines are conflicting. Therefore, the current systematic review and meta-analysis of RCT were conducted with the aim of elucidating the role of curcumin supplementation on serum adiponectin and leptin. The search included PubMed, Embase, Cochrane Library, Scopus, Web of Science and Google Scholar from inception to August 2023. For net changes in adipokines, standardised mean differences (SMD) were calculated using random effects models. Thirteen RCT with fourteen treatment arms were eligible for inclusion in this meta-analysis. Curcumin supplementation was effective in increasing serum adiponectin (SMD = 0·86, 95 % CI (0·33, 1·39), P < 0·001; I2 = 93·1 %, P < 0·001) and reducing serum leptin (SMD = -1·42, 95 % CI (-2·29, -0·54), P < 0·001; I2 = 94·7 %, P < 0·001). In conclusion, curcumin supplementation significantly increased circulating adiponectin and decreased leptin levels in adults.
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Affiliation(s)
- Vali Musazadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- School of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shaghayegh Abbasi
- Department of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zeynab Kavyani
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- School of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Hossein Moridpour
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- School of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Diba Safarzadeh
- Vocational School of Health Service, Near East University, Nicosia, Cyprus
| | - Zahra Moradi
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Joensuu, Finland
| | - Fatemeh Bahadori
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Amir Hossein Faghfouri
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
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3
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Tomasiuk R. Evaluation of Applicability of Novel Markers of Metabolic Syndrome in Adult Men. Am J Mens Health 2022; 16:15579883221108895. [PMID: 35962582 PMCID: PMC9380215 DOI: 10.1177/15579883221108895] [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] [Indexed: 11/15/2022] Open
Abstract
There is a continuous worldwide increase in incidences of metabolic
syndrome (MetS) reaching about a quarter of the world’s population.
Thus, studies that allow for a robust diagnosis of MetS are of
paramount importance from an economic and medical point of view. This
study was carried out in a group of men diagnosed with MetS using
consensus definition criteria that included the definitions of the
International Diabetes Foundation and Diabetes Federation and the
American Heart Association/National Heart, Lung, and Blood Institute.
The control group consisted of men for whom the parameters that define
the MetS were in the norm. This study analyzed statistical differences
between MetS and healthy men and the correlations between the set of
14 potential markers of MetS, that is, between body mass index, total
cholesterol, high-density lipoprotein cholesterol, low-density
lipoprotein, triglycerides, cortisol, adiponectin, monocyte
chemotactic protein-1 (MCP-1), C-reactive protein (CRP), adipsin,
leptin, resistin, and plasminogen activator inhibitor-1 (PAI)-1. This
report revealed a significant difference between MetS and healthy men
in most of the parameters studied. Furthermore, a strong positive
correlation between cortisol levels and body mass index was
demonstrated. Furthermore, MCP-1 levels in men with MetS were
significantly higher than their levels in healthy men. Finally, a
strong positive correlation was also observed between adiponectin and
adipsin in Mets men. Thus, this study reveals the potential usefulness
of adiponectin, MCP-1, adipsin, leptin, resistin, and PAI-1 as markers
of MetS in adult men.
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Affiliation(s)
- Ryszard Tomasiuk
- Faculty of Medical Sciences and Health Sciences, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland
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4
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Villa N, Badla O, Goit R, Saddik SE, Dawood SN, Rabih AM, Mohammed A, Raman A, Uprety M, Calero MJ, Villanueva MRB, Joshaghani N, Mohammed L. The Role of Leptin in Systemic Lupus Erythematosus: Is It Still a Mystery? Cureus 2022; 14:e26751. [PMID: 35967162 PMCID: PMC9365198 DOI: 10.7759/cureus.26751] [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: 06/06/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is a chronic inflammatory connective tissue disease with varying clinical manifestations. Recent studies have proposed that leptin may be related to SLE development. This study aims to assess current information regarding the relationship between leptin and SLE. A systematic search was done using PubMed, Google Scholar, ScienceDirect, Epistemonikos, and Cochrane Library databases. Studies published in the English language in the last 10 years were selected based on predefined eligibility criteria. The quality of the studies was evaluated using the Newcastle-Ottawa Scale and the Assessment of Multiple Systematic Reviews 2 tool. A total of 12 studies were included in this systematic review. These included systematic reviews/meta-analyses, cross-sectional studies, and case-control studies. Based on the findings of this review, we conclude thatleptin is significantly elevated in SLE patients; however, it does not seem to correlate with disease activity. The exact mechanism of leptin in the pathogenesis of the disease remains unknown and further research is needed regarding this aspect.
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Affiliation(s)
- Nicole Villa
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Omar Badla
- General Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Raman Goit
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Samia E Saddik
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sarah N Dawood
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ahmad M Rabih
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ahmad Mohammed
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Aishwarya Raman
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Manish Uprety
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Maria Jose Calero
- Gynecology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | | | - Narges Joshaghani
- Psychiatry and Behavioral Sciences, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Lubna Mohammed
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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5
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de Sousa Melo SR, Dos Santos LR, Morais JBS, Cruz KJC, de Oliveira ARS, da Silva NC, de Sousa GS, Payolla TB, Murata G, Bordin S, Henriques GS, do Nascimento Marreiro D. Leptin and its relationship with magnesium biomarkers in women with obesity. Biometals 2022; 35:689-697. [PMID: 35546213 DOI: 10.1007/s10534-022-00393-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/13/2022] [Indexed: 11/27/2022]
Abstract
Some studies have demonstrated the participation of leptin in magnesium metabolism. On the other hand, there is evidence of the role of magnesium in the leptin intracellular signaling pathway. Therefore, the aim of this study was to investigate the existence of a relationship between serum leptin concentrations and magnesium biomarkers in women with obesity. Case-control study involving 108 women aged between 20 and 50 years, divided into two groups: obese (n = 52) and control (n = 56). Body weight, height and waist circumference, body mass index, dietary magnesium intake, magnesium biomarkers and serum leptin concentrations were measured. Serum leptin concentrations showed a statistically significant difference between groups (p < 0.001). Mean values of magnesium intake were lower than intake recommended, and with no statistically significant difference between two groups (p > 0.05). Women with obesity had lower plasma and erythrocyte magnesium concentrations than control group did (p < 0.001). Magnesium concentrations found in the urine of women with obesity were higher than the control group was, with a statistically significant difference (p < 0.001). There was a correlation between serum leptin and magnesium biomarkers (p < 0.001). Women with obesity show an inadequate magnesium nutritional status characterized by low plasma and erythrocyte concentrations and high concentrations in urine, and they also have high serum leptin concentrations. Thus, it was possible to observe a correlation between hyperleptinemia and magnesium biomarkers, requiring further studies to determine whether the dysfunction of this hormone can influence the compartmentalization of the mineral in obese organisms.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Gilson Murata
- Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Silvana Bordin
- Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | | | - Dilina do Nascimento Marreiro
- Department of Nutrition, Health Sciences Center, Federal University of Piauí, Rua Hugo Napoleão, 665, Ed. Palazzo Reale, Apto 2001, Jockey, Teresina, PI, CEP 64048-320, Brazil.
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6
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Aryanian Z, Shirzadian A, Farzaneh S, Goodarzi A, Azizpour A, Hatami P. Metabolic derangement in patients with vitiligo: a cross-sectional study. J Investig Med 2022; 70:963-966. [PMID: 35169000 PMCID: PMC9016231 DOI: 10.1136/jim-2021-002062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 12/02/2022]
Abstract
Vitiligo is a pigmentary disorder resulting from progressive destruction of melanocytes in the skin. There is a growing body of evidence about higher risk of metabolic syndrome and dyslipidemia in some dermatoses including vitiligo. We aimed to evaluate lipid profile, leptin and C reactive protein (CRP) status among Iranian patients with vitiligo, compared with healthy controls and perused the relationship between abnormal values of these parameters with disease duration and physical characteristics of patients. 40 patients with vitiligo and 40 age-matched and sex-matched healthy controls were enrolled in the study. Data on weight, height, lipid profile, leptin and CRP values were recorded and compared. The mean values for nearly all study parameters (except for high-density lipoprotein) were significantly higher in patients with vitiligo, compared with healthy controls, irrespective of age and sex. We could not find any correlation between vitiligo and study parameters, regarding disease severity and extension of lesions; but in patients who have been suffering from vitiligo for more than 5 years, systolic blood pressure, diastolic blood pressure and CRP values were noted to be significantly higher (p<0.001, p=0.003 and p=0.03, respectively). In conclusion, screening of patients with vitiligo in regard to their lipid profile as well as blood pressure should be considered, especially in patients with longer disease duration or those who have other cardiovascular risk factors to prevent morbidity and mortality as a result of developing cardiovascular events.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azar Shirzadian
- Department of Dermatology, Babol University of Medical Sciences, Babol, Mazandaran, Iran
| | - Sepideh Farzaneh
- Department of Dermatology, Babol University of Medical Sciences, Babol, Mazandaran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Iran University of Medical Sciences, Tehran, Iran
| | - Arghavan Azizpour
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Tehran Universityof medical Sciences, Tehran, Iran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Association of TNF-α 308G/A and LEPR Gln223Arg Polymorphisms with the Risk of Type 2 Diabetes Mellitus. Genes (Basel) 2021; 13:genes13010059. [PMID: 35052401 PMCID: PMC8796026 DOI: 10.3390/genes13010059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 01/17/2023] Open
Abstract
The objective of the present study was to identify the association of the TNF-α- 308G/A and leptin receptor (LEPR) Gln223Arg polymorphisms with the risk of development of type 2 diabetes mellitus (T2DM). Methods: A total of 160 volunteers were studied: 108 with T2DM and 52 participants as control, who served as the control group. Polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) for the genomic region of TNF-α- 308G/A and LEPR Gln223Arg were carried out. Results: The frequency of LEPR Gln223Arg genotypes in T2DM and control groups showed significant differences in the distribution of genotypes (p < 0.05). The frequency also of TNF-α- 308G/A genotypes in T2DM and control subjects showed significant differences in the distribution of genotypes (p < 0.05). Conclusion: Our results indicate that there are significant differences in the distribution of genotypes and alleles between the individuals with T2DM and control subjects (p < 0.05).
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Hassannejad R, Sharrouf H, Haghighatdoost F, Kirk B, Amirabdollahian F. Diagnostic Power of Circulatory Metabolic Biomarkers as Metabolic Syndrome Risk Predictors in Community-Dwelling Older Adults in Northwest of England (A Feasibility Study). Nutrients 2021; 13:nu13072275. [PMID: 34209146 PMCID: PMC8308366 DOI: 10.3390/nu13072275] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS; however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Methods: Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured; and their fasting capillary and venous blood were collected. The components of the MetS; and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Results: Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06–1.64)), TNF-α (OR: 1.37 (1.02–1.84)), Resistin (OR: 1.27 (1.04–1.54)) and CRP (OR: 1.29 (1.09–1.54)) with MetS risk; however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16–1.53)) and MetS risk (OR: 1.24 (1.12–1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24–2.83) and OR: 1.25 (1.09–1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683–0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653–0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Conclusion: Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.
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Affiliation(s)
- Razieh Hassannejad
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran; (R.H.); (F.H.)
| | - Hamsa Sharrouf
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran; (R.H.); (F.H.)
| | - Ben Kirk
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Furlong Road, St. Albans, Melbourne, VIC 3021, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St. Albans, Melbourne, VIC 3201, Australia
| | - Farzad Amirabdollahian
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
- Correspondence:
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Anche P, Maiya GA, Kamath SU, Shastry BA. Influence of a 12-week physical activity program on leptin resistance in metabolic syndrome: a preliminary study. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-00928-6] [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: 11/30/2022] Open
Abstract
Abstract
Purpose
Metabolic syndrome is a condition with clustering of risk factors like insulin resistance, obesity, dyslipidemia, and hypertension. Leptin is a protein of obese gene produced by white adipose tissue. Leptin resistance is the insensitivity of leptin in hypothalamus despite high amounts in blood causing obesity and metabolic syndrome. The study focused on the influence of a 12-week physical activity promotion program on leptin resistance in people with metabolic syndrome
Methods
After approval from institutional ethics committee (IEC 343-2018), 18 participants (males N= 4, females N=14) of age group 45.0±7.6 years with metabolic syndrome according to (NCEP ATP-III) criteria were included in the study. The participants underwent a 12-week physical activity program consisting of 150 min of moderate to vigorous activity per week as per GPAQ domains—work, transport, and recreation. The outcomes were measured at baseline and after 12 weeks.
Results
Out of 18 participants, 10 participants who completed the study were analysed. Twelve-week physical activity showed significant changes in waist circumference (p=0.047), post prandial blood glucose (p=0.0396), triglycerides (p=0.0323), body mass index (p=0.0056), subcutaneous fat (p=0.0354), and basal metabolic rate (p=0.0035). Fasting blood glucose (p=0.254), lipid profiles (total cholesterol (p=0.062)), high-density lipoprotein (p=0.367), low-density lipoprotein (p=0.641), and leptin showed insignificant change (p=0.328). Global physical activity questionnaire showed significant change (p=0.0254) suggesting changes in physical activity behaviors.
Conclusion
From present study, it is concluded that a 12-week physical activity promotion program brought marginal changes in leptin levels and has potential to modify metabolic syndrome parameters and improve physical activity.
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Parameshwar A, Maiya GA, Kamath SU, Shastry BA. Lifestyle Modification with Physical Activity Promotion on Leptin Resistance and Quality of Life in Metabolic Syndrome - A Systematic Review with Meta-Analysis. Curr Diabetes Rev 2021; 17:345-355. [PMID: 32072915 DOI: 10.2174/1573399816666200211102917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/30/2019] [Accepted: 01/20/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study focused to systematically extract, summarize and analyse the data on the effect of lifestyle modification on leptin resistance and quality of life in metabolic syndrome. METHODS The systematic search was done using PubMed, Cochrane Database, EMBASE, Science Direct, CINAHL, Springer link, Web of Science from 2000-2018. English language articles and quantitative studies focusing on leptin resistance and quality of life were included. Random effect analysis was adopted to pool data and estimate 95% CI. The meta-analysis was done separately for leptin resistance and quality of life which included a total of 9 studies on both RCTs and Non-RCTs. RESULTS The meta-analysis of RCTs reported insignificant effect of lifestyle modification on leptin resistance in metabolic syndrome when compared to comparison group (-5.94(-14.28, 2.41). Two clinical trials showed a significant effect with pooled data (5.52(2.14, 8.91). Meta-analysis of RCTs focusing on quality of life showed significant effect on mental component (4.89 (0.16, 9.62) of quality of life (2.36 (-3.67, 8.39) when compared to comparison group. CONCLUSION This meta-analysis suggested that lifestyle modification has a potential to improve leptin resistance and mental component of quality of life in metabolic syndrome. However, more clearly defined studies are required to come to a stronger conclusion.
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Affiliation(s)
- Anche Parameshwar
- Department of Physiotherapy, Centre for Diabetic Foot Care & Research, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - G Arun Maiya
- Department of Physiotherapy, Centre for Diabetic Foot Care & Research, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Shobha Ullas Kamath
- Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, India
| | - B Ananthakrishna Shastry
- Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education Manipal, India
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Lopes LMP, de Oliveira EC, Becker LK, Costa GDP, Pinto KMDC, Talvani A, Carraro JCC, Coelho DB. Resistance Training Associated with Dietetic Advice Reduces Inflammatory Biomarkers in the Elderly. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7351716. [PMID: 32964042 PMCID: PMC7492897 DOI: 10.1155/2020/7351716] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/05/2020] [Indexed: 02/08/2023]
Abstract
Aging is a biological process during which chronic low-grade inflammation is present due to changes in the immune system of the elderly. The main objective of this study is to evaluate the effects of resistance training associated with dietary advice on chronic inflammation in the elderly. We conducted a prospective intervention study in which we evaluated anthropometric parameters and inflammatory biomarkers (CRP, IL-8, CCL-2, and leptin) in 40 elderly people before and after long-term progressive resistance training (19 weeks) associated with dietary advice. The participants trained twice a week on nonconsecutive days, and the training lasted one hour with an intensity of 60-85% of 1-MR. Dietary advice was explained in person and individually focusing on foods rich in compounds with anti-inflammatory and antioxidant properties. Participants were instructed at the beginning of the training program, and dietary advice was reinforced verbally weekly. There was an improvement in body composition evidenced by a reduction in waist circumference and body fat percentage and by the increase in arm circumference, calf circumference, and corrected arm muscle area. In addition, there was a reduction in the inflammatory biomarkers CCL-2 (p = 0.01) and leptin (p < 0.01). Resistance training associated with dietary guidance can contribute to a healthy aging due to observed improvements in body composition and in the inflammatory profile of the elderly.
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Affiliation(s)
- Lilian Maria Peixoto Lopes
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Emerson Cruz de Oliveira
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Physical Education School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Lenice Kappes Becker
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Physical Education School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Guilherme de Paula Costa
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Kelerson Mauro de Castro Pinto
- Physical Education School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Inflammation Immunobiology Laboratory, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - André Talvani
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Inflammation Immunobiology Laboratory, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Júlia Cristina Cardoso Carraro
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Daniel Barbosa Coelho
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Physical Education School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
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Kumar AA, Satheesh G, Vijayakumar G, Chandran M, Prabhu PR, Simon L, Kutty VR, Kartha CC, Jaleel A. Plasma leptin level mirrors metabolome alterations in young adults. Metabolomics 2020; 16:87. [PMID: 32772182 DOI: 10.1007/s11306-020-01708-9] [Citation(s) in RCA: 1] [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: 01/21/2020] [Accepted: 08/03/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Leptin is known to regulate pathways of energy metabolism, reproduction, and control appetite. Whether plasma leptin levels reflect changes in metabolites of these pathways is unknown. OBJECTIVES We aimed to find whether there is an association between leptin levels and levels of metabolites of energy and hormone metabolism. METHODS We performed an untargeted metabolomics analysis of plasma from 110 healthy adults (men: women = 1:1; aged 18-40 years), using liquid chromatography-tandem mass spectrometry. Blood samples were collected from all the study subjects in the fasting state. Clinical features and markers of obesity and Type 2 diabetes mellitus (T2DM) were assessed in all. The association between levels of metabolites and clinical and biochemical parameters was identified using the multivariable-adjusted linear regression model and PLS-DA analysis. RESULTS The leptin level was found to have a significant association with a substantial number of metabolites in women and men. Leptin level was positively associated with glycocholic acid and arachidic acid, metabolites related to energy metabolisms, pregnanediol-3-glucuronide, a metabolite of progesterone metabolism, and quercetin 3'-sulfate, a diet-derived metabolite. Leptin level was negatively associated with ponasteroside A and barringtogenol C levels. Leptin level was positively correlated with adiponectin and negatively with total calorie intake and levels of triglyceride and very-low-density lipoprotein. Leptin levels were associated with lipid and sex hormone metabolism in women, while metabolites involved in amino acid metabolism were correlated to leptin in men. CONCLUSION Our study indicates that leptin level reflects metabolome alterations and hence could be a useful marker to detect early changes in energy and hormone metabolisms.
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Affiliation(s)
- A Aneesh Kumar
- Cardiovascular Diseases & Diabetes Biology, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, 695012, India
- Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Gopika Satheesh
- Cardiovascular Diseases & Diabetes Biology, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, 695012, India
| | - Gadadharan Vijayakumar
- Medical Trust Hospital and Diabetes Care Centre, Kulanada, Pathanamthitta, Kerala, India
| | - Mahesh Chandran
- Mass Spectrometry and Proteomics Core Facility, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, 695012, India
| | - Priya R Prabhu
- Cancer Research Program, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, 695012, India
| | - Leena Simon
- Medical Trust Hospital and Diabetes Care Centre, Kulanada, Pathanamthitta, Kerala, India
| | - Vellappillil Raman Kutty
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram, Kerala, 695012, India
| | - Chandrasekharan C Kartha
- Society for Continuing Medical Education & Research, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, 695029, India
| | - Abdul Jaleel
- Cardiovascular Diseases & Diabetes Biology, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, 695012, India.
- Mass Spectrometry and Proteomics Core Facility, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, 695012, India.
- Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
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Wojciechowska-Kulik A, Blus E, Kowalczyk Z, Baj Z, Majewska E. The Effect of Noninvasive Bariatric Surgery on the Levels of Certain Adipokines and Atherosclerosis Risk Factors in Patients with Metabolic Syndrome. J Am Coll Nutr 2019; 39:481-487. [DOI: 10.1080/07315724.2019.1695017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
| | - Edyta Blus
- Department of Pathophysiology and Clinical Immunology, Medical University of Lodz, Lodz, Poland
| | | | - Zbigniew Baj
- Department of Pathophysiology and Clinical Immunology, Medical University of Lodz, Lodz, Poland
| | - Ewa Majewska
- Department of Pathophysiology and Clinical Immunology, Medical University of Lodz, Lodz, Poland
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Irisin as a Multifunctional Protein: Implications for Health and Certain Diseases. ACTA ACUST UNITED AC 2019; 55:medicina55080485. [PMID: 31443222 PMCID: PMC6722973 DOI: 10.3390/medicina55080485] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 01/10/2023]
Abstract
Sedentary life style is considered to be an independent risk factor for many disorders, including development of type 2 diabetes, obesity, immune dysfunction, asthma, and neurological or coronary heart disease. Irisin is released from myocytes during physical activity, and acts as a link between muscles and other tissues and organs. This myokine is produced as a result of proteolytic cleavage of FNDC5 protein present in the membrane of myocytes. Secretion of irisin is regulated by N-linked oligosaccharides attached to the protein molecule. The two N-glycan molecules, which constitute a significant part of the irisin glycoprotein, regulate the browning of adipocytes, which is the most important function of irisin. A receptor specific for irisin has still not been discovered. In some tissues irisin probably acts via integrins, which are widely expressed transmembrane receptors. Many studies have confirmed the multifunctional role of irisin and the beneficial effects of this molecule on body homeostasis. Irisin reduces systemic inflammation, maintains the balance between resorption and bone formation, and modulates metabolic processes and the functioning of the nervous system. It suppresses the expression and release of pro-inflammatory cytokines in obese individuals and attenuates inflammation in adipose tissue. The impact of irisin on cancer cell proliferation, migration, and invasion has also been demonstrated in numerous studies, which proves its role in carcinogenesis. Owing to these pleiotropic and beneficial properties, irisin may be a potential option to prevent and treat civilization-related diseases which are, nowadays, considered to be the major health problems in Western societies.
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Supriya R, Tam BT, Yu AP, Lee PH, Lai CW, Cheng KK, Yau SY, Chan LW, Yung BY, Sheridan S, Siu PM. Adipokines demonstrate the interacting influence of central obesity with other cardiometabolic risk factors of metabolic syndrome in Hong Kong Chinese adults. PLoS One 2018; 13:e0201585. [PMID: 30114249 PMCID: PMC6095502 DOI: 10.1371/journal.pone.0201585] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Accepted: 07/18/2018] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Metabolic syndrome (MetS) or prediabetes is a complex disorder that is defined by a clustering of cardiometabolic risk factors, including obesity, hypertriglyceridemia, reduced high-density lipoprotein (HDL) cholesterol, hypertension, and insulin resistance. Among cardiometabolic risk factors, central obesity plays a key role in the development of MetS through alterations in the secretion of adipokines and interacts with other MetS risk factors to unfavorably influence overall cardiometabolic risk. Obesity has grasped epidemic proportions in Asia, which has the highest number of people with diabetes in the world. But, the importance of central obesity in the clustering of all four MetS risk factors or vice versa in predicting severity of MetS has not yet been investigated in Asian population. Therefore, the present study examined the influence of central obesity on circulating levels of adipokines through its interaction with the clustering of cardiometabolic risk factors of MetS including hyperglycemia, hypertriglyceridemia, dyslipidemia and hypertension in Hong Kong Chinese adults. SUBJECTS Blood samples from 83 Hong Kong Chinese adults, who were previously screened for MetS according to the guideline of the United States National Cholesterol Education Program Expert Panel Adult Treatment Panel III criteria were selected. Insulin and adipokines, including visfatin, chemerin, plasminogen activator inhibitor-1 (PAI-1), resistin, C-C motif chemokine ligand 2 (CCL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumour necrosis factor-α (TNF-α), leptin and adiponectin were assessed. RESULTS The interacting effect of central obesity with all of the other four MetS risk factors increased the proinflammatory status of adipokines (TNF-α, leptin) and decreased the anti-inflammatory status of adipokine (adiponectin). CONCLUSION Our results indicate that the inflammatory status of MetS may be more severe in the presence of central obesity. Adipokines, as biomarkers for pathophysiological changes, may help to improve early patient identification and to predict MetS-associated morbidity and mortality.
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Affiliation(s)
- Rashmi Supriya
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Bjorn T. Tam
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Angus P. Yu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Paul H. Lee
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Christopher W. Lai
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Kenneth K. Cheng
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Sonata Y. Yau
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Lawrence W. Chan
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Benjamin Y. Yung
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Sinead Sheridan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Parco M. Siu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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Hijjawi NS, Al-Radaideh AM, Al-Fayomi KI, Nimer NA, Alabadi HA, Al-Zu'bi RM, Agraib LM, Allehdan SS, Tayyem RF. Relationship of serum leptin with some biochemical, anthropometric parameters and abdominal fat volumes as measured by magnetic resonance imaging. Diabetes Metab Syndr 2018; 12:207-213. [PMID: 28967613 DOI: 10.1016/j.dsx.2017.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 09/20/2017] [Indexed: 12/15/2022]
Abstract
AIMS To measure the level of leptin in volunteers and correlate it with several anthropometric, biochemical variables and abdominal fat volumes. METHODS The level of leptin was investigated in 167 disease-free volunteers. Serum levels of IL-6, adiponectin, and resistin, blood lipid profile (cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) were determined. Waist circumference (WC) was measured using tape and magnetic resonance imaging (MRI) images. RESULTS All measured anthropometric (BMI, WC measured by tape and MRI) and biochemical variables (adiponectin, resistin, cholesterol, HDL, LDL and TG); and abdominal fats showed a significant (p<0.05) difference between participants with abnormal serum leptin levels and those with normal leptin levels. A higher percentage of participants with abnormal serum leptin were obese males while participants with normal leptin levels were either overweight or normal weight females. A significant (p <0.05) positive correlation was detected between serum leptin concentration and WC, BMI, subcutaneous fat, visceral fat, total abdominal fat, and resistin. A moderate association was found between serum leptin concentration and the inflammatory cytokine IL-6. CONCLUSION Abnormal serum leptin, was detected in obese male individuals which may be considered as an important indicator for the development of cardiovascular diseases and type 2 diabetes.
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Affiliation(s)
- Nawal S Hijjawi
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Ali M Al-Radaideh
- Department of Medical Imaging, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Kholoud I Al-Fayomi
- Department of Medical Imaging, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Nisreen A Nimer
- Department of Chemistry, College of Sciences and Health Professions, Cleveland State University, Cleveland, OH, USA
| | - Hadeel A Alabadi
- Department of Radiology, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Rana M Al-Zu'bi
- Department of Nutrition, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Lana M Agraib
- Department of Nutrition and Food Technology, Faculty of Agriculture, University of Jordan, Amman, Jordan
| | - Sabika S Allehdan
- Department of Nutrition and Food Technology, Faculty of Agriculture, University of Jordan, Amman, Jordan
| | - Reema F Tayyem
- Department of Nutrition and Food Technology, Faculty of Agriculture, University of Jordan, Amman, Jordan.
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17
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Sharma DL, Lakhani HV, Klug RL, Snoad B, El-Hamdani R, Shapiro JI, Sodhi K. Investigating Molecular Connections of Non-alcoholic Fatty Liver Disease with Associated Pathological Conditions in West Virginia for Biomarker Analysis. ACTA ACUST UNITED AC 2017; 8. [PMID: 29177105 PMCID: PMC5701750 DOI: 10.4172/2155-9899.1000523] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a disease characterized by a steatosis of the liver that may progress to more serious pathological conditions including: nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. As the prevalence of NAFLD has increased worldwide in recent years, pathophysiology and risk factors associated with disease progression of NAFLD are at the focus of many studies. NAFLD is related to and shares common serum biomarkers with cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), obesity, and metabolic syndrome (MetS). West Virginia (WV) is a state with some of the highest rates of CVD, obesity and diabetes mellitus. As NAFLD is closely related to these diseases, it is of particular interest in WV. Currently there is no cost-effective, standardized method used clinically to detect NAFLD prior to the onset of reversible complications. At this time, the diagnosis of NAFLD is made with costly radiologic studies and invasive biopsy. These studies are only diagnostic once changes to hepatic tissue have occurred. The diagnosis of NAFLD by traditional methods may not allow for successful intervention and may not be readily available in areas with already sparse medical resources. In this literature review, we identify a list of biomarkers common among CVD, T2DM, obesity, MetS and NAFLD. From this research we propose the following biomarkers are good candidates for inclusion in a panel of biomarkers for the early detection of NAFLD: adiponectin, AST, ALT, apo-B, CK18, CPS1, CRP, FABP-1, ferritin, GGT, GRP78, HDL-C, IGF-1, IL-1β, 6, 8, 10, IRS-2PAI-1, leptin, lumican, MDA SREBP-1c and TNF-α. Creating and implementing a biomarker panel for the early detection and attenuation of NAFLD, prior to the onset of irreversible complication would provide maximum benefit and decrease the disease burden on the patients and healthcare system of WV.
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Affiliation(s)
- Dana L Sharma
- Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Hari Vishal Lakhani
- Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Rebecca L Klug
- Department of Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Brian Snoad
- Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Rawan El-Hamdani
- Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Joseph I Shapiro
- Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Komal Sodhi
- Department of Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
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Gubin DG, Nelaeva AA, Uzhakova AE, Hasanova YV, Cornelissen G, Weinert D. Disrupted circadian rhythms of body temperature, heart rate and fasting blood glucose in prediabetes and type 2 diabetes mellitus. Chronobiol Int 2017; 34:1136-1148. [PMID: 28759269 DOI: 10.1080/07420528.2017.1347670] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We report a progressive disruption of 24-h rhythms in fasting blood glucose (FBG), body temperature (BT) and heart rate (HR) associated with metabolic dysfunction and the development of prediabetes (PD) and type 2 diabetes mellitus (T2DM) in overweight middle-aged (40-69 years old) humans. Increasing BT and HR mean values and declining 24-h BT and HR amplitudes accompany adverse changes in metabolic state. Increased nocturnal BT and a phase delay of the 24-h BT rhythm, deviant 24-h HR profile and a phase advance of the 24-h HR and FBG rhythms are early signs of the PD metabolic state. In T2DM, the 24-h FBG rhythm is no longer detectable, and the 24-h amplitudes of BT and HR are greatly diminished. In addition, lepton and creatinine values were lowered in T2DM. Moreover, positive correlations between FBG and body mass index, BMI, and negative correlations between the 24-h amplitude of FBG and BMI indicate that overweight is an additional factor causing disruption of the circadian rhythms. Further studies on circadian disruption as a consequence of metabolic dysfunction are necessary. The quantitative analysis of changing circadian BT and HR rhythms may provide prognostic markers of T2DM and therapeutic targets for its prevention and correction.
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Affiliation(s)
- D G Gubin
- a Department of Biology , Medical University , Tyumen , Russia
| | - A A Nelaeva
- b Department of Endocrinology , Medical University , Tyumen , Russia
| | - A E Uzhakova
- b Department of Endocrinology , Medical University , Tyumen , Russia
| | - Y V Hasanova
- b Department of Endocrinology , Medical University , Tyumen , Russia
| | - G Cornelissen
- c Halberg Chronobiology Center , University of Minnesota , Minneapolis , MN , USA
| | - D Weinert
- d Institute of Biology/Zoology , Martin Luther University , Halle-Wittenberg , Germany
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Adiponectin, Leptin, and Leptin Receptor in Obese Patients with Type 2 Diabetes Treated with Insulin Detemir. Molecules 2017; 22:molecules22081274. [PMID: 28758947 PMCID: PMC6152287 DOI: 10.3390/molecules22081274] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 07/25/2017] [Accepted: 07/26/2017] [Indexed: 01/08/2023] Open
Abstract
The aim of the present study is to quantitatively assess the expression of selected regulatory molecules, such as leptin, leptin receptor, and adiponectin in the blood of obese patients with type 2 diabetes both before treatment and after six months of pharmacological therapy with the long-lasting insulin analogue, insulin detemir. A significant decrease in the analysed regulatory molecules, i.e., leptin receptor and adiponectin, was found in blood plasma of the patients with untreated type 2 diabetes. These changes were accompanied by an increase in plasma leptin concentrations. Insulin treatment resulted in the normalization of plasma leptin receptor and adiponectin concentrations. The circulating leptin level did not change following anti-diabetic therapy with insulin detemir. Gender was a significant factor modifying the circulating level of all the analysed regulatory active compounds. Bioinformatic analysis was performed using Matlab with the Signal Processing Toolbox. The conducted discriminant analysis revealed that the leptin receptor, Δw(19), and adiponectin, Δw(21), were the parameters undergoing the most significant quantitative changes during the six-month therapy with insulin detemir. The conducted examinations indicated the contribution of adipocytokines—the biologically-active mediators of systemic metabolism, such as leptin and adiponectin in the pathomechanism of disorders being the basis for obesity which leads to development of insulin resistance, which, in turn, results in the occurrence of type 2 diabetes.
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20
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Morfeld KA, Brown JL. Ovarian acyclicity in zoo African elephants (Loxodonta africana) is associated with high body condition scores and elevated serum insulin and leptin. Reprod Fertil Dev 2017; 28:640-7. [PMID: 25375263 DOI: 10.1071/rd14140] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 09/03/2014] [Indexed: 12/25/2022] Open
Abstract
The purpose of the present study was to determine whether excessive body fat and altered metabolic hormone concentrations in the circulation were associated with ovarian acyclicity in the world's largest land mammal, the African elephant. We compared body condition, glucose, insulin and leptin concentrations and the glucose-to-insulin ratio (G:I) between cycling (n=23; normal 14-16 week cycles based on serum progestagens for at least 2 years) and non-cycling (n=23; consistent baseline progestagen concentrations for at least 2 years) females. A validated body condition score (BCS) index (five-point scale; 1=thinnest, 5=fattest) was used to assess the degree of fatness of the study elephants. The mean BCS of non-cycling elephants was higher than that of their cycling counterparts. There were differences in concentrations of serum metabolic biomarkers, with non-cycling elephants in the BCS 5 category having higher leptin and insulin concentrations and a lower G:I ratio than cycling BCS 5 females. Using 'non-cycling' as the outcome variable in regression models, high BCS was a strong predictor of a non-cycling status. This study provides the first evidence that ovarian acyclicity in zoo African elephants is associated with body condition indicative of obesity, as well as elevated, perturbed biomarkers of metabolic status.
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Affiliation(s)
- Kari A Morfeld
- Center for Species Survival, Smithsonian Conservation Biology Institute, National Zoological Park, 1500 Remount Road, Front Royal, VA 22630, USA
| | - Janine L Brown
- Center for Species Survival, Smithsonian Conservation Biology Institute, National Zoological Park, 1500 Remount Road, Front Royal, VA 22630, USA
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Slama FB, Jridi N, Rayana MCB, Trimeche A, Hsairi M, Belhadj O. Plasma levels of leptin and ghrelin and their correlation with BMI, and circulating lipids and glucose in obese Tunisian women. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0902.382] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background
A National Survey on the Effect of Nutrition conducted in 1996−1997 showed a 14% overall prevalence of obesity in Tunisia with a female predominance. Leptin and ghrelin play crucial roles in regulating body weight and energy balance. Leptin, an anorectic hormone, and ghrelin, an orexigenic hormone, appear to interact with glucose and lipid metabolism.
Objectives
To determine the circulating levels of ghrelin and leptin in obese Tunisian women and to investigate the correlations of these hormones with body mass index (BMI), and circulating lipids and glucose.
Methods
Forty obese women were recruited from patients in the “C” Unit of the National Institute of Nutrition and Food Technology. Twenty normal women were recruited as controls. Plasma levels of the studied variables were measured in patients from both groups and findings were analyzed.
Results
Circulating levels of leptin were significantly higher, while high-density lipoprotein (HDL)-cholesterol and ghrelin levels were significantly lower in the obese women. In the obese women, significant positive correlations were found between circulating levels of leptin and low-density lipoprotein (LDL)-cholesterol, BMI, and glucose; and ghrelin and HDL-cholesterol. Significant negative correlations were found between circulating levels of leptin and HDL-cholesterol and ghrelin; and ghrelin and leptin, LDL-cholesterol, BMI, and glucose. Multivariate analysis revealed that ghrelin was significantly associated with HDL-cholesterol, LDL-cholesterol, and blood glucose.
Conclusions
The significant negative correlation between leptin and ghrelin suggests that these two hormones may be antagonistic. Increased levels of ghrelin are correlated with decreased circulating levels of HDL-cholesterol and increased levels of LDL-cholesterol.
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Affiliation(s)
- Fethi Ben Slama
- National Institute of Public Health (INSP), Ministry of Public Health , Tunis , Tunisia
| | - Nahawand Jridi
- Faculty of Pharmacy , University of Monastir , Tunis , Tunisia
| | - Mohamed Chiheb Ben Rayana
- National Institute of Nutrition and Food Technology (INNTA) , Ministry of Public Health , Tunis , Tunisia
| | - Abdelmagid Trimeche
- National Institute of Nutrition and Food Technology (INNTA) , Ministry of Public Health , Tunis , Tunisia
| | - Mohamed Hsairi
- National Institute of Public Health (INSP), Ministry of Public Health , Tunis , Tunisia
| | - Omrane Belhadj
- Biochemistry and Biotechnology Laboratory, Faculty of Sciences of Tunis , Tunis El Manar University , Tunis , Tunisia
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van Zyl S, van der Merwe LJ, van Rooyen FC, Joubert G, Walsh CM. The relationship between obesity, leptin, adiponectin and the components of metabolic syndrome in urban African women, Free State, South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2017. [DOI: 10.1080/16070658.2017.1267380] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Sanet van Zyl
- Faculty of Health Sciences, Department of Basic Medical Sciences, University of the Free State, Bloemfontein, South Africa
| | - Lynette J van der Merwe
- Faculty of Health Sciences, Department of Basic Medical Sciences, University of the Free State, Bloemfontein, South Africa
| | - Francois C van Rooyen
- Faculty of Health Sciences, Department of Biostatistics, University of the Free State, Bloemfontein, South Africa
| | - Gina Joubert
- Faculty of Health Sciences, Department of Biostatistics, University of the Free State, Bloemfontein, South Africa
| | - Corinna M Walsh
- Faculty of Health Sciences, Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa
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Huang IC, Chang CC, Hsu BG, Lee CJ, Wang JH. Association of hyperleptinemia with peripheral arterial disease in hypertensive patients. Tzu Chi Med J 2017; 29:148-153. [PMID: 28974908 PMCID: PMC5615994 DOI: 10.4103/tcmj.tcmj_56_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective: Hypertension is a risk factor for peripheral artery disease (PAD). Serum leptin plays an important role in promoting endothelial dysfunction. The aim of this study is to investigate whether the leptin level is associated with PAD in hypertensive patients. Materials and Methods: Ninety-eight hypertensive patients were enrolled in this study. Ankle-brachial index (ABI) values were measured using an automated oscillometric device. Patients with an ABI value <0.9 were considered the low ABI group. C-reactive protein (CRP) was measured using standard enzymatic automated methods. Serum levels of human leptin were determined using a commercially available enzyme immunoassay. Results: Eighteen (18.4%) hypertensive patients were included in the low ABI group. Hypertensive patients in the low ABI group had higher serum creatinine (P < 0.001), CRP (P = 0.003), and leptin (P < 0.001) levels, higher prevalence of diabetes (P = 0.036), and current smoking (P = 0.034) than patients in the normal ABI group. Univariate linear regression analyses revealed that body weight (P = 0.014), waist circumference (P = 0.010), body mass index (P = 0.002), and logarithmically transformed CRP (log-CRP, P = 0.001) were positively correlated with serum log-leptin levels in hypertensive patients. Multivariate stepwise linear regression analysis showed that log-leptin (β = 0.439, adjusted R2 change = 0.224, P < 0.001) was also an associated factor of PAD in hypertensive patients. Conclusion: A higher log-leptin value is an independent predictor of PAD in hypertensive patients.
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Affiliation(s)
- I-Ching Huang
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | | | - Bang-Gee Hsu
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Chung-Jen Lee
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Ji-Hung Wang
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Cardiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
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Goguet-Rubio P, Klug RL, Sharma DL, Srikanthan K, Puri N, Lakhani VH, Nichols A, O'Hanlon KM, Abraham NG, Shapiro JI, Sodhi K. Existence of a Strong Correlation of Biomarkers and miRNA in Females with Metabolic Syndrome and Obesity in a Population of West Virginia. Int J Med Sci 2017; 14. [PMID: 28638270 PMCID: PMC5479123 DOI: 10.7150/ijms.18988] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objectives: Metabolic syndrome causes complications like cardiovascular disease and type 2 diabetes mellitus (T2DM). As metabolic syndrome develops, altered levels of cytokines and microRNAs (miRNA) are measurable in the circulation. We aimed to construct a panel detecting abnormal levels of cytokines and miRNAs in patients at risk for metabolic syndrome. Methods: Participants included 54 patients from a Family Medicine Clinic at Marshall University School of Medicine, in groups of: Control, Obese, and Metabolic Syndrome (MetS). Results: Serum levels of leptin, adiponectin, leptin: adiponectin ratio, IL-6, six miRNAs (320a, 197-3p, 23-3p, 221-3p, 27a-3p, and 130a-3p), were measured. Among the three groups, leptin, and leptin: adiponectin ratio, and IL-6 levels were highest in MetS, and levels in Obese were greater than Control (p>0.05). Adiponectin levels were lower in Obese compared to Control, but lowest in MetS (p<0.05). MiRNAs levels were lowest in MetS, and levels in Obese were lower than Control (p>0.05). Conclusion: Our results support the clinical application of biomarkers in diagnosing early stage MetS, which will enable attenuation of disease progression before onset of irreversible complications. Since West Virginians are high-risk for developing MetS, our biomarker panel could reduce the disease burden on our population.
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Affiliation(s)
- Perrine Goguet-Rubio
- Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Rebecca L Klug
- Department of Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Dana L Sharma
- Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Krithika Srikanthan
- Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Nitin Puri
- Department of Physiology & Pharmacology, University of Toledo College of Medicine, Toledo OH, USA
| | - Vishal H Lakhani
- Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Alexandra Nichols
- Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Kathleen M O'Hanlon
- Department of Family Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Nader G Abraham
- Department of Pharmacology and Medicine, New York Medical College, The Touro College and University System, Valhalla, NY, USA
| | - Joseph I Shapiro
- Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
| | - Komal Sodhi
- Department of Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
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25
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Pediatric reference data of serum lipids and prevalence of dyslipidemia: Results from a population-based cohort in Germany. Clin Biochem 2016; 49:740-9. [DOI: 10.1016/j.clinbiochem.2016.02.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/13/2016] [Accepted: 02/26/2016] [Indexed: 11/22/2022]
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26
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Martins AS, Jansen AK, Rodrigues LOC, Matos CM, Souza MLR, de Souza JF, Diniz MDFHS, Barreto SM, Diniz LM, de Rezende NA, Riccardi VM. Lower fasting blood glucose in neurofibromatosis type 1. Endocr Connect 2016; 5:28-33. [PMID: 26631381 PMCID: PMC4703950 DOI: 10.1530/ec-15-0102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 12/02/2015] [Indexed: 12/23/2022]
Abstract
Studies indicate a lower occurrence of diabetes mellitus (DM) in patients with neurofibromatosis type 1 (NF1). Fasting blood glucose (FBG) level is the main criterion used to diagnose DM and glucose intolerance. Therefore, this study compared FBG level between adults with NF1 and non-NF1 controls. We selected clinical records of 57 out of 701 individuals attending the Neurofibromatosis Outpatient Reference Center of the Clinics Hospital of the Federal University of Minas Gerais in Brazil. The selected patients with NF1 were matched to non-NF1 controls selected from the Brazilian Longitudinal Study of Adult Health according to sex, age (range, 35-74 years) and BMI at a ratio of 1:3. In both groups, individuals with DM were excluded. Median FBG level in the NF1 group (86 mg/dl (range, 56-127 mg/dl)) was lower than that in the non-NF1 control group (102 mg/dl (range, 85-146 mg/dl)) (P<0.001). Prevalence of FBG level ≥100 mg/dl in the NF1 group (16%) was lower than that in the non-NF1 control group (63%) (P<0.05). The chance of a high FBG level was 89% lower in the NF1 group (odds ratio, 0.112; 95% CI, 0.067-0.188) (P<0.05). In conclusion, adults with NF1 showed a lower FBG level and a lower prevalence of high FBG level compared with non-NF1 controls.
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Affiliation(s)
- Aline Stangherlin Martins
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Ann Kristine Jansen
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Luiz Oswaldo Carneiro Rodrigues
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Camila Maria Matos
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Marcio Leandro Ribeiro Souza
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Juliana Ferreira de Souza
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Maria de Fátima Haueisen Sander Diniz
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Sandhi Maria Barreto
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Leonardo Mauricio Diniz
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Nilton Alves de Rezende
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
| | - Vincent Michael Riccardi
- Neurofibromatosis Outpatient Reference CenterFederal University of Minas Gerais, Alameda Álvaro Celso 55, Belo Horizonte, Minas Gerais, BrazilDepartment of Nutrition, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Medical Clinic, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Preventive and Social Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilDepartment of Internal Medicine, Federal University of Minas GeraisProfessor Alfredo Balena Avenue, 190, Santa Efigênia, Belo Horizonte, Minas Gerais, BrazilThe Neurofibromatosis Institute5415 Briggs Avenue, La Crescenta, CA, USA
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Srikanthan K, Feyh A, Visweshwar H, Shapiro JI, Sodhi K. Systematic Review of Metabolic Syndrome Biomarkers: A Panel for Early Detection, Management, and Risk Stratification in the West Virginian Population. Int J Med Sci 2016; 13:25-38. [PMID: 26816492 PMCID: PMC4716817 DOI: 10.7150/ijms.13800] [Citation(s) in RCA: 268] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 11/09/2015] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Metabolic syndrome represents a cluster of related metabolic abnormalities, including central obesity, hypertension, dyslipidemia, hyperglycemia, and insulin resistance, with central obesity and insulin resistance in particular recognized as causative factors. These metabolic derangements present significant risk factors for cardiovascular disease, which is commonly recognized as the primary clinical outcome, although other outcomes are possible. Metabolic syndrome is a progressive condition that encompasses a wide array of disorders with specific metabolic abnormalities presenting at different times. These abnormalities can be detected and monitored via serum biomarkers. This review will compile a list of promising biomarkers that are associated with metabolic syndrome and this panel can aid in early detection and management of metabolic syndrome in high risk populations, such as in West Virginia. METHODS A literature review was conducted using PubMed, Science Direct, and Google Scholar to search for markers related to metabolic syndrome. Biomarkers searched included adipokines (leptin, adiponectin), neuropeptides (ghrelin), pro-inflammatory cytokines (IL-6, TNF-α), anti-inflammatory cytokines (IL-10), markers of antioxidant status (OxLDL, PON-1, uric acid), and prothrombic factors (PAI-1). RESULTS According to the literature, the concentrations of pro-inflammatory cytokines (IL-6, TNF-α), markers of pro-oxidant status (OxLDL, uric acid), and prothrombic factors (PAI-1) were elevated in metabolic syndrome. Additionally, leptin concentrations were found to be elevated in metabolic syndrome as well, likely due to leptin resistance. In contrast, concentrations of anti-inflammatory cytokines (IL-10), ghrelin, adiponectin, and antioxidant factors (PON-1) were decreased in metabolic syndrome, and these decreases also correlated with specific disorders within the cluster. CONCLUSION Based on the evidence presented within the literature, the aforementioned biomarkers correlate significantly with metabolic syndrome and could provide a minimally-invasive means for early detection and specific treatment of these disorders. Further research is encouraged to determine the efficacy of applying these biomarkers to diagnosis and treatment in a clinical setting.
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Affiliation(s)
- Krithika Srikanthan
- 1. Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, USA
| | - Andrew Feyh
- 1. Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, USA
| | - Haresh Visweshwar
- 1. Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, USA
| | - Joseph I. Shapiro
- 1. Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, USA
| | - Komal Sodhi
- 2. Department of Surgery and Pharmacology, Joan C. Edwards School of Medicine, Marshall University, USA
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Doneda D, Lopes AL, Teixeira BC, Mittelstadt SD, Moulin CC, Schwartz IV. Ghrelin, leptin and adiponectin levels in Gaucher disease type I patients on enzyme replacement therapy. Clin Nutr 2015; 34:727-31. [DOI: 10.1016/j.clnu.2014.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 08/16/2014] [Accepted: 08/20/2014] [Indexed: 02/08/2023]
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Repeated sense of hunger leads to the development of visceral obesity and metabolic syndrome in a mouse model. PLoS One 2014; 9:e98276. [PMID: 24879081 PMCID: PMC4039491 DOI: 10.1371/journal.pone.0098276] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 04/30/2014] [Indexed: 01/29/2023] Open
Abstract
Obesity-related disorders, especially metabolic syndrome, contribute to 2.8 million deaths each year worldwide, with significantly increasing morbidity. Eating at regular times and proper food quantity are crucial for maintaining a healthy status. However, many people in developed countries do not follow a regular eating schedule due to a busy lifestyle. Herein, we show that a repeated sense of hunger leads to a high risk of developing visceral obesity and metabolic syndrome in a mouse model (both 3-week and 6-week-old age, 10 mice in each group). The ad libitum (AL) group (normal eating pattern) and the food restriction (FR) group (alternate-day partially food restriction by given only 1/3 of average amount) were compared after 8-week experimental period. The total food consumption in the FR group was lower than in the AL group, however, the FR group showed a metabolic syndrome-like condition with significant fat accumulation in adipose tissues. Consequently, the repeated sense of hunger induced the typical characteristics of metabolic syndrome in an animal model; a distinct visceral obesity, hyperlipidemia, hyperglycemia and hepatic steatosis. Furthermore, we found that specifically leptin, a major metabolic hormone, played a major role in the development of these pathological disorders. Our study indicated the importance of regular eating habits besides controlling calorie intake.
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Suriyaprom K, Tungtrongchitr R, Thawnasom K. Measurement of the levels of leptin, BDNF associated with polymorphisms LEP G2548A, LEPR Gln223Arg and BDNF Val66Met in Thai with metabolic syndrome. Diabetol Metab Syndr 2014; 6:6. [PMID: 24444121 PMCID: PMC3900466 DOI: 10.1186/1758-5996-6-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 01/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Metabolic syndrome is a cluster of metabolic risk factors including dyslipidemia, impaired glucose tolerance, hypertension and central obesity. BDNF (Brain-derived neurotrophic factor) and leptin have been implied in the energy homeostasis. The purposes of this study were to examine concentrations of leptin, BDNF and biochemical parameters in metabolic-syndrome subjects and healthy controls, and also to search for associations of leptin gene (LEP) G2548A, leptin receptor gene (LEPR) Gln223Arg, and BDNF gene (BDNF) Val66Met polymorphisms with leptin levels, BDNF levels and metabolic syndrome among Thais. METHODS The case-controlled design was performed using 322 Thai volunteers (160 metabolic-syndrome subjects; 162 controls) during the health screening program. Metabolic syndrome was assessed by using the modified National Cholesterol Education Program, Adult Treatment Panel III criteria. The levels of leptin, BDNF, insulin, glucose and lipids were measured in samples. Genotyping of LEP G2548A, LEPR Gln223Arg and BDNF Val66Met was carried out using polymerase chain reaction-restriction fragment length polymorphism technique. RESULTS Serum leptin levels were significantly higher in the metabolic-syndrome group than the control group (p < 0.01), but the BDNF difference between them was not significant. Significant associations of LEPR Gln223Arg polymorphism were found with leptin and glucose levels (p < 0.05), after adjusting for potential covariates. This LEPR polymorphism in the metabolic-syndrome group was also significantly more frequent than in the control group (p < 0.05). However, other gene polymorphisms, LEP G2548A and BDNF Val66Met, showed no significant relationship with leptin levels, BDNF levels or metabolic syndrome. CONCLUSION These findings suggest leptin levels are linked with metabolic syndrome. LEPR Gln223Arg polymorphism impacted leptin concentrations, and this gene polymorphism may influence susceptibility to metabolic syndrome among Thais.
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Affiliation(s)
- Kanjana Suriyaprom
- Faculty of Medical Technology, Rangsit University, Paholyothin Road, Pathumthani 12000, Thailand
| | - Rungsunn Tungtrongchitr
- Department of Tropical Nutrition & Food Science, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Rajthevee, Bangkok 10400, Thailand
| | - Kittisak Thawnasom
- Faculty of Medical Technology, Rangsit University, Paholyothin Road, Pathumthani 12000, Thailand
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Demirkol S, Cakar M, Balta S, Unlu M. Are leptin levels a cause or an indicator of cardiovascular risk? Rev Port Cardiol 2013; 32:953. [PMID: 24239393 DOI: 10.1016/j.repc.2013.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 01/03/2013] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sait Demirkol
- Gulhane Medical Academy, Department of Cardiology, Ankara, Turkey
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Demirkol S, Cakar M, Balta S, Unlu M. Are leptin levels a cause or an indicator of cardiovascular risk? REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2013. [DOI: 10.1016/j.repce.2013.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Leon-Cabrera S, Solís-Lozano L, Suárez-Álvarez K, González-Chávez A, Béjar YL, Robles-Díaz G, Escobedo G. Hyperleptinemia is associated with parameters of low-grade systemic inflammation and metabolic dysfunction in obese human beings. Front Integr Neurosci 2013; 7:62. [PMID: 23986664 PMCID: PMC3750204 DOI: 10.3389/fnint.2013.00062] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 08/01/2013] [Indexed: 12/14/2022] Open
Abstract
Leptin is an adipose tissue-derived hormone that has been involved in hypothalamic and systemic inflammation, altered food-intake patterns, and metabolic dysfunction in obese mice. However, it remains unclear whether leptin has a relationship with parameters of systemic inflammation and metabolic dysfunction in humans. We thus evaluated in a cross-sectional study the circulating levels of leptin in 40 non-obese and 41 obese Mexican individuals, examining their relationship with tumor necrosis factor alpha (TNF-α), interleukin (IL) 12, IL-10, central obesity, serum glucose and insulin levels, and serum triglyceride and cholesterol concentrations. Circulating levels of leptin, TNF-α, IL-12, IL-10, and insulin were measured by ELISA, while concentrations of glucose, triglyceride, and cholesterol were determined by enzymatic assays. As expected, serum levels of leptin exhibited a significant elevation in obese individuals as compared to non-obese subjects, showing a clear association with increased body mass index (r = 0.4173), central obesity (r = 0.4678), and body fat percentage (r = 0.3583). Furthermore, leptin also showed a strong relationship with serum TNF-α (r = 0.6989), IL-12 (r = 0.3093), and IL-10 (r = −0.5691). Interestingly, leptin was also significantly related with high concentrations of fasting glucose (r = 0.5227) and insulin (r = 0.2229), as well as elevated levels of insulin resistance (r = 0.3611) and circulating triglyceride (r = 0.4135). These results suggest that hyperleptinemia is strongly associated with the occurrence of low-grade systemic inflammation and metabolic alteration in obese subjects. Further clinical research is still needed to determine whether hyperleptinemia may be a potential marker for recognizing the advent of obesity-related metabolic disorders in human beings.
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Affiliation(s)
- Sonia Leon-Cabrera
- Departamento de Biología de la Reproducción y Clínica de Desórdenes de Sueño, Universidad Autónoma Metropolitana-Iztapalapa D.F., México
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Abstract
Metabolic syndrome comprises a cluster of cardiovascular risk factors (hypertension, altered glucose metabolism, dyslipidemia, and abdominal obesity) that occur in obese children. However, metabolic syndrome can also occur in lean individuals, suggesting that obesity is a marker for the syndrome, not a cause. Metabolic syndrome is difficult to define, due to its nonuniform classification and reliance on hard cutoffs in the evaluation of disorders with non-Gaussian distributions. Defining the syndrome is even more difficult in children, owing to racial and pubertal differences and lack of cardiovascular events. Lipid partitioning among specific fat depots is associated with insulin resistance, which can lead to mitochondrial overload and dysfunctional subcellular energy use and drive the various elements of metabolic syndrome. Multiple environmental factors, in particular a typical Western diet, drive mitochondrial overload, while other changes in Western society, such as stress and sleep deprivation, increase insulin resistance and the propensity for food intake. These culminate in an adverse biochemical phenotype, including development of altered glucose metabolism and early atherogenesis during childhood and early adulthood.
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Affiliation(s)
- Ram Weiss
- Department of Pediatrics, Hadassah Hebrew University School of Medicine, Jerusalem, Israel
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