Creatine Kinase Is a Marker of Metabolic Syndrome in Qatari Women With and Without Polycystic Ovarian Syndrome

Association between Metabolic Syndrome and Musculoskeletal Status: A Cross-Sectional Study of NHANES

Objective

The metabolic effects of metabolic syndrome (MetS) on musculoskeletal metabolism are controversial. This study explored the effect of MetS on bone mineral density (BMD) and muscle quality index (MQI).

Methods

Data from the NHANES database from 2011 to 2014 were extracted, and nonpregnant participants aged 45-59 years were included. The included data were first weighted by complex sampling, and then, the effect of MetS on BMD and MQI was analyzed using multifactorial linear regression. We then performed a stratified analysis by gender and BMI classification. Moreover, a mediation analysis of MetS on BMD was conducted, with MQI as a mediating variable. A propensity score matching analysis method with a complex sampling design was additionally performed to verify the stability of the results.

Results

A total of 1943 participants were eventually included. After adjusting for covariates, the results of linear regression show that MetS is associated with elevated pelvic BMD (beta = 0.03; 95% CI = 0.01, 0.06; P=0.02) and reduced MQI, especially arm MQI (beta = -1.02; 95% CI = -1.27, -0.77; P < 0.0001). MetS is more associated with BMD in women, MQI in normal or heavyweight, and BMD in lightweight, according to stratified analysis. MQI explains the indirect effect of MetS on BMD (beta = 0.007; 95% CI = 0.003, 0.010).

Conclusion

This study provides evidence that MetS elevates BMD and reduces MQI, and further, that there is a mediating effect of MQI on elevated BMD.

Time-restricted eating with or without a low-carbohydrate diet improved myocardial status and thyroid function in individuals with metabolic syndrome: secondary analysis of a randomized clinical trial

BACKGROUND

Obesity and metabolic syndrome (MetS) have become urgent worldwide health problems, predisposing patients to unfavorable myocardial status and thyroid dysfunction. Low-carbohydrate diet (LCD) and time-restricted eating (TRE) have been confirmed to be effective methods for weight management and improving MetS, but their effects on the myocardium and thyroid are unclear.

METHODS

We conducted a secondary analysis in a randomized clinical diet-induced weight-loss trial. Participants (N = 169) diagnosed with MetS were randomized to the LCD group, the 8 h TRE group, or the combination of the LCD and TRE group for 3 months. Myocardial enzymes and thyroid function were tested before and after the intervention. Pearson's or Spearman's correlation was assessed between functions of the myocardium and thyroid and cardiometabolic parameters at baseline.

RESULTS

A total of 162 participants who began the trial were included in the intention-to-treat (ITT) analysis, and 57 participants who adhered to their assigned protocol were involved in the per-protocol (PP) analysis. Relative to baseline, lactate dehydrogenase, creatine kinase MB, hydroxybutyrate dehydrogenase, and free triiodothyronine (FT3) declined, and free thyroxine (FT4) increased after all 3 interventions (both analyses). Creatine kinase (CK) decreased only in the TRE (- 18 [44] U/L, P < 0.001) and combination (- 22 [64] U/L, P = 0.003) groups (PP analysis). Thyrotropin (- 0.24 [0.83] μIU/mL, P = 0.011) and T3 (- 0.10 ± 0.04 ng/mL, P = 0.011) decreased in the combination group (ITT analysis). T4 (0.82 ± 0.39 μg/dL, P = 0.046), thyroglobulin antibodies (TgAb, 2 [1] %, P = 0.021), and thyroid microsomal antibodies (TMAb, 2 [2] %, P < 0.001) increased, while the T3/T4 ratio (- 0.01 ± 0.01, P = 0.020) decreased only in the TRE group (PP analysis). However, no significant difference between groups was observed in either analysis. At baseline, CK was positively correlated with the visceral fat area. FT3 was positively associated with triglycerides and total cholesterol. FT4 was negatively related to insulin and C-peptide levels. TgAb and TMAb were negatively correlated with the waist-to-hip ratio.

CONCLUSIONS

TRE with or without LCD confers remarkable metabolic benefits on myocardial status and thyroid function in subjects with MetS.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04475822.

A study on the immunological vitality of an inflammatory biomarker explored with rs5743708 polymorphism in TLR2 gene among Saudi women confirmed with polycystic ovarian syndrome

Introduction

Polycystic ovary syndrome (PCOS) is an ovarian health condition as well as a long-term endocrine dysfunction that affects reproductive-aged women. Toll-like receptor 2 (TLR2) gene was linked to PCOS and chronic inflammation, and the prevalence of obesity was rising in Saudi women. Previous studies on rs5743708 polymorphism were documented in the obesity as well as in PCOS women.

Aim

In this study, we investigated the molecular role of rs5743708 polymorphism in TLR2 gene among Saudi women diagnosed with PCOS using the Rotterdam criteria.

Methods

Blood samples were collected from 220 Saudi women in this hospital-based case-control study; 110 were PCOS women and remaining 110 were non-PCOS (control women). Biochemical analysis was performed on serum samples, and molecular analysis was performed on EDTA blood. Genotyping for rs5743708 polymorphism was performed with polymerase chain reaction-restriction fragment length polymorphism analysis.

Results

In both groups, clinical data was calculated using t-test, which revealed both positive (p < 0.05) and negative (p > 0.05) associations. HWE analysis supported the rs5743708 polymorphism (p < 0.05). In the rs5743708 polymorphism, none of the genotypes, genetic models, or allele frequencies were found to be associated with PCOS and non-PCOS women. However, both ANOVA and regression analyses revealed a positive relationship in PCOS with weight and BMI (p < 0.0001).

Conclusion

The rs5743708 polymorphism was not associated to PCOS in Saudi women. One of the predictions could be that 42.7% of PCOS and 73.6% of non-PCOS women were obese, and the rs5743708 polymorphism has been linked to both obesity and PCOS in the previous studies. This study suggests screening for additional polymorphisms with a large sample size.

The correlation between serum creatine kinase with low muscle mass in type 2 diabetes patients

Creatine kinase (CK), the key enzyme in regulating energy metabolism, is demonstrated to be correlated with insulin resistance. Type 2 diabetes mellitus (T2DM) is considered as a risk factor for developing low muscle mass. The purpose of this investigation was to evaluate whether serum CK is associated with low muscle mass in T2DM patients. This cross-sectional study enrolled a consecutive population of 1086 T2DM patients recruited from the inpatients in our department. Dual-energy X-ray absorptiometry was utilized to detect the skeletal muscle index (SMI). In all, 117 males (20.24%) and 72 females (16.51%) showed low muscle mass in T2DM patients. CK was associated with a reduced risk of low muscle mass in male and female T2DM patients. SMI was correlated with age, duration of diabetes, body mass index (BMI), diastolic blood pressure (DBP), triglyceride, high-density lipoprotein cholesterol, and CK in male subjects analyzed using linear regression. Linear regression analysis showed that SMI was correlated with age, BMI, DBP, and CK in female subjects. In addition, CK was correlated with BMI and fasting plasma glucose in male and female T2DM groups. CK is inversely correlated with low muscle mass in T2DM patients.

Creatine kinase is associated with glycated haemoglobin in a nondiabetic population. The Tromsø study

BACKGROUND

Creatine kinase (CK) has been associated with insulin resistance and identified as a risk marker of cardiovascular disease largely by its relationship with hypertension and increased body mass index. This study determined whether CK is a predictor of glycated haemoglobin (HbA1C) in a nondiabetic general population.

METHODS

Associations between CK and the outcome variable HbA1C (%) were performed by variance and multivariate analyses in 11662 nondiabetic subjects defined as HbA1C (%) <6.5 who participated in the population based Tromsø study (Tromsø 6) in Norway.

RESULTS

Abnormal elevated CK was detected in 543/11662 participants (4.66%). Mean HbA1C (%) in the "high CK" group was 5.62 (SD = 0.33) compared to 5.52 (SD = 0.36) in the "normal CK" group, P <0.001. CK increased significantly and linearly with higher levels of HbA1C (%) quartiles in women (P <0.001) and non-linearly in men (P <0.001). In a multivariate analysis, CK was independently associated with HbA1C (%) after adjusting for age, sex, body mass index, blood pressure, glucose, lipids, C-reactive protein, creatinine, alanine transaminase and aspartate aminotransferase. A 1-unit increase in log CK was associated with a 0.17-unit increase in HbA1C (%).

CONCLUSION

These data demonstrate a positive and independent association between CK and glycated haemoglobin in a nondiabetic general population.

Metabolic syndrome among adults in Qatar: A review of the literature across medical specialties

This study aims to collate all metabolic syndrome-related studies among adults in Qatar, shedding light on gaps in knowledge related to this topic to be addressed in future research studies. PubMed was used in searching for metabolic syndrome-related articles in Qatar, which was executed using relevant terms and was conducted with no restrictions. A second search was executed at a later stage to include any recent publications. A total of 20 articles were found to be relevant and related to the topic in hand. Three definitions of metabolic syndrome were used across the reviewed studies, which were classified based on medical specialties. The main findings and key components of each study were summarized. Studies were unevenly distributed across various medical specialties. This article serves to direct future research activities by identifying what aspects of the disease have been covered under current or past research projects and what more needs to be addressed comprehensively in view of clinical and public health significance.