Assessment of metabolic profile in a clinical setting

The Effect of Prenatal Food Restriction on Brain Proteome in Appropriately Grown and Growth Restricted Male Wistar Rats

Background

Fetal growth restriction (FGR) has been associated with a higher risk of developing adverse perinatal outcomes and distinct neurodevelopmental and neurobehavioral disorders. The aim of the present study was to investigate the impact of prenatal food restriction on the brain proteome in both FGR and appropriately grown rats and to identify potential pathways connecting maternal malnutrition with altered brain development.

Methods

Ten time-dated pregnant Wistar rats were housed individually at their 12th day of gestation. On the 15th day of gestation, the rats were randomly divided into two groups, namely the food restricted one (n = 6) and the control group (n = 4). From days 15 to 21 the control group had unlimited access to food and the food restricted group was given half the amount of food that was on average consumed by the control group, based on measurements taken place the day before. On the 21st day of gestation, all rats delivered spontaneously and after birth all newborn pups of the food restricted group were weighed and matched as appropriately grown (non-FGR) or growth restricted (FGR) and brain tissues were immediately collected. A multiplex experiment was performed analyzing brain tissues from 4 FGR, 4 non-FGR, and 3 control male offspring. Differentially expressed proteins (DEPs) were subjected to bioinformatics analysis in order to identify over-represented processes.

Results

Proteomic analysis resulted in the profiling of 3,964 proteins. Gene ontology analysis of the common DEPs using DAVID (https://david.ncifcrf.gov/) showed significant enrichment for terms related to cellular morphology, learning, memory and positive regulation of NF-kappaB signaling. Ingenuity Pathway Analysis showed significant induction of inflammation in FGR pups, whereas significant induction of cell migration and cell spreading were observed in non-FGR pups.

Conclusion

This study demonstrated that in both FGR and non-FGR neonates, a range of adaptive neurodevelopmental processes takes place, which may result in altered cellular morphology, chronic stress, poor memory and learning outcomes. Furthermore, this study highlighted that not only FGR, but also appropriately grown pups, which have been exposed to prenatal food deprivation may be at increased risk for impaired cognitive and developmental outcomes.

Metabolic syndrome: definitions and controversies

Metabolic syndrome (MetS) is a complex disorder defined by a cluster of interconnected factors that increase the risk of cardiovascular atherosclerotic diseases and diabetes mellitus type 2. Currently, several different definitions of MetS exist, causing substantial confusion as to whether they identify the same individuals or represent a surrogate of risk factors. Recently, a number of other factors besides those traditionally used to define MetS that are also linked to the syndrome have been identified. In this review, we critically consider existing definitions and evolving information, and conclude that there is still a need to develop uniform criteria to define MetS, so as to enable comparisons between different studies and to better identify patients at risk. As the application of the MetS model has not been fully validated in children and adolescents as yet, and because of its alarmingly increasing prevalence in this population, we suggest that diagnosis, prevention and treatment in this age group should better focus on established risk factors rather than the diagnosis of MetS.

Lack of association of high body mass index with risk for developing polymyalgia rheumatica

BACKGROUND

High body mass index (BMI) may have modulatory effects on the immune system.

OBJECTIVES

To determine the association between BMI and polymyalgia rheumatica (PMR) as well as the influence of BMI on glucocorticoid treatment duration and development of giant-cell arteritis (GCA) in patients with PMR.

METHODS

The BMI of 364 patients with PMR from a population-based incidence cohort was compared to the BMI of non-PMR subjects from the same population. High and low BMI were defined as > or = 25 and < 18.5 kg/m2, respectively. The association between BMI and case status was determined. The association between BMI and the duration of glucocorticoid therapy, as well as the development of GCA after accounting for relevant variables, were also examined.

RESULTS

The mean BMI at index was similar in both groups (PMR: 26 +/- 5.4 kg/m2; non-PMR: 25.9 +/- 4.0 kg/m(2), P = 0.83). There was no association between BMI and the duration of glucocorticoid therapy. No significant association was found between BMI and the development of GCA in patients with PMR.

CONCLUSION

Patients with high BMI (> or = 25 kg/m2) are not more likely to develop PMR. BMI did not influence the duration of glucocorticoid therapy or the occurrence of GCA in patients with PMR.

The association of posttraumatic stress disorder and metabolic syndrome: a study of increased health risk in veterans

BACKGROUND

There is accumulating evidence for a link between trauma exposure, posttraumatic stress disorder (PTSD) and diminished health status. To assess PTSD-related biological burden, we measured biological factors that comprise metabolic syndrome, an important established predictor of morbidity and mortality, as a correlate of long-term health risk in PTSD.

METHODS

We analyzed clinical data from 253 male and female veterans, corresponding to five factors linked to metabolic syndrome (systolic and diastolic blood pressure, waist-to-hip ratio and fasting measures of high-density lipoprotein (HDL) cholesterol, serum triglycerides and plasma glucose concentration). Clinical cut-offs were defined for each biological parameter based on recommendations from the World Health Organization and the National Cholesterol Education Program. Controlling for relevant variables including sociodemographic variables, alcohol/substance/nicotine use and depression, we examined the impact of PTSD on metabolic syndrome using a logistic regression model.

RESULTS

Two-fifths (40%) of the sample met criteria for metabolic syndrome. Of those with PTSD (n = 139), 43% met criteria for metabolic syndrome. The model predicted metabolic syndrome well (-2 log likelihood = 316.650, chi-squared = 23.731, p = 0.005). Veterans with higher severity of PTSD were more likely to meet diagnostic criteria for metabolic syndrome (Wald = 4.76, p = 0.03).

CONCLUSION

These findings provide preliminary evidence linking higher severity of PTSD with risk factors for diminished health and increased morbidity, as represented by metabolic syndrome.

Prevalence of metabolic syndrome and associated risk factors in Illinois

PURPOSE

To examine the prevalence of metabolic syndrome (MS) in Illinois and associated risk factors to document emerging problems as a basis for preventive and/or therapeutic interventions.

DESIGN

The 2005 Illinois Behavioral Risk Factor Surveillance System data were analyzed for prevalence rates and relative risk (RR) of risk factors for MS.

SETTING

Illinois.

SUBJECTS

Representative sample of 5077 noninstitutionalized Illinoisans aged > or = 18.

MEASURES

Presence of diabetes, hypertension, hypercholesterolemia, angina, and obesity; adequate fruit/vegetable intake; adequate daily physical activity; routine consumption of calcium-rich foods; smoking; and demographic variables.

ANALYSIS

Prevalence, chi-square, RR, and analyses of variance.

RESULTS

MS prevalence was 16.2%. The RR for MS was 8 for those having diabetes; 20 for those with hypertension; 14 for those with hypercholesterolemia; 6 for those with angina; and 7 for those with obesity. Fruit/vegetable intake did not significantly influence the RR (RR = 1.01), but RR was greater when calcium-rich foods were not routinely consumed (RR = 1.61) and with inadequate physical activity (RR = 1.85). MS prevalence was highest in those over 65 years; with incomes < $15,000; and among Blacks. Differences among those with one through five indicators of MS were not significant for fruit/vegetable intake, but were for physical activity, age group, income, and education level (p < .001).

CONCLUSION

These findings reveal that MS prevention should be emphasized for lower-income, older Blacks. Increasing physical activity and calcium-rich foods are areas for community-based education.

Fetal growth restriction and postnatal development

The interaction between genetic constitution and in utero environment determines fetal growth and development and influences the susceptibility to certain disorders in adulthood. Data from both animal and human studies indicate that prenatal and early postnatal malnutrition can program the hypothalamus-pituitary-adrenal axis (HPA axis), altering neuroendocrine response to stressors throughout lifetime. Impaired uteroplacental perfusion results in fetal growth restriction (FGR). In FGR there is evidence of chronic hypoxemia and alterations in metabolic, endocrine, and hematological parameters, compatible with starvation. Furthermore, FGR is associated with increased perinatal mortality and in the survivors there is increased susceptibility to diabetes and cardiovascular disease in adulthood. There is evidence that early postnatal growth acceleration, which would normally be considered desirable, may exacerbate metabolic dysfunction in later life.