1
|
Mørk FB, Madsen JOB, Pilgaard KA, Jensen AK, Klakk H, Tarp J, Bugge A, Heidemann M, Van Hall G, Pociot F, Wedderkopp N, Johannesen J. The metabolic syndrome is frequent in children and adolescents with type 1 diabetes compared to healthy controls. Pediatr Diabetes 2022; 23:1064-1072. [PMID: 35678773 DOI: 10.1111/pedi.13378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE There is a rise in overweight and obesity among children and adolescents with type 1 diabetes (T1D) in parallel with the rise in the metabolic syndrome (MetS) among children and adolescents. The aim of the study was to describe the prevalence and characteristics of MetS in children and adolescents with T1D compared to their healthy counterparts. RESEARCH DESIGN AND METHODS The study includes two Danish cohorts; (i) the Copenhagen cross sectional cohort 2016 of 277 children and adolescents with T1D that attend the pediatric outpatient clinic at a large hospital in greater Copenhagen and (ii) the CHAMPS-study DK which is a population-based cohort study of Danish children and adolescents (control cohort). Participants were categorized to have MetS if at least two of the following criteria were met: (i) systolic and/or diastolic blood pressure ≥ 90th percentile, (ii) waist circumference ≥90th percentile, and (iii) triglyceride ≥90th percentile and/or HDL ≤10th percentile. RESULTS The prevalence of children with Mets in the T1D cohort was higher than in the control cohort (p = 0.002). Moreover, participants with T1D had MetS at a lower level of BMI (p < 0.001) and waist circumference (p < 0.001) than participants with MetS from the control cohort (z-scores = 0.90 and 1.51). Participants with MetS were younger than the other T1D participants (median 12.8 [9.9,14.8] vs. median 14.6 [11.2,16.9] years, p = 0.006). CONCLUSIONS Children and adolescents with T1D have an increased risk of MetS compared to healthy controls and clinicians and caretakers should consider early prevention and health promotion strategies.
Collapse
Affiliation(s)
- Freja Barrett Mørk
- Department of Clinical Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Paediatrics and Adolescent Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Jens Otto Broby Madsen
- Department of Paediatrics and Adolescent Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Kasper Ascanius Pilgaard
- Department of Clinical Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Paediatrics and Adolescent Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Andreas Kryger Jensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Heidi Klakk
- Center for Applied Health Science, University College South, Haderslev, Denmark.,Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - Jakob Tarp
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Anna Bugge
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, University College Copenhagen, Copenhagen, Denmark
| | - Malene Heidemann
- Odense University Hospital, Hans Christian Andersen Children's Hospital, Odense, Denmark.,Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Gerrit Van Hall
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Clinical Metabolomics Core Facility, Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Flemming Pociot
- Department of Clinical Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels Wedderkopp
- Odense Patient Data Explorative Network, Institute of Clinical Research OPEN, Odense University Hospital, Odense, Denmark.,Pediatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jesper Johannesen
- Department of Clinical Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Department of Paediatrics and Adolescent Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Vedder D, Walrabenstein W, Heslinga M, de Vries R, Nurmohamed M, van Schaardenburg D, Gerritsen M. Dietary Interventions for Gout and Effect on Cardiovascular Risk Factors: A Systematic Review. Nutrients 2019; 11:nu11122955. [PMID: 31817107 PMCID: PMC6950134 DOI: 10.3390/nu11122955] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/26/2019] [Accepted: 11/28/2019] [Indexed: 02/07/2023] Open
Abstract
Gout is one of the most prevalent inflammatory rheumatic disease. It is preceded by hyperuricemia and associated with an increased risk for cardiovascular disease, both related to unhealthy diets. The objective of this systematic review is to better define the most appropriate diet addressing both disease activity and traditional cardiovascular risk factors in hyperuricemic patients. We included clinical trials with patients diagnosed with hyperuricemia or gout, investigating the effect of dietary interventions on serum uric acid (SUA) levels, gout flares and—if available—cardiovascular risk factors. Eighteen articles were included, which were too heterogeneous to perform a meta-analysis. Overall, the risk of bias of the studies was moderate to high. We distinguished four groups of dietary interventions: Calorie restriction and fasting, purine-low diets, Mediterranean-style diets, and supplements. Overall, fasting resulted in an increase of SUA, whilst small (SUA change +0.3 to −2.9 mg/dL) but significant effects were found after low-calorie, purine-low, and Mediterranean-style diets. Studies investigating the effect on cardiovascular risk factors were limited and inconclusive. Since Mediterranean-style diets/DASH (Dietary Approach to Stop Hypertension) have shown to be effective for the reduction of cardiovascular risk factors in other at-risk populations, we recommend further investigation of such diets for the treatment of gout.
Collapse
Affiliation(s)
- Daisy Vedder
- Amsterdam Rheumatology and Immunology Center|Reade, 1056 AB Amsterdam, The Netherlands; (M.H.); (M.N.); (D.v.S.); (M.G.)
- Correspondence: (D.V.); (W.W.)
| | - Wendy Walrabenstein
- Amsterdam Rheumatology and Immunology Center|Reade, 1056 AB Amsterdam, The Netherlands; (M.H.); (M.N.); (D.v.S.); (M.G.)
- Amsterdam UMC|Amsterdam Medical Center, 1105 AZ Amsterdam, The Netherlands
- Correspondence: (D.V.); (W.W.)
| | - Maaike Heslinga
- Amsterdam Rheumatology and Immunology Center|Reade, 1056 AB Amsterdam, The Netherlands; (M.H.); (M.N.); (D.v.S.); (M.G.)
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands;
| | - Michael Nurmohamed
- Amsterdam Rheumatology and Immunology Center|Reade, 1056 AB Amsterdam, The Netherlands; (M.H.); (M.N.); (D.v.S.); (M.G.)
- Amsterdam UMC|VU Medical Center, 1081 HV Amsterdam, The Netherlands
| | - Dirkjan van Schaardenburg
- Amsterdam Rheumatology and Immunology Center|Reade, 1056 AB Amsterdam, The Netherlands; (M.H.); (M.N.); (D.v.S.); (M.G.)
- Amsterdam UMC|Amsterdam Medical Center, 1105 AZ Amsterdam, The Netherlands
| | - Martijn Gerritsen
- Amsterdam Rheumatology and Immunology Center|Reade, 1056 AB Amsterdam, The Netherlands; (M.H.); (M.N.); (D.v.S.); (M.G.)
| |
Collapse
|
3
|
Vanzella LM, Dagostinho DBB, Figueiredo MPF, Castrillón CIM, Netto Junior J, Vanderlei LCM. Periodized Aerobic Interval Training Modifies Geometric Indices of Heart Rate Variability in Metabolic Syndrome. ACTA ACUST UNITED AC 2019; 55:E532. [PMID: 31454929 DOI: 10.3390/medicina55090532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/16/2019] [Accepted: 08/22/2019] [Indexed: 01/25/2023]
Abstract
Background: Metabolic syndrome (MetS) influences the autonomic modulation, increasing the risk of cardiovascular events, which demands the identification of effective treatments for this population. Considering this, the study has the objective of evaluating the effects of periodized aerobic interval training (AIT) on geometrical methods of heart rate variability (HRV) on individuals with MetS. Methods: 52 individuals with MetS were considered for analysis. They were divided into two groups: aerobic interval training group (AITG; n = 26) and control group (CG; n = 26). The AITG performed 16 weeks of periodized AIT. For HRV analysis, the heart rate was recorded beat-by-beat at the beginning and the end of the AIT program and geometrical methods were used for analysis. Results: significant increase was observed for triangular index (RRtri, −1.25 ± 0.58 vs. 1.41 ± 0.57), standard deviation of distances from diagonal to points (SD1, −0.13 ± 1.52 vs. 4.34 ± 1.49), and standard deviation of distances from points to lines (SD2, −2.14 ± 3.59 vs. 11.23 ± 3.52) on AITG compared to CG. Significant differences were not observed for triangular interpolation of normal heartbeats interval histogram (TINN, −4.05 ± 17.38 vs. 25.52 ± 17.03) and SD1/SD2 ratio (0.03 ± 0.02 vs. 0.00 ± 0.02). Qualitative analysis of the Poincaré plot identified increase on dispersion of both short and long-term intervals between successive heartbeats (RR interval) on AITG after the AIT program. Conclusion: geometric indices of HRV suggest an increase in cardiac autonomic modulation in individuals with MetS after 16 weeks of periodized AIT.
Collapse
|
4
|
Shokouh P, Jeppesen PB, Hermansen K, Laustsen C, Stødkilde-Jørgensen H, Hamilton-Dutoit SJ, Søndergaard Schmedes M, Qi H, Stokholm Nørlinger T, Gregersen S. Effects of Unfiltered Coffee and Bioactive Coffee Compounds on the Development of Metabolic Syndrome Components in a High-Fat-/High-Fructose-Fed Rat Model. Nutrients 2018; 10:E1547. [PMID: 30347674 DOI: 10.3390/nu10101547] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/08/2018] [Accepted: 10/11/2018] [Indexed: 12/22/2022] Open
Abstract
The literature is inconsistent as to how coffee affects metabolic syndrome (MetS), and which bioactive compounds are responsible for its metabolic effects. This study aimed to evaluate the effects of unfiltered coffee on diet-induced MetS and investigate whether or not phenolic acids and trigonelline are the main bioactive compounds in coffee. Twenty-four male Sprague‒Dawley rats were fed a high-fat (35% W/W) diet plus 20% W/W fructose in drinking water for 14 weeks, and were randomized into three groups: control, coffee, or nutraceuticals (5-O-caffeoylquinic acid, caffeic acid, and trigonelline). Coffee or nutraceuticals were provided in drinking water at a dosage equal to 4 cups/day in a human. Compared to the controls, total food intake (p = 0.023) and mean body weight at endpoint (p = 0.016) and estimated average plasma glucose (p = 0.041) were lower only in the coffee group. Surrogate measures of insulin resistance including the overall fasting insulin (p = 0.010), endpoint HOMA-IR (p = 0.022), and oral glucose tolerance (p = 0.029) were improved in the coffee group. Circulating triglyceride levels were lower (p = 0.010), and histopathological and quantitative (p = 0.010) measurements indicated lower grades of liver steatosis compared to controls after long-term coffee consumption. In conclusion, a combination of phenolic acids and trigonelline was not as effective as coffee per se in improving the components of the MetS. This points to the role of other coffee chemicals and a potential synergism between compounds.
Collapse
|
5
|
Gui XY, Jin HZ, Wang ZJ, Xu TD. Serum uric acid levels and hyperuricemia in patients with psoriasis: a hospital-based cross-sectional study. An Bras Dermatol 2018; 93:761-763. [PMID: 30156637 PMCID: PMC6106671 DOI: 10.1590/abd1806-4841.20187547] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 12/13/2017] [Indexed: 11/22/2022] Open
Abstract
A hospital-based cross-sectional study was performed, including 117 psoriatic patients and 117 controls matched for age, gender, and body mass index. Psoriatic patients had higher levels of serum uric acid (6.25 ± 1.62 vs 5.71 ± 1.35 mg/dl; P=0.019) and significantly greater prevalence of hyperuricemia (31.6% vs 16.2%; P=0.009) than individuals without psoriasis. Psoriatic patients had significantly higher serum uric acid than controls in subjects without metabolic syndrome. Multivariate logistic regression analysis showed that psoriasis can be a strong predictor of hyperuricemia (odds ratio 2.61; 95% confidence interval 1.34-5.00; P=0.004).
Collapse
Affiliation(s)
- Xin-Yu Gui
- Department of Dermatology, Peking Union Medical College Hospital,
Beijing, China
| | - Hong-Zhong Jin
- Department of Dermatology, Peking Union Medical College Hospital,
Beijing, China
| | - Zhen-Jie Wang
- Department of Physical Examination Center, Peking Union Medical
College Hospital, Beijing, China
| | - Teng-Da Xu
- Department of Physical Examination Center, Peking Union Medical
College Hospital, Beijing, China
| |
Collapse
|
6
|
Paschoal RS, Silva DA, Cardili RN, Souza CDS. Metabolic syndrome, C-reactive protein and cardiovascular risk in psoriasis patients: a cross-sectional study. An Bras Dermatol 2018; 93:222-228. [PMID: 29723366 PMCID: PMC5916394 DOI: 10.1590/abd1806-4841.20186397] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 03/14/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Psoriasis has been associated with co-morbidities and elevated cardiovascular risk. OBJECTIVES To analyze the relationships among metabolic syndrome, cardiovascular risk, C-reactive protein, gender, and Psoriasis severity. METHODS In this cross-sectional study, plaque Psoriasis patients (n=90), distributed equally in gender, were analyzed according to: Psoriasis Area and Severity Index, cardiovascular risk determined by the Framingham risk score and global risk assessment, C-reactive protein and metabolic syndrome criteria (NCEPT-ATP III). RESULTS Metabolic syndrome frequency was 43.3% overall, without significance between genders (P=0.14); but women had higher risk for obesity (OR 2.56, 95%CI 1.02-6.41; P=0.04) and systemic arterial hypertension (OR 3.29, 95%CI 1.39-7.81; P=0.006). The increase in the Psoriasis Area and Severity Index also increased the risk for metabolic syndrome (OR 1.060, 95%CI 1.006-1.117; P=0.03). Absolute 10-year cardiovascular risk was higher in males (P=0.002), but after global risk assessment, 51.1% patients, 52.2% women, were re-classified as high-intermediate cardiovascular risk; without significance between genders (P=0.83). C-reactive protein level was elevated nearly six-fold overall, higher in metabolic syndrome (P=0.05), systemic arterial hypertension (P=0.004), and high-intermediate 10-year cardiovascular risk patients (P<0.001); positively correlated to: Framingham risk score (P<0.001; r=0.60), absolute 10-year cardiovascular risk (P<0.001; r=0.58), and age (P=0.001; r=0.35); but not to Psoriasis Area and Severity Index (P=0.14; r=0.16); increased the 10-year cardiovascular risk (R2=33.6; P<0.001), MetS risk (OR 1.17, 95%CI 0.99-1.37; P=0.05) and with age (P=0.001). HDL-cholesterol level was higher in normal C-reactive protein patients (t=1.98; P=0.05). STUDY LIMITATIONS Restricted sample, hospital-based and representative of a single center and no specification of psoriatic arthritis. CONCLUSIONS Psoriasis, metabolic syndrome, systemic arterial hypertension and age share the increase in C-reactive protein, which could implicate in additional burden for increasing the cardiovascular risk and be an alert for effective interventions.
Collapse
Affiliation(s)
- Renato Soriani Paschoal
- Postgraduate program of Internal Medicine Department, Faculdade de
Medicina de Ribeirão Preto, Universidade de São Paulo (USP) -
Ribeirão Preto (SP), Brazil
| | - Daniela Antoniali Silva
- Division of Dermatology, Internal Medicine Department, Hospital das
Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de
São Paulo (USP) - Ribeirão Preto (SP), Brazil
| | - Renata Nahas Cardili
- Division of Dermatology, Internal Medicine Department, Hospital das
Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de
São Paulo (USP) - Ribeirão Preto (SP), Brazil
| | - Cacilda da Silva Souza
- Division of Dermatology, Internal Medicine Department, Hospital das
Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de
São Paulo (USP) - Ribeirão Preto (SP), Brazil
| |
Collapse
|
7
|
Guyot E, Baudry J, Hercberg S, Galan P, Kesse-Guyot E, Péneau S. Mindfulness Is Associated with the Metabolic Syndrome among Individuals with a Depressive Symptomatology. Nutrients 2018; 10:E232. [PMID: 29462979 DOI: 10.3390/nu10020232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 02/01/2018] [Accepted: 02/13/2018] [Indexed: 02/03/2023] Open
Abstract
The Metabolic Syndrome (MetS) is a major public health burden. Dispositional mindfulness has recently been associated with eating disorders, being overweight, and could therefore be associated with the MetS. We aimed to examine in a cross-sectional design the relationship between mindfulness, the MetS, and its risk factors in a large sample of the adult general population and the influence of depressive symptomatology on this association. Adults participating in the NutriNet-Santé study who had completed the Five Facets Mindfulness Questionnaire and attended a clinical and biological examination were available for inclusion. Multivariable logistic regression models adjusted for socio-demographic and lifestyle factors were performed. A total of 17,490 individuals were included. Among individuals with a depressive symptomatology, those with higher mindfulness were less likely to have a MetS (OR: 0.73, 95% CI: 0.57–0.93), a high waist circumference, a low HDL-cholesterol level and an elevated fasting blood glucose level (all p <0.05). In those without depressive symptomatology, individuals with higher mindfulness were less likely to have a high waist circumference (p <0.01). In conclusion, higher mindfulness was associated with lower odds of developing a MetS only among individuals with a depressive symptomatology.
Collapse
|
8
|
Zhang W, Xin L, Lu Y. Integrative Analysis to Identify Common Genetic Markers of Metabolic Syndrome, Dementia, and Diabetes. Med Sci Monit 2017; 23:5885-5891. [PMID: 29229897 PMCID: PMC5737114 DOI: 10.12659/msm.905521] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 06/18/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Emerging data have established links between systemic metabolic dysfunction, such as diabetes and metabolic syndrome (MetS), with neurocognitive impairment, including dementia. The common gene signature and the associated signaling pathways of MetS, diabetes, and dementia have not been widely studied. MATERIAL AND METHODS We exploited the translational bioinformatics approach to choose the common gene signatures for both dementia and MetS. For this we employed "DisGeNET discovery platform". RESULTS Gene mining analysis revealed that a total of 173 genes (86 genes common to all three diseases) which comprised a proportion of 43% of the total genes associated with dementia. The gene enrichment analysis showed that these genes were involved in dysregulation in the neurological system (23.2%) and the central nervous system (20.8%) phenotype processes. The network analysis revealed APOE, APP, PARK2, CEPBP, PARP1, MT-CO2, CXCR4, IGFIR, CCR5, and PIK3CD as important nodes with significant interacting partners. The meta-regression analysis showed modest association of APOE with dementia and metabolic complications. The directionality of effects of the variants on Alzheimer disease is generally consistent with previous observations and did not differ by race/ethnicity (p>0.05), although our study had low power for this test. CONCLUSIONS Our novel approach showed APOE as a common gene signature with a link to dementia, MetS, and diabetes. Future gene association studies should focus on the association of gene polymorphisms with multiple disease models to identify novel putative drug targets.
Collapse
Affiliation(s)
| | | | - Ying Lu
- Corresponding Author: Ying Lu, e-mail:
| |
Collapse
|
9
|
Ju SY, Lee JY, Kim DH. Association of metabolic syndrome and its components with all-cause and cardiovascular mortality in the elderly: A meta-analysis of prospective cohort studies. Medicine (Baltimore) 2017; 96:e8491. [PMID: 29137039 PMCID: PMC5690732 DOI: 10.1097/md.0000000000008491] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
There is increasing evidence regarding the relationship between metabolic syndrome and mortality. However, previous research examining metabolic syndrome and mortality in older populations has produced mixed results. In addition, there is a clear need to identify and manage individual components of metabolic syndrome to decrease cardiovascular disease (CVD) mortality. In this meta-analysis, we searched the MEDLINE databases using PubMed, Cochrane Library, and EMBASE databases. Based on 20 prospective cohort studies, metabolic syndrome was associated with a higher risk of all-cause mortality [relative risk (RR), 1.23; 95% confidence interval (CI), 1.15-1.32; I = 55.9%] and CVD mortality (RR, 1.24; 95% CI, 1.11-1.39; I = 58.1%). The risk estimates of all-cause mortality for single components of metabolic syndrome were significant for higher values of waist circumference or body mass index (RR, 0.94; 95% CI, 0.88-1.00), higher values of blood glucose (RR, 1.19; 95% CI, 1.05-1.34), and lower values of high-density lipoprotein (HDL) cholesterol (RR, 1.11; 95% CI, 1.02-1.21). In the elderly population, metabolic syndrome was associated with an increased risk of all-cause and CVD mortality. Among the individual components of metabolic syndrome, increased blood glucose and HDL cholesterol levels were significantly associated with increased mortality. However, older obese or overweight individuals may have a decreased mortality risk. Thus, the findings of the current meta-analysis raise questions about the utility of the definition of metabolic syndrome in predicting all-cause mortality and CVD mortality in the elderly population.
Collapse
Affiliation(s)
- Sang-Yhun Ju
- Department of Family Medicine, College of Medicine, Yeouido St. Mary's Hospital, the Catholic University of Korea
| | - June-Young Lee
- Department of Biostatistics, Korea University College of Medicine
| | - Do-Hoon Kim
- Department of Family Medicine, Korea University Ansan Hospital, Ansan-Si Gyeonggi, Republic of Korea
| |
Collapse
|
10
|
Łężak W, Mokros Ł, Karbownik MS, Witusik A, Kosmalski M, Kowalczyk E, Pietras T. [Metabolic safety of antidepressant medicines]. Pol Merkur Lekarski 2017; 42:210-213. [PMID: 28557969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
UNLABELLED Metabolic syndrome is a very serious health issue, not only from internal medicine's point of view. Patients suffering from overweight, arterial hypertension, lipids and carbohydrates metabolism disorders are also in the circle of interest of other areas of medicine, including psychiatry. Currently, one of key problems of pharmacotherapy is a comorbidity of metabolic syndrome and mental disorder. Depression is more common than schizophrenia. Despite the fact that in everyday clinical practice there are more patients with depression than schizophrenia, there is a bigger interest among scientists for metabolic syndrome after antipsychotic drugs than as an effect of use of antidepressant agents. AIM The aim of an analysis was to review literature committed to influence of depression pharmacotherapy on development of metabolic syndrome. 169 results were provided, including 18 original publications. Final analysis consists of 9 that investigate correlation between antidepressive medicines use and metabolic syndrome development (but not its each individual component). RESULTS In general, antidepressant pharmacotherapy is associated not only with increased risk of metabolic syndrome occurrence but also their worsening. However, it needs to be emphasized that there is a difference between antidepressants groups - tricyclic antidepressive medicines are the most commonly associated with risk of developing metabolic disorders, but also SNRIs and SSRIs are mentioned as significant contributors. Mechanisms of aforementioned changes are still unclear. However, their influence on histamine and serotonin pathways, which take part in regulation of i.e. food intake, is suggested. The search for mechanisms that are precisely responsible for metabolic changes continues, in hope of finding a way to avoid adverse effects of antidepressant medicines use.
Collapse
Affiliation(s)
- Wojciech Łężak
- Medical University of Lodz, Poland: Department of Pharmacology and Toxicology
| | - Łukasz Mokros
- Department of Clinical Pharmacology; Jan Kochanowski University in Kielce, Kielce, Poland
| | | | - Andrzej Witusik
- Sub-Department of Psychology, Institute of Pedagogical Sciences, Faculty of Social Science, Piotrków Trybunalski Branch
| | - Marcin Kosmalski
- Department of Clinical Pharmacology; Jan Kochanowski University in Kielce, Kielce, Poland
| | - Edward Kowalczyk
- Medical University of Lodz, Poland: Department of Pharmacology and Toxicology
| | - Tadeusz Pietras
- Department of Clinical Pharmacology; Jan Kochanowski University in Kielce, Kielce, Poland
| |
Collapse
|
11
|
Abstract
CONTEXT AND OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) has been increasingly diagnosed worldwide and is now recognized as a source of public health concern. It comprises a wide spectrum of histological features that range from simple steatosis to severe forms of fibrosis, steatohepatitis and even cirrhosis. The impact of bariatric surgery on the course of NAFLD in individuals with obesity has been extensively studied. DESIGN AND SETTING: Narrative review; public university hospital. METHODS: A comprehensive review was conducted based on an online search on the electronic databases MEDLINE and LILACS using the MeSH terms "fatty liver" and "bariatric surgery". RESULTS: The exact mechanisms that lead to improvement in NAFLD following bariatric surgery are not completely understood. Since Roux-en-Y gastric bypass (RYGB) is the bariatric surgical procedure most performed worldwide, it is also the one from which the effects on NAFLD have been most studied, although there is also consistent evidence regarding the effects from gastric banding, sleeve gastrectomy and biliopancreatic diversions. CONCLUSION: According to the currently available evidence, bariatric surgery leads to significant improvement in NAFLD. Further research, especially by means of randomized controlled trials enrolling larger cohorts of individuals, is needed to determine the optimal procedure for this group of subjects.
Collapse
Affiliation(s)
- Everton Cazzo
- MD, MSc, PhD. Assistant Professor, Department of Surgery, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - José Carlos Pareja
- MD, PhD. Associate Professor, Department of Surgery, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Elinton Adami Chaim
- MD, MSc, PhD. Full Professor, Department of Surgery, Universidade Estadual de Campinas (UNICAMP), Campinas, (SP), Brazil.
| |
Collapse
|
12
|
Duarte GV, de Oliveira MDFSP, Follador I, Silva TS, de Carvalho Filho EM. Diagnosis and underdiagnosis of comorbidities in psoriasis patients - need for a multidisciplinary approach. An Bras Dermatol 2016; 91:743-747. [PMID: 28099594 PMCID: PMC5198231 DOI: 10.1590/abd1806-4841.20164716] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 01/11/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND: Psoriasis is an immune-mediated disease that manifests predominantly in the skin, although systemic involvement may also occur. Although associated comorbidities have long been recognized and despite several studies indicating psoriasis as an independent risk factor for cardiovascular events, little has been done in general medical practice regardind screening. In the United States, less than 50% of clinicians are aware of these recommendations. OBJECTIVE: To identify the prevalence of these comorbidities in 296 patients followed up at a university dermatology clinic. METHODS: Systematically investigated comorbidity frequencies were compared with general practitioners' registry frequencies. Clinical features correlated with comorbidities were also investigated. RESULTS: High prevalences of systematically investigated comorbidities such as hypertension (30%) and dyslipidemia (26.5%) were documented. Conversely, data from general practitioners' records showed that 33% of dyslipidemia cases were undiagnosed and indicated possible underdiagnosis of some comorbidities. Furthermore, an association was found between: the number of comorbidities and psoriasis duration, age and high body mass index an association was found between the number of comorbidities and psoriasis duration, age, high body mass index, waist circumference or waist-to-hip ratio. (p<0.05). CONCLUSION: Disease duration, age and high body mass index, waist circumference or waist-to-hip ratio are possible criteria for choosing which patients should be screened for comorbidities. Underdiagnosis of comorbidities by general practitioners highlights the need for a multidisciplinary approach in psoriasis management.
Collapse
|
13
|
Klijs B, Angelini V, Mierau JO, Smidt N. The role of life-course socioeconomic and lifestyle factors in the intergenerational transmission of the metabolic syndrome: results from the LifeLines Cohort Study. Int J Epidemiol 2016; 45:1236-1246. [PMID: 27170762 DOI: 10.1093/ije/dyw076] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The risk of metabolic syndrome is associated between parents and offspring, but studies are inconsistent on differences by sex of parents and offspring. Our aim is to investigate to what extent metabolic syndrome present in fathers and mothers is associated with risk of metabolic syndrome in sons and daughters. Furthermore, we investigate to what extent these associations are explained by socioeconomic factors and health behaviours. METHODS We used data from the LifeLines Cohort Study (N = 7239). Metabolic syndrome was defined according to the NCEP-ATPIII criteria. Logistic regression analyses were performed to investigate associations of metabolic syndrome present in parents with the risk of metabolic syndrome in offspring. Analyses were sequentially adjusted for: age and sex; childhood factors (socioeconomic position and parental smoking); and adult factors (education, income, smoking, physical activity, alcohol intake, and dietary factors). RESULTS Multivariate regression analysis adjusted for age and sex showed associations of the metabolic syndrome between father-son: odds ratio (OR) [95% confidence interval (CI)] 2.41 (1.93-3.00), father-daughter: OR (95% CI) 1.80 (1.39-2.33)), mother-son: OR (95% CI) 1.82 (1.44-2.29) and mother-daughter: OR (95% CI) 1.97 (1.52-2.55). Furthermore, each individual factor underlying the metabolic syndrome in parents was associated with metabolic syndrome in offspring, but not for all parent-offspring combinations. None of the parent-offspring associations was attenuated when adjusting for socioeconomic factors and health behaviours. CONCLUSIONS High risk of metabolic syndrome is transmitted from fathers and mothers to sons and daughters. Our results suggest that this transmission is irrespective of the socioeconomic position and health behaviours of the offspring.
Collapse
Affiliation(s)
- Bart Klijs
- University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands,
| | - Viola Angelini
- University of Groningen, Faculty of Economics and Business, Groningen, The Netherlands and
| | - Jochen O Mierau
- University of Groningen, Faculty of Economics and Business, Groningen, The Netherlands and
| | - Nynke Smidt
- University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands.,University Medical Center Groningen, Department of Geriatrics, Groningen, The Netherlands
| |
Collapse
|
14
|
Bloch KV, Szklo M, Kuschnir MCC, Abreu GDA, Barufaldi LA, Klein CH, de Vasconcelos MTL, da Veiga GV, Figueiredo VC, Dias A, Moraes AJP, Souza ALL, de Oliveira AMA, Schaan BD, Tavares BM, de Oliveira CL, Cunha CDF, Giannini DT, Belfort DR, Ribas DLB, Santos EL, de Leon EB, Fujimori E, Oliveira ERA, Magliano EDS, Vasconcelos FDAG, Azevedo GD, Brunken GS, Dias GM, Filho HRC, Monteiro MI, Guimarães ICB, Faria Neto JR, Oliveira JS, de Carvalho KMB, Gonçalves LGDO, Santos MM, Muniz PT, Jardim PCBV, Ferreira PAM, Montenegro RM, Gurgel RQ, Vianna RP, Vasconcelos SM, da Matta SS, Martins SMS, Goldberg TBL, da Silva TLN. The Study of Cardiovascular Risk in Adolescents--ERICA: rationale, design and sample characteristics of a national survey examining cardiovascular risk factor profile in Brazilian adolescents. BMC Public Health 2015; 15:94. [PMID: 25880653 PMCID: PMC4334602 DOI: 10.1186/s12889-015-1442-x] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 01/19/2015] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The Study of Cardiovascular Risk in Adolescents (Portuguese acronym, "ERICA") is a multicenter, school-based country-wide cross-sectional study funded by the Brazilian Ministry of Health, which aims at estimating the prevalence of cardiovascular risk factors, including those included in the definition of the metabolic syndrome, in a random sample of adolescents aged 12 to 17 years in Brazilian cities with more than 100,000 inhabitants. Approximately 85,000 students were assessed in public and private schools. Brazil is a continental country with a heterogeneous population of 190 million living in its five main geographic regions (North, Northeast, Midwest, South and Southeast). ERICA is a pioneering study that will assess the prevalence rates of cardiovascular risk factors in Brazilian adolescents using a sample with national and regional representativeness. This paper describes the rationale, design and procedures of ERICA. METHODS/DESIGN Participants answered a self-administered questionnaire using an electronic device, in order to obtain information on demographic and lifestyle characteristics, including physical activity, smoking, alcohol intake, sleeping hours, common mental disorders and reproductive and oral health. Dietary intake was assessed using a 24-hour dietary recall. Anthropometric measures (weight, height and waist circumference) and blood pressure were also be measured. Blood was collected from a subsample of approximately 44,000 adolescents for measurements of fasting glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glycated hemoglobin and fasting insulin. DISCUSSION The study findings will be instrumental to the development of public policies aiming at the prevention of obesity, atherosclerotic diseases and diabetes in an adolescent population.
Collapse
Affiliation(s)
- Katia Vergetti Bloch
- Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, Brazil.
| | - Moyses Szklo
- Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, Brazil.
| | - Maria Cristina C Kuschnir
- Universidade do Estado do Rio de Janeiro, Núcleo de Estudos da Saúde do Adolescente, Rio de Janeiro, Brazil.
| | - Gabriela de Azevedo Abreu
- Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, Brazil.
| | - Laura Augusta Barufaldi
- Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, Brazil.
| | | | - Maurício T L de Vasconcelos
- Escola Nacional de Ciências Estatísticas, Fundação Instituto Brasileiro de Geografia e Estatística (ENCE/IBGE), Rio de Janeiro, Brazil.
| | - Glória Valéria da Veiga
- Universidade Federal do Rio de Janeiro, Instituto de Nutrição Josué de Castro, Rio de Janeiro, Brazil.
| | - Valeska C Figueiredo
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública, Rio de Janeiro, Brazil.
| | - Adriano Dias
- Universidade Estadual Paulista, Faculdade de Medicina, São Paulo, Brazil.
| | | | - Ana Luiza Lima Souza
- Universidade Federal de Goiás, Faculdade de Enfermagem e Nutrição, Goiás, Brazil.
| | | | - Beatriz D'Argord Schaan
- Universidade federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil.
| | - Bruno Mendes Tavares
- Universidade Federal do Amazonas, Instituto de Saúde e Biotecnologia, Amazonas, Brazil.
| | | | | | - Denise Tavares Giannini
- Universidade do Estado do Rio de Janeiro, Centro Biomédico - Nutrição, Rio de Janeiro, Brazil.
| | | | | | - Eduardo Lima Santos
- Instituto Federal de Educação Técnico Tecnológico do Tocantins, Tocantis, Brazil.
| | - Elisa Brosina de Leon
- Universidade Federal do Amazonas, Faculdade de Educação Física e Fisioterapia, Amazonas, Brazil.
| | - Elizabeth Fujimori
- Universidade Federal do Espirito Santo, Departamento de Enfermagem, Espírito Santo, Brazil.
| | | | - Erika da Silva Magliano
- Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, Brazil.
| | | | - George Dantas Azevedo
- Universidade Federal do Rio Grande do Norte, Centro de Biociências, Departamento de Morfologia, Rio Grande do Norte, Brazil.
| | - Gisela Soares Brunken
- Universidade Federal de Mato Grosso, Instituto de Saúde Coletiva, Departamento de Saúde Coletiva, Mato Grosso, Brazil.
| | - Glauber Monteiro Dias
- Instituto Nacional de Cardiologia, Laboratório de Biologia e Diagnósticos Moleculares, Rio de Janeiro, Brazil.
| | - Heleno R Correa Filho
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Medicina Preventiva e Social, São Paulo, Brazil.
| | - Maria Inês Monteiro
- Universidade Estadual de Campinas, Faculdade de Enfermagem, São Paulo, Brazil.
| | | | | | | | | | | | - Marize M Santos
- Universidade Federal do Piauí, Centro de Ciências da Saúde, Departamento de Nutrição, Piauí, Brazil.
| | - Pascoal Torres Muniz
- Universidade Federal do Acre, Departamento de Ciências da Saúde e Educação Física, Acre, Brazil.
| | | | | | | | - Ricardo Queiroz Gurgel
- Universidade Federal de Sergipe, Centro de Ciências Biológicas e da Saúde, Departamento de Medicina, Sergipe, Brazil.
| | - Rodrigo Pinheiro Vianna
- Universidade Federal da Paraíba, Centro de Ciências da Saúde - Campus I, Departamento de Nutrição, Paraíba, Brazil.
| | | | - Sandro Silva da Matta
- Hospital Estadual Getúlio Vargas, Núcleo Hospitalar de Geriatria e Gerontologia, Rio de Janeiro, Brazil.
| | | | - Tamara Beres Lederer Goldberg
- Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Departamento de Pediatria, São Paulo, Brazil.
| | | |
Collapse
|
15
|
Stocks T, Bjørge T, Ulmer H, Manjer J, Häggström C, Nagel G, Engeland A, Johansen D, Hallmans G, Selmer R, Concin H, Tretli S, Jonsson H, Stattin P. Metabolic risk score and cancer risk: pooled analysis of seven cohorts. Int J Epidemiol 2015; 44:1353-63. [PMID: 25652574 PMCID: PMC4588859 DOI: 10.1093/ije/dyv001] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2015] [Indexed: 01/10/2023] Open
Abstract
Background: There are few data on the joint influence of metabolic factors on risk of separate cancers. Methods: We analysed data on body mass index, blood pressure and plasma levels of glucose, total cholesterol and triglycerides from seven European cohorts comprising 564 596 men and women with a mean age of 44 years. We weighted those factors equally into a standardized metabolic risk score [MRS, mean = 0, standard deviation (SD) = 1], with an individual’s level indicated as SDs from the sex- and cohort-specific means. Cancer hazard ratios were calculated by Cox regression with age as timescale and with relevant adjustments including smoking status. All statistical tests were two-sided. Results: During a mean follow-up of 12 years, 21 593 men and 14 348 women were diagnosed with cancer. MRS was linearly and positively associated with incident cancer in total and at sites (P < 0.05). In men, risk per SD MRS was increased by 43% (95% confidence interval: 27–61) for renal cell cancer, 43% (16–76) for liver cancer, 29% (20–38) for colon cancer, 27% (5–54) for oesophageal cancer, 20% (9–31) for rectal cancer, 19% (4–37) for leukaemias, 15% (1–30) for oral cancer and 10% (2–19) for bladder cancer. In women, risk increases per SD MRS were 56% (42–70) for endometrial cancer, 53% (29–81) for pancreatic cancer, 40% (16–67) for renal cell cancer, 27% (9–47) for cervical cancer and 17% (3–32) for rectal cancer. Conclusion: This largest study to date on the joint influence of metabolic factors on risk of separate cancers showed increased risks for several cancers, in particular renal cell and liver cancer in men and endometrial and pancreatic cancer in women.
Collapse
Affiliation(s)
- Tanja Stocks
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden, Department of Clinical Sciences in Malmö, Diabetes and Cardiovascular Diseases, Genetic Epidemiology, Lund University, Lund, Sweden,
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway, Institute of Population-based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Hanno Ulmer
- Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria
| | - Jonas Manjer
- Department of Surgery, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Christel Häggström
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany, Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Anders Engeland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway, Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Dorthe Johansen
- Department of Surgery, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Nutritional Research, and
| | - Randi Selmer
- Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Steinar Tretli
- Institute of Population-based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Håkan Jonsson
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Pär Stattin
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| |
Collapse
|
16
|
de Faria ER, Gontijo CA, Franceschini SDCC, Peluzio MDCG, Priore SE. Body composition and risk for metabolic alterations in female adolescents. Rev Paul Pediatr 2014; 32:207-15. [PMID: 25119752 PMCID: PMC4183020 DOI: 10.1590/0103-0582201432215313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 11/29/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To study anthropometrical and body composition variables as predictors of risk for metabolic alterations and metabolic syndrome in female adolescents. METHODS Biochemical, clinical and corporal composition data of 100 adolescents from 14 to 17 years old, who attended public schools in Viçosa, Southeastern Brazil, were collected. RESULTS Regarding nutritional status, 83, 11 and 6% showed eutrophia, overweight/obesity and low weight, respectively, and 61% presented high body fat percent. Total cholesterol presented the highest percentage of inadequacy (57%), followed by high-density lipoprotein (HDL - 50%), low-density lipoprotein (LDL - 47%) and triacylglycerol (22%). Inadequacy was observed in 11, 9, 3 and 4% in relation to insulin resistance, fasting insulin, blood pressure and glycemia, respectively. The highest values of the fasting insulin and the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) were verified at the highest quartiles of body mass index (BMI), waist perimeter, waist-to-height ratio and body fat percent. Body mass index, waist perimeter, and waist-to-height ratio were the better predictors for high levels of HOMA-IR, blood glucose and fasting insulin. Waist-to-hip ratio was associated to arterial hypertension diagnosis. All body composition variables were effective in metabolic syndrome diagnosis. CONCLUSIONS Waist perimeter, BMI and waist-to-height ratio showed to be good predictors for metabolic alterations in female adolescents and then should be used together for the nutritional assessment in this age range.
Collapse
|
17
|
Moura RDSSES, Vasconcelos DF, Freitas E, de Moura FJD, Rosa TT, Veiga JPR. Cystatin C, CRP, log TG/HDLc and metabolic syndrome are associated with microalbuminuria in hypertension. Arq Bras Cardiol 2014; 102:54-9. [PMID: 24162470 PMCID: PMC3987393 DOI: 10.5935/abc.20130210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 06/24/2013] [Accepted: 07/22/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND In patients with systemic hypertension, microalbuminuria is a marker of endothelial damage and is associated with an increased risk for cardiovascular disease. OBJECTIVE To determine the factors that may lead to the occurrence of microalbuminuria in hypertensive patients with serum creatinine lower than 1.5 mg/dL. METHODS This cross-sectional study included 133 Brazilians with essential hypertension followed up at a hypertension outpatient clinic. Those with serum creatinine higher than 1.5 mg/dL, as well as those with diabetes mellitus, were excluded. Systolic and diastolic blood pressures were measured, and body mass index (BMI) and GFR estimated by using the CKD-EPI formula were calculated. The serum levels of the following were assessed: CysC, creatinine, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, C-reactive protein (CRP) and fasting glucose. Microalbuminuria was determined in 24-hour urine. Hypertensive patients were classified according to the presence of one or more criteria for metabolic syndrome. RESULTS In a multiple regression analysis, the serum levels of CysC and CRP, the atherogenic index log TG/HDLc and the presence of three or more criteria for metabolic syndrome were positively correlated with microalbuminuria (r2: 0.277, p < 0.05). CONCLUSION CysC, CRP, log TG/HDLc, and the presence of three or more criteria for metabolic syndrome, regardless of serum creatinine, were associated with microalbuminuria, an early marker of kidney damage and cardiovascular risk in patients with essential hypertension.
Collapse
Affiliation(s)
| | | | - Eduardo Freitas
- Departamento de Estatística, Universidade de Brasília, Brasília, DF -
Brazil
| | - Flavio José Dutra de Moura
- Área de Clínica Médica, Nefrologia, Faculdade de Medicina, Universidade
de Brasília, Brasília, DF - Brazil
| | - Tânia Torres Rosa
- Área de Clínica Médica, Nefrologia, Faculdade de Medicina, Universidade
de Brasília, Brasília, DF - Brazil
| | - Joel Paulo Russomano Veiga
- Área de Clínica Médica, Nefrologia, Faculdade de Medicina, Universidade
de Brasília, Brasília, DF - Brazil
| |
Collapse
|
18
|
de Sá EQC, de Sá FCF, Oliveira KC, Feres F, Verreschi ITN. Association between sex hormone-binding globulin (SHBG) and metabolic syndrome among men. SAO PAULO MED J 2014; 132:111-5. [PMID: 24714992 PMCID: PMC10896580 DOI: 10.1590/1516-3180.2014.1322666] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 07/14/2013] [Accepted: 07/16/2013] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Metabolic syndrome consists of a set of factors that imply increased risk of cardiovascular diseases. The objective here was to evaluate the association between sex hormone-binding globulin (SHBG), sex hormones and metabolic syndrome among men. DESIGN AND SETTING Retrospective analysis on data from the study "Endogenous oestradiol but not testosterone is related to coronary artery disease in men", conducted in a hospital in São Paulo. METHODS Men (aged 40-70) who underwent coronary angiography were selected. The age, weight, height, waist circumference, body mass index and prevalence of dyslipidemia, hypertension and diabetes of each patient were registered. Metabolic syndrome was defined in accordance with the criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP-ATPIII). Serum samples were collected to assess the levels of glucose, total cholesterol, HDL-cholesterol (high density lipoprotein), triglycerides, albumin, SHBG, estradiol and total testosterone (TT). The levels of LDL-cholesterol (low density lipoprotein) were calculated using Friedewald's formula and free testosterone (FT) and bioavailable testosterone (BT) using Vermeulen's formula. RESULTS 141 patients were enrolled in the study. The prevalence of metabolic syndrome was significantly higher in the first SHBG tercile than in the second and third terciles. A statistically significant positive association between the SHBG and TT values was observed, but no such association was seen between SHBG, BT and FT. CONCLUSION Low serum levels of SHBG are associated with higher prevalence of metabolic syndrome among male patients, but further studies are required to confirm this association.
Collapse
Affiliation(s)
| | | | | | - Fausto Feres
- MD, PhD. Cardiologist and Hemodynamicist, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
| | | |
Collapse
|
19
|
Sarmento PLDFA, Plavnik FL, Scaciota A, Lima JO, Miranda RB, Ajzen SA. Relationship between cardiovascular risk factors and the echogenicity and pattern of the carotid intima-media complex in men. SAO PAULO MED J 2014; 132:97-104. [PMID: 24714990 PMCID: PMC10896581 DOI: 10.1590/1516-3180.2014.1322490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 05/30/2013] [Accepted: 06/27/2013] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE The thickness of the carotid intima-media complex (C-IMC) is considered to be a marker of early atherosclerosis, but visual and echogenic changes to the C-IMC can also be noted. The objective here was to evaluate the relationship between cardiovascular risk factors and the echogenicity of the C-IMC and identify those most associated with an "abnormal" C-IMC. DESIGN AND SETTING Cross-sectional study in the ultrasound sector of the Department of Diagnostic Imaging, Universidade Federal de São Paulo. METHODS Eighty men were evaluated. Measurements of arterial blood pressure, waist circumference (WC), lipid profile, fasting glucose, uric acid and high-sensitivity C-reactive protein were obtained. The thickness of the C-IMC was measured by means of B-mode ultrasound, and the intima-media gray-scale mean (IM-GSM) and standard deviation (IM-SD) were calculated. RESULTS The following were discriminating variables: fasting glucose (r2 = 0.036; P = 0.013), uric acid (r2 = 0.08; P = 0.03), IM-SD (r2 = 0.43; P < 0.001), IM-GSM (r2 = 0.35; P < 0.001) and thickness of the C-IMC (r2 = 0.29; P < 0.001). IM-GSM showed significant correlations with WC (r = -0.22; P = 0.005), fasting glucose (r = -0.24; P = 0.002) and high-density lipoprotein cholesterol (HDL-C) (r = 0.27; P = 0.0007). CONCLUSION IM-GSM showed correlations with WC, fasting glucose and HDL-C. However, uric acid and IM-SD presented the greatest discriminating impact. These results suggest that visual changes in C-IMC may help identify patients with potential cardiovascular risk, independently of the thickness of the C-IMC.
Collapse
Affiliation(s)
| | - Frida Liane Plavnik
- MD, MSc, PhD. Affiliate Professor, Department of Nephrology, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - Andrea Scaciota
- BSc. Computer Graphics Specialist, Coordinator of Teaching and Research Support for Residents and Postgraduate Students, Department of Diagnostic Imaging, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - Joab Oliveira Lima
- MD, PhD. Adjunct Professor, Department of Statistics, Universidade Federal da Paraíba (UFPB), João Pessoa, Paraíba, Brazil
| | - Robson Barbosa Miranda
- MD. Assistant Professor, Department of Surgery, Faculdade de Medicina do ABC (FMABC), Santo André, São Paulo, Brazil
| | - Sergio Aron Ajzen
- MD, MSc, PhD. Titular Professor, Head of the Department of Diagnostic Imaging, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| |
Collapse
|
20
|
Caponi PW, Lehnen AM, Pinto GH, Borges J, Markoski M, Machado UF, Schaan BD. Aerobic exercise training induces metabolic benefits in rats with metabolic syndrome independent of dietary changes. Clinics (Sao Paulo) 2013; 68:1010-7. [PMID: 23917668 PMCID: PMC3714777 DOI: 10.6061/clinics/2013(07)20] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 03/05/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES We evaluated the effects of aerobic exercise training without dietary changes on cardiovascular and metabolic variables and on the expression of glucose transporter Type 4 in rats with metabolic syndrome. METHODS Twenty male spontaneously hypertensive rats received monosodium glutamate during the neonatal period. The animals were allocated to the following groups: MS (sedentary metabolic syndrome), MS-T (trained on a treadmill for 1 hour/day, 5 days/week for 10 weeks), H (sedentary spontaneously hypertensive rats) and H-T (trained spontaneously hypertensive rats). The Lee index, blood pressure (tail-cuff system), insulin sensitivity (insulin tolerance test) and functional capacity were evaluated before and after 10 weeks of training. Glucose transporter Type 4 expression was analyzed using Western blotting. The data were compared using analysis of variance (ANOVA) (p<0.05). RESULTS At baseline, the MS rats exhibited lower insulin sensitivity and increased Lee index compared with the H rats. Training decreased the body weight and Lee index of the MS rats (MS-T vs. MS), but not of the H rats (H-T vs. H). There were no differences in food intake between the groups. At the end of the experiments, the systolic blood pressure was lower in the two trained groups than in their sedentary controls. Whole-body insulin sensitivity increased in the trained groups. Glucose transporter Type 4 content increased in the heart, white adipose tissue and gastrocnemius muscle of the trained groups relative to their respective untrained groups. CONCLUSION In conclusion, the present study shows that an isolated aerobic exercise training intervention is an efficient means of improving several components of metabolic syndrome, that is, training reduces obesity and hypertension and increases insulin sensitivity.
Collapse
Affiliation(s)
- Paula Wesendonck Caponi
- Medicina Experimental, Fundação Universitária de Cardiologia, Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre/RS, Brazil
| | | | | | | | | | | | | |
Collapse
|
21
|
Pimenta AM, Felisbino-Mendes MS, Velasquez-Melendez G. Clustering and combining pattern of metabolic syndrome components in a rural Brazilian adult population. SAO PAULO MED J 2013; 131:213-9. [PMID: 24141291 PMCID: PMC10871831 DOI: 10.1590/1516-3180.2013.1314326] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 06/26/2011] [Accepted: 11/26/2012] [Indexed: 12/19/2022] Open
Abstract
CONTEXT AND OBJECTIVE Metabolic syndrome is characterized by clustering of cardiovascular risk factors such as obesity, dyslipidemia, insulin resistance, hyperinsulinemia, glucose intolerance and arterial hypertension. The aim of this study was to estimate the probability of clustering and the combination pattern of three or more metabolic syndrome components in a rural Brazilian adult population. DESIGN AND SETTING This was a cross-sectional study conducted in two rural communities located in the Jequitinhonha Valley, Minas Gerais, Brazil. METHODS The sample was composed of 534 adults (both sexes). Waist circumference, blood pressure and demographic, lifestyle and biochemical characteristics were assessed. The prevalences of metabolic syndrome and its components were estimated using the definitions of the National Cholesterol Education Program - Adult Treatment Panel III. A binomial distribution equation was used to evaluate the probability of clustering of metabolic syndrome components. The statistical significance level was set at 5% (P < 0.05). RESULTS Metabolic syndrome was more frequent among women (23.3%) than among men (6.5%). Clustering of three or more metabolic syndrome components was greater than expected by chance. The commonest combinations of three metabolic syndrome components were: hypertriglyceridemia + low levels of HDL-c + arterial hypertension and abdominal obesity + low levels of HDL-c + arterial hypertension; and of four metabolic syndrome components: abdominal obesity + hypertriglyceridemia + low levels of HDL-c + arterial hypertension. CONCLUSION The population studied presented high prevalence of metabolic syndrome among women and clustering of its components greater than expected by chance, suggesting that the combination pattern was non-random.
Collapse
Affiliation(s)
- Adriano Marçal Pimenta
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo HorizonteMinas Gerais, Brazil
| | | | | |
Collapse
|
22
|
Rosende A, Pellegrini C, Iglesias R. [Obesity and metabolic syndrome in children and adolescents]. Medicina (B Aires) 2013; 73:470-481. [PMID: 24152409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Obesity and the metabolic syndrome are closely related to the cases of cardiovascular disease; they are usually regarded as belonging to the adult population but are seen with increasing frequency in children and adolescents. There is evidence that atherosclerotic lesions occur most often in young people with obesity. The factors involved in this pandemic are manifold and range from genetic-biological to cultural changes. The family and the environment in which the child develops play a key role in the adoption of habits related to diet and physical activity. This problem does not respect borders and cultures but all countries are being affected, even more those of middle-income. State and Society as a whole can play a role oriented to modify this environment. The restriction on sales of unhealthy food and the fight against the sedentary lifestyle are urgently needed to be applied. The impact that these disorders will have in terms of cardiovascular disease, has not yet reached its true dimension.
Collapse
Affiliation(s)
- Andrés Rosende
- Servicio de Cardiología, Sanatorio de la Trinidad Mitre, Buenos Aires
| | | | | |
Collapse
|
23
|
Naveed B, Weiden MD, Kwon S, Gracely EJ, Comfort AL, Ferrier N, Kasturiarachchi KJ, Cohen HW, Aldrich TK, Rom WN, Kelly K, Prezant DJ, Nolan A. Metabolic syndrome biomarkers predict lung function impairment: a nested case-control study. Am J Respir Crit Care Med 2012; 185:392-9. [PMID: 22095549 PMCID: PMC3297095 DOI: 10.1164/rccm.201109-1672oc] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 11/04/2011] [Indexed: 01/16/2023] Open
Abstract
RATIONALE Cross-sectional studies demonstrate an association between metabolic syndrome and impaired lung function. OBJECTIVES To define if metabolic syndrome biomarkers are risk factors for loss of lung function after irritant exposure. METHODS A nested case-control study of Fire Department of New York personnel with normal pre-September 11th FEV(1) and who presented for subspecialty pulmonary evaluation before March 10, 2008. We correlated metabolic syndrome biomarkers obtained within 6 months of World Trade Center dust exposure with subsequent FEV(1). FEV(1) at subspecialty pulmonary evaluation within 6.5 years defined disease status; cases had FEV(1) less than lower limit of normal, whereas control subjects had FEV(1) greater than or equal to lower limit of normal. MEASUREMENTS AND MAIN RESULTS Clinical data and serum sampled at the first monitoring examination within 6 months of September 11, 2001, assessed body mass index, heart rate, serum glucose, triglycerides and high-density lipoprotein (HDL), leptin, pancreatic polypeptide, and amylin. Cases and control subjects had significant differences in HDL less than 40 mg/dl with triglycerides greater than or equal to 150 mg/dl, heart rate greater than or equal to 66 bpm, and leptin greater than or equal to 10,300 pg/ml. Each increased the odds of abnormal FEV(1) at pulmonary evaluation by more than twofold, whereas amylin greater than or equal to 116 pg/ml decreased the odds by 84%, in a multibiomarker model adjusting for age, race, body mass index, and World Trade Center arrival time. This model had a sensitivity of 41%, a specificity of 86%, and a receiver operating characteristic area under the curve of 0.77. CONCLUSIONS Abnormal triglycerides and HDL and elevated heart rate and leptin are independent risk factors of greater susceptibility to lung function impairment after September 11, 2001, whereas elevated amylin is protective. Metabolic biomarkers are predictors of lung disease, and may be useful for assessing risk of impaired lung function in response to particulate inhalation.
Collapse
Affiliation(s)
- Bushra Naveed
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, New York
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York City, Brooklyn, New York
| | - Michael D. Weiden
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, New York
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York City, Brooklyn, New York
| | - Sophia Kwon
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, New York
| | - Edward J. Gracely
- Drexel University College of Medicine and Drexel University School of Public Health, Philadelphia, Pennsylvania
| | - Ashley L. Comfort
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, New York
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York City, Brooklyn, New York
| | - Natalia Ferrier
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, New York
| | - Kusali J. Kasturiarachchi
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, New York
| | - Hillel W. Cohen
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Thomas K. Aldrich
- Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - William N. Rom
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, New York
| | - Kerry Kelly
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York City, Brooklyn, New York
| | - David J. Prezant
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York City, Brooklyn, New York
- Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Anna Nolan
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, New York
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York City, Brooklyn, New York
| |
Collapse
|
24
|
Colas R, Sassolas A, Guichardant M, Cugnet-Anceau C, Moret M, Moulin P, Lagarde M, Calzada C. LDL from obese patients with the metabolic syndrome show increased lipid peroxidation and activate platelets. Diabetologia 2011; 54:2931-40. [PMID: 21847583 PMCID: PMC3367234 DOI: 10.1007/s00125-011-2272-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 07/14/2011] [Indexed: 10/17/2022]
Abstract
AIMS/HYPOTHESIS This study assessed oxidative stress in LDL from obese patients with the metabolic syndrome and compared it with that in LDL from type 2 diabetic patients or control volunteers. It also determined the effect on platelets of LDL from the three groups. METHODS The profiles of lipids, fatty acids and fatty acid oxidation products were determined in LDL isolated from plasma of patients with the metabolic syndrome, patients with type 2 diabetes and volunteers (n = 10 per group). The effects of LDL from the participant groups on the platelet arachidonic acid signalling cascade and aggregation were investigated. RESULTS Compared with LDL from control volunteers, LDL from obese metabolic syndrome and type 2 diabetic patients had lower cholesteryl ester, higher triacylglycerol and lower ethanolamine plasmalogen levels. Proportions of linoleic acid were decreased in phosphatidylcholine and cholesteryl esters in LDL from both patient groups. Among the markers of lipid peroxidation, oxidation products of linoleic acid (hydroxy-octadecadienoic acids) and malondialdehyde were increased by 59% and twofold, respectively in LDL from metabolic syndrome and type 2 diabetic patients. LDL from metabolic syndrome and type 2 diabetic patients were equally potent in activating the platelet arachidonic acid signalling cascade through increased phosphorylation of p38 mitogen-activated protein kinase and cytosolic phospholipase A(2), and through increased thromboxane B(2) formation. LDL from patients with the metabolic syndrome and type 2 diabetes potentiated platelet aggregation by threefold and 3.5-fold respectively, whereas control LDL had no activating effects on platelets. CONCLUSIONS/INTERPRETATION The metabolic syndrome in obese patients, without or with diabetes, is associated with increased oxidative stress in LDL, which triggers platelet activation.
Collapse
Affiliation(s)
- Romain Colas
- CARMEN, Laboratoire de recherche en cardiovasculaire, métabolisme, diabétologie et nutrition
INSERM : U1060INRAInstitut National des Sciences Appliquées de LyonUniversité Claude Bernard - Lyon IHospices Civils de LyonFaculté de Médecine Lyon Sud - BP 12 - 165 Chemin du Grand Revoyet - 69921 Oullins cedex INSA, Bât. IMBL, La Doua - 11 Avenue Jean Capelle - 69621 Villeurbanne Cedex,FR
| | - Agnès Sassolas
- CARMEN, Laboratoire de recherche en cardiovasculaire, métabolisme, diabétologie et nutrition
INSERM : U1060INRAInstitut National des Sciences Appliquées de LyonUniversité Claude Bernard - Lyon IHospices Civils de LyonFaculté de Médecine Lyon Sud - BP 12 - 165 Chemin du Grand Revoyet - 69921 Oullins cedex INSA, Bât. IMBL, La Doua - 11 Avenue Jean Capelle - 69621 Villeurbanne Cedex,FR
| | - Michel Guichardant
- CARMEN, Laboratoire de recherche en cardiovasculaire, métabolisme, diabétologie et nutrition
INSERM : U1060INRAInstitut National des Sciences Appliquées de LyonUniversité Claude Bernard - Lyon IHospices Civils de LyonFaculté de Médecine Lyon Sud - BP 12 - 165 Chemin du Grand Revoyet - 69921 Oullins cedex INSA, Bât. IMBL, La Doua - 11 Avenue Jean Capelle - 69621 Villeurbanne Cedex,FR
| | | | - Myriam Moret
- Fédération d'endocrinologie
Hospices Civils de LyonBron,FR
| | - Philippe Moulin
- CARMEN, Laboratoire de recherche en cardiovasculaire, métabolisme, diabétologie et nutrition
INSERM : U1060INRAInstitut National des Sciences Appliquées de LyonUniversité Claude Bernard - Lyon IHospices Civils de LyonFaculté de Médecine Lyon Sud - BP 12 - 165 Chemin du Grand Revoyet - 69921 Oullins cedex INSA, Bât. IMBL, La Doua - 11 Avenue Jean Capelle - 69621 Villeurbanne Cedex,FR
- Fédération d'endocrinologie
Hospices Civils de LyonBron,FR
| | - Michel Lagarde
- CARMEN, Laboratoire de recherche en cardiovasculaire, métabolisme, diabétologie et nutrition
INSERM : U1060INRAInstitut National des Sciences Appliquées de LyonUniversité Claude Bernard - Lyon IHospices Civils de LyonFaculté de Médecine Lyon Sud - BP 12 - 165 Chemin du Grand Revoyet - 69921 Oullins cedex INSA, Bât. IMBL, La Doua - 11 Avenue Jean Capelle - 69621 Villeurbanne Cedex,FR
| | - Catherine Calzada
- CARMEN, Laboratoire de recherche en cardiovasculaire, métabolisme, diabétologie et nutrition
INSERM : U1060INRAInstitut National des Sciences Appliquées de LyonUniversité Claude Bernard - Lyon IHospices Civils de LyonFaculté de Médecine Lyon Sud - BP 12 - 165 Chemin du Grand Revoyet - 69921 Oullins cedex INSA, Bât. IMBL, La Doua - 11 Avenue Jean Capelle - 69621 Villeurbanne Cedex,FR
- * Correspondence should be adressed to: Catherine Calzada
| |
Collapse
|
25
|
Abstract
PURPOSE This study aimed to estimate the prevalence of metabolic syndrome (MetS) in adolescents and adults and to compare the impact of body mass index (BMI) on MetS between adolescents and adults in Korea. MATERIALS AND METHODS Data were used from 6,186 subjects aged 10 years or more who representatively participated in the Third Korean National Health and Nutrition Examination Survey. Body composition, blood test, and health behavioral factors were measured. We used the definition of MetS from the modified the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) for adolescents and the NCEP-ATP Ⅲ for adults. RESULTS The prevalence of MetS was 6.4 (95% CI 4.5-8.4) and 22.3 (95% CI 20.8-23.8) in adolescents and adults, respectively. The prevalence of MetS among normal, overweight and obese body types for both adolescents and adults differed significantly (p<0.001). After adjustment for covariates, the odds ratios (ORs) of obese and overweight body types on MetS compared with normal BMI in adolescents were 28.1 (95% CI 11.4-69.1) and 8.7 (95% CI 2.3-33.1), respectively. The ORs of obesity on MetS were 32.0 (95% CI 7.5-136.9), 32.2 (95% CI 12.8-80.8), 16.2 (95% CI 9.4-27.9), 7.6 (95% CI 4.7-12.2) and 9.9 (95% CI 6.8-14.6) for subjects in their 20's, 30's, 40's, 50's and older than 60, in order. CONCLUSION We found that the prevalence of MetS increased with age and was more prevalent in males. Moreover, the group younger than 39 years of age had a higher chance of having MetS than the group older than 40 years of age. Weight control is more vital in the earlier stages of life for the prevention and management of MetS.
Collapse
Affiliation(s)
- Soo Jeong Kim
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Jakyoung Lee
- Department of Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Chung Mo Nam
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Soon Young Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| |
Collapse
|
26
|
Gala TR, Seaman DR. Lifestyle modifications and the resolution of obstructive sleep apnea syndrome: a case report. J Chiropr Med 2011; 10:118-25. [PMID: 22014867 PMCID: PMC3110415 DOI: 10.1016/j.jcm.2010.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Revised: 12/29/2010] [Accepted: 12/29/2010] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This purpose of this case study is to describe a natural method to help in management of obstructive sleep apnea syndrome (OSAS), which is known to be a common and debilitating condition. CLINICAL FEATURES Obstructive sleep apnea syndrome is typically managed with a continuous positive airway pressure (CPAP) device, which the patient wears during sleep to help maintain respiration. This report describes the chiropractic management and resolution of OSAS with dietary modifications in a 55-year-old man who wore a CPAP for 10 years. INTERVENTION AND OUTCOME After adhering to dietary modifications for 3 months, the patient no longer required the use of the CPAP device and continues to have a normal active lifestyle almost 7 years later. CONCLUSION Dietary modifications may be an effective tool to improve the management of OSAS.
Collapse
Affiliation(s)
| | - David R. Seaman
- Professor of Clinical Sciences, National University of Health Sciences, Pinellas Park, FL 33781
| |
Collapse
|
27
|
van Vliet M, Gazendam RP, von Rosenstiel IA, van Zanten AP, Brandjes DPM, Beijnen JH, Rotteveel J, Diamant M. Differential impact of impaired fasting glucose versus impaired glucose tolerance on cardiometabolic risk factors in multi-ethnic overweight/obese children. Eur J Pediatr 2011; 170:589-97. [PMID: 20960007 PMCID: PMC3078320 DOI: 10.1007/s00431-010-1323-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Accepted: 09/28/2010] [Indexed: 11/24/2022]
Abstract
We aimed to investigate the prevalence of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), and their associations with cardiometabolic risk factors, according to ethnicity in a large obese paediatric cohort. A 75-g oral glucose tolerance test was performed in 1,007 overweight/obese Dutch children of multi-ethnic origin, referred to the obesity outpatient clinics of two Dutch hospitals in Amsterdam (mean age, 11.4 ± 3.2 years; 50.7% boys). Anthropometric parameters and blood samples were collected, and cardiometabolic risk factors were assessed. The cohort consisted of Dutch native (26.0%), Turkish (23.7%), Moroccan (18.8%) and children of 'other' (31.5%) ethnicity. The prevalence of IFG was significantly higher in Moroccan and Turkish children as compared to Dutch native children (25.4% and 19.7% vs. 11.8%, respectively, P < 0.05). IGT was most frequently present in Turkish and Dutch native children, relative to Moroccan children (6.3% and 5.3% vs. 1.6%, P < 0.05). Besides pubertal status and ethnicity, components of 'metabolic syndrome' (MetS) which were associated with IGT, independent of hyperinsulinaemia, were hypertension [odds ratio (OR), 2.3; 95% CI, 1.1-4.9] while a trend was seen for high triglycerides (OR, 2.0; 95% CI, 0.9-4.3). When analyzing components of MetS which were associated with IFG, only low high-density lipoprotein cholesterol was significantly associated (OR, 1.7; 95% CI, 1.2-2.5) independent of hyperinsulinaemia. In conclusion, in a Dutch multi-ethnic cohort of overweight/obese children, a high prevalence of IFG was found against a low prevalence of IGT, which differed in their associations with cardiometabolic risk factors.
Collapse
Affiliation(s)
- Mariska van Vliet
- Department of Paediatrics, Slotervaart Hospital, Amsterdam, The Netherlands,
| | - Roel P. Gazendam
- Department of Internal Medicine, Diabetes Centre, VU University Medical Centre, Haarlem, The Netherlands
| | | | - Anton P. van Zanten
- Department of Clinical Chemistry, Slotervaart Hospital, Amsterdam, The Netherlands
| | | | - Jos H. Beijnen
- Department Pharmacy and Pharmacology, Slotervaart Hospital, Amsterdam, The Netherlands
| | - Joost Rotteveel
- Department of Paediatrics, VU University Medical Centre, Haarlem, The Netherlands
| | - Michaela Diamant
- Department of Internal Medicine, Diabetes Centre, VU University Medical Centre, Haarlem, The Netherlands
| |
Collapse
|
28
|
Zambon JP, Mendonça RRD, Wroclawski ML, Karam Junior A, Santos RD, Carvalho JAMD, Wroclawski ER. Cardiovascular and metabolic syndrome risk among men with and without erectile dysfunction: case-control study. SAO PAULO MED J 2010; 128:137-40. [PMID: 20963365 PMCID: PMC10938961 DOI: 10.1590/s1516-31802010000300006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Revised: 02/08/2010] [Accepted: 04/09/2010] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Erectile dysfunction has been associated with cardiovascular diseases. The aim here was to evaluate cardiovascular risk through the Framingham Risk Score (FRS) criteria, C-reactive protein (CRP) assays and presence of metabolic syndrome (MS) in men with and without erectile dysfunction diagnosed within a healthcare program. DESIGN AND SETTING A retrospective case-control study was conducted. The patients were selected from a healthcare program at the Hospital Israelita Albert Einstein, between January and December 2007. METHODS 222 men were retrospectively selected, and they were divided into two groups: men with erectile dysfunction (n = 111) and men without erectile dysfunction (n = 111). The patients were stratified according to the International Index of Erectile Function-Erectile Function domain (IIEF-EF domain). CRP and FRS were analyzed and the two groups were compared. RESULTS The CRP levels were significantly higher among men with erectile dysfunction (P = 0.04). Patients with erectile dysfunction also had high FRS (P = 0.0015). CRP and FRS did not correlate with the severity of erectile dysfunction. The presence of metabolic syndrome was greater among men with erectile dysfunction (P < 0.05). The severity of erectile dysfunction was directly associated with metabolic syndrome. CONCLUSION Men with erectile dysfunction presented higher cardiovascular risk according to the FRS criteria and CRP measurements. Severe erectile dysfunction seemed to have a correlation with metabolic syndrome.
Collapse
|
29
|
Vissers D, Verrijken A, Mertens I, Van Gils C, Van de Sompel A, Truijen S, Van Gaal L. Effect of long-term whole body vibration training on visceral adipose tissue: a preliminary report. Obes Facts 2010; 3:93-100. [PMID: 20484941 PMCID: PMC6452127 DOI: 10.1159/000301785] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
AIM To determine the effect of whole body vibration (WBV), combined with caloric restriction, on weight, body composition and metabolic risk factors in overweight and obese adults. METHODS A randomized, controlled study with a 6-month intervention period and a 6-month 'no intervention' follow-up. 61 of the 79 participants completed the study. Data were collected at baseline and at 3, 6 and 12 months in the control group (CONTROL), the diet only group (DIET), the diet plus fitness group (FITNESS) and the diet plus WBV group (VIBRATION). RESULTS Weight decreased significantly in all three intervention groups. Only FITNESS and VIBRATION managed to maintain a weight loss of 5% or more in the long term. Visceral adipose tissue (VAT) changed most in VIBRATION: -47.8 +/- 41.2 and -47.7 +/- 45.7 cm2 after 6 and 12 months respectively compared to CONTROL (-3.6 +/- 20.5 or +26.3 +/- 30.6 cm(2)), DIET (-24.3 +/- 29.8 or -7.5 +/- 28.3 cm(2)) and FITNESS (-17.6 +/- 36.6 or -1.6 +/- 33.3 cm(2)) (p < 0.001). CONCLUSIONS Combining aerobic exercise or WBV training with caloric restriction can help to achieve a sustained long-term weight loss of 5-10%. These preliminary data show that WBV training may have the potential to reduce VAT more than aerobic exercise in obese adults, possibly making it a meaningful addition to future weight loss programs.
Collapse
Affiliation(s)
- Dirk Vissers
- Department of Health Sciences – Physiotherapy, University College of Antwerp, Antwerp, Belgium
- Faculty of Medicine, University of Antwerp, Antwerp, Belgium
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - An Verrijken
- Faculty of Medicine, University of Antwerp, Antwerp, Belgium
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - Ilse Mertens
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - Caroline Van Gils
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - Annemie Van de Sompel
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - Steven Truijen
- Department of Health Sciences – Physiotherapy, University College of Antwerp, Antwerp, Belgium
| | - Luc Van Gaal
- Faculty of Medicine, University of Antwerp, Antwerp, Belgium
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
- *Prof. Dr. Luc Van Gaal Department of Endocrinology, Diabetology and Metabolism Antwerp University Hospital Wilrijkstraat 10, 2650 Edegem, Belgium Tel. +32 3 82–13266, Fax -54980
| |
Collapse
|
30
|
Abstract
UNLABELLED Nonalcoholic fatty liver disease is a burgeoning problem. We have previously shown that Hispanics were at greater risk for nonalcoholic fatty liver disease than were African-Americans despite a similar prevalence of risk factors between these groups. We have performed the largest, population-based study to date (n = 2170) utilizing proton magnetic resonance (MR) spectroscopy, dual-energy x-ray absorptiometry, and multislice abdominal MR imaging to determine the contribution of body fat distribution to the differing prevalence of hepatic steatosis in the three major U.S. ethnic groups (African-American, Hispanic, Caucasian). Despite controlling for age and total adiposity, African-Americans had less intraperitoneal (IP) fat and more lower extremity fat than their Hispanic and Caucasian counterparts. The differences in hepatic triglyceride content (HTGC) between these groups remained after controlling for total, abdominal subcutaneous, and lower extremity adiposity; however, controlling for IP fat nearly abolished the differences in HTGC, indicating a close association between IP and liver fat regardless of ethnicity. Despite the lower levels of IP and liver fat in African-Americans, their prevalence of insulin resistance was similar to Hispanics, who had the highest levels of IP and liver fat. Furthermore, insulin levels and homeostasis model assessment values were highest and serum triglyceride levels were lowest among African-Americans after controlling for IP fat. CONCLUSION IP fat is linked to HTGC, irrespective of ethnicity. The differing prevalence of hepatic steatosis between these groups was associated with similar differences in visceral adiposity. The metabolic response to obesity and insulin resistance differs in African-Americans when compared to either Hispanics or Caucasians: African-Americans appear to be more resistant to both the accretion of triglyceride in the abdominal visceral compartment (adipose tissue and liver) and hypertriglyceridemia associated with insulin resistance.
Collapse
Affiliation(s)
- Richard Guerrero
- Department of Internal Medicine, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA,Advanced Imaging Research Center, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - Gloria L. Vega
- Donald W. Reynolds Cardiovascular Clinical Research Center, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA,Center for Human Nutrition, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| | - Scott M. Grundy
- Donald W. Reynolds Cardiovascular Clinical Research Center, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA,Center for Human Nutrition, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA,Veterans Affairs Medical Center, Dallas, Texas, USA
| | - Jeffrey D. Browning
- Department of Internal Medicine, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA,Advanced Imaging Research Center, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
| |
Collapse
|
31
|
Abstract
We describe here the case of a 39-year-old woman with a cortisol-producing adrenal adenoma and she presented with endometrial hyperplasia and hypertension without the specific characteristics of Cushing's syndrome. The patient had consulted a gynecologist for menometrorrhagia 2 years prior to her referral and she was diagnosed with endometrial hyperplasia and hypertension. Her blood pressure and the endometrial lesion were refractory despite taking multiple antihypertensives and repetitive dilation and curettage and progestin treatment. On admission, the clinical examination revealed mild central obesity (a body mass index of 22.9 kg/m2, a waist circumference of 85 cm and a hip circumference of 94cm), but there was no hirsutism and myopathy. She showed impaired glucose tolerance on an oral glucose tolerance test. The biochemical hypercortisolemia together with the prolactin and androgen levels were evaluated to explore the cause of her anovulation. Adrenal Cushing's syndrome was confirmed on the basis of the elevated urinary free cortisol (454 microg/24h, normal range: 20-70) with a suppressed ACTH level (2.0 pg/mL, normal range: 6.0-76.0) and the loss of circadian cortisol secretion. A CT scan revealed a 3.1 cm, hyperechoic, well-marginated mass in the left adrenal gland. Ten months post-adrenalectomy, the patient had unintentionally lost 9 kg of body weight, had regained a regular menstrual cycle and had normal thickness of her endometrium.
Collapse
Affiliation(s)
- Sang Min Lee
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jong Ryeal Hahm
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
- Gyeongsang Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Tae Sik Jung
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
- Gyeongsang Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jung Hwa Jung
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Mi Yeon Kang
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Sun Joo Kim
- Department of Laboratory Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
- Gyeongsang Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Soon Il Chung
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
- Gyeongsang Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Korea
| |
Collapse
|
32
|
Siviero-Miachon AA, Spinola-Castro AM, Guerra-Junior G. Detection of metabolic syndrome features among childhood cancer survivors: a target to prevent disease. Vasc Health Risk Manag 2008; 4:825-36. [PMID: 19065999 PMCID: PMC2597761 DOI: 10.2147/vhrm.s2881] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Along with the growing epidemic of obesity, the risk of atherosclerosis, cardiovascular disease morbidity, and mortality are increasing markedly. Several risk factors for cardiovascular disease, such as visceral obesity, glucose intolerance, arterial hypertension, and dyslipidemia commonly cluster together as a condition currently known as metabolic syndrome. Thus far, insulin resistance, and endothelial dysfunction are the primary events of the metabolic syndrome. Several groups have recommended clinical criteria for the diagnosis of metabolic syndrome in adults. Nonetheless, in what concerns children and adolescents, there are no unified definitions, and modified adult criteria have been suggested by many authors, despite major problems. Some pediatric disease states are at risk for premature cardiovascular disease, with clinical coronary events occurring very early in adult life. Survivors of specific pediatric cancer groups, particularly acute lymphocytic leukemia, central nervous system tumors, sarcomas, lymphomas, testicular cancer, and following bone marrow transplantation, may develop metabolic syndrome traits due to: hormonal deficiencies (growth hormone deficiency, thyroid dysfunction, and gonadal failure), drug or radiotherapy damage, endothelial impairment, physical inactivity, adipose tissue dysfunction, and/or drug-induced magnesium deficiency. In conclusion, some primary and secondary prevention remarks are proposed in order to reduce premature cardiovascular disease risk in this particular group of patients.
Collapse
Affiliation(s)
| | - Angela Maria Spinola-Castro
- Division of Pediatric Endocrinology, Department of Pediatrics, Federal University of Sao Paulo – UNIFESP/EPM, Brazil
| | - Gil Guerra-Junior
- Division of Pediatric Endocrinology, Department of Pediatrics, State University of Campinas – FCM/UNICAMP, Brazil
| |
Collapse
|
33
|
Hamburg NM, Larson MG, Vita JA, Vasan RS, Keyes MJ, Widlansky ME, Fox CS, Mitchell GF, Levy D, Meigs JB, Benjamin EJ. Metabolic syndrome, insulin resistance, and brachial artery vasodilator function in Framingham Offspring participants without clinical evidence of cardiovascular disease. Am J Cardiol 2008; 101:82-8. [PMID: 18157970 PMCID: PMC2214853 DOI: 10.1016/j.amjcard.2007.07.053] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2007] [Revised: 07/16/2007] [Accepted: 07/16/2007] [Indexed: 11/17/2022]
Abstract
The metabolic syndrome (MS), a clustering of metabolic disturbances, is associated with increased cardiovascular risk. Limited information is available about the relations between MS, insulin resistance, and vascular function. We measured brachial artery flow-mediated dilation (n = 2,123) and reactive hyperemia (n = 1,521) in Framingham Offspring participants without diabetes or clinical cardiovascular disease (mean age 59 +/- 9 years, 57% women). MS, determined by National Cholesterol Education Program criteria, was present in 36% of participants. Insulin resistance was determined using Homeostatic Model Assessment. In age- and gender-adjusted models, MS was associated with lower flow-mediated dilation and reactive hyperemia. There was progressively lower vasodilator function with increasing number of MS components (p for trend <0.0001). In multivariable models adjusting for the 5 MS components as continuous variables, MS (presence vs absence) remained associated with lower flow-mediated dilation (2.84 +/- 0.12% vs 3.17 +/- 0.08%, p = 0.0496) and reactive hyperemia (50.8 +/- 1.0 vs 54.4 +/- 0.7 cm/s, p = 0.009). Insulin resistance was inversely associated with flow-mediated dilation and reactive hyperemia in age- and gender-adjusted models, but these relations were not significant in models adjusting for the MS components. In conclusion, our observations are consistent with the hypothesis that MS and insulin resistance impair vascular function predominantly through the influence of the component metabolic abnormalities that comprise MS.
Collapse
Affiliation(s)
- Naomi M. Hamburg
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Martin G. Larson
- National Heart, Lung and Blood Institute’s Framingham Heart Study, Framingham, MA
- Department of Mathematics and Statistics, Boston University, Boston, MA
| | - Joseph A. Vita
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Ramachandran S. Vasan
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA
- National Heart, Lung and Blood Institute’s Framingham Heart Study, Framingham, MA
| | - Michelle J. Keyes
- National Heart, Lung and Blood Institute’s Framingham Heart Study, Framingham, MA
- Department of Mathematics and Statistics, Boston University, Boston, MA
| | | | - Caroline S. Fox
- National Heart, Lung and Blood Institute’s Framingham Heart Study, Framingham, MA
- Department of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | - Daniel Levy
- National Heart, Lung and Blood Institute’s Framingham Heart Study, Framingham, MA
| | - James B. Meigs
- General Medical Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Emelia J. Benjamin
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA
- National Heart, Lung and Blood Institute’s Framingham Heart Study, Framingham, MA
| |
Collapse
|
34
|
Norman D, Bardwell WA, Arosemena F, Nelesen R, Mills PJ, Loredo JS, Lavine JE, Dimsdale JE. Serum aminotransferase levels are associated with markers of hypoxia in patients with obstructive sleep apnea. Sleep 2008; 31:121-6. [PMID: 18220085 PMCID: PMC2225546 DOI: 10.1093/sleep/31.1.121] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
STUDY OBJECTIVES Nonalcoholic fatty liver disease (NAFLD) is a disorder that often presents with elevated serum aminotransferase levels. Although it has classically been linked with the metabolic syndrome, recent studies suggest NAFLD may also be associated with obstructive sleep apnea (OSA). This study evaluates the association between serum aminotransferase levels and factors connected with: either the metabolic syndrome (elevated body mass index [BMI], lipid profile, blood pressure, fasting glucose), or with OSA severity (apnea hypopnea index, lowest oxygen saturation level, oxygen desaturation index, percent of time below 90% saturation [%T<90]). DESIGN Retrospective case series. PATIENTS AND SETTING 109 adult patients with OSA at a university hospital general clinical research center. MEASUREMENTS AND RESULTS Markers of hypoxia (lowest oxygen saturation level and %T<90), correlated significantly with aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels (Pearson's r = -0.31 to -0.38, P <0.003), while apnea hypopnea index, body mass index, blood pressure, fasting glucose, triglyceride, and cholesterol levels did not. Hierarchical linear regression was then done to determine the best predictors of aminotransferase levels. Markers of metabolic syndrome were entered as one block and markers of sleep apnea as another. Regression analyses explained 16.3% of the variance in AST and 18.9% of the variance in ALT, with %T<90 playing the largest role. CONCLUSIONS In patients with obstructive sleep apnea, serum aminotransferase levels are better predicted by markers of oxygen desaturation than by factors traditionally associated with the metabolic syndrome.
Collapse
Affiliation(s)
- Daniel Norman
- Department of Pulmonary and Critical Care Medicine, University of California at San Diego, San Diego, CA 92103-8383, USA.
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Narisawa S, Nakamura K, Kato K, Yamada K, Sasaki J, Yamamoto M. Appropriate waist circumference cutoff values for persons with multiple cardiovascular risk factors in Japan: a large cross-sectional study. J Epidemiol 2008; 18:37-42. [PMID: 18305365 PMCID: PMC4771601 DOI: 10.2188/jea.18.37] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Accepted: 11/12/2007] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In Japan, the current standard waist circumference cutoff value for persons with multiple cardiovascular risk factors remains controversial. In this study we aimed to analyze the health-check examination data from a large Japanese population and propose a revised waist circumference cutoff value. METHODS Subjects of this study were 12,725 adults who underwent a health-check by thorough medical examination between April 2006 and March 2007. Medical examinations included measurement of waist circumference, fasting blood triglycerides, HDL cholesterol, glucose concentrations, blood pressure and collection of demographic characteristics. Receiver operating characteristic (ROC) curve analysis was utilized to find appropriate waist circumference cutoff values in relation to multiple cardiovascular risk factors with two or more of the following: dyslipidemia (hypertriglyceridemia or low HDL cholesterol), hypertension, and hyperglycemia defined by the Japanese criteria of metabolic syndrome. RESULTS The average age of the subjects was 50.7 years (standard deviation [SD]: 8.8) for men and 49.7 years (SD: 8.6) for women. ROC curve analysis showed maximum sensitivity plus specificity at a waist circumference of 87 cm in men (0.66 and 0.62, respectively) and 83 cm in women (0.73 and 0.70). When analyzed by ten-year age groups, the ROC curves for younger age groups were shifted up and to the left compared to older age groups, but associations between cutoff values and age were not clear. CONCLUSION In Japan, the appropriate cutoff value of waist circumference for persons with multiple cardiovascular risk factors is 87 cm for men and 83 cm for women.
Collapse
Affiliation(s)
- Sachiko Narisawa
- Department of Nursing, School of Health Sciences, Niigata University, Japan.
| | | | | | | | | | | |
Collapse
|
36
|
Karnikowski M, Córdova C, de Oliveira RJ, Karnikowski MGDO, Nóbrega ODT. Non-alcoholic fatty liver disease and metabolic syndrome in Brazilian middle-aged and older adults. SAO PAULO MED J 2007; 125:333-7. [PMID: 18317603 PMCID: PMC11020559 DOI: 10.1590/s1516-31802007000600006] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2006] [Revised: 11/14/2007] [Accepted: 11/23/2007] [Indexed: 12/17/2022] Open
Abstract
CONTEXT AND OBJECTIVES Non-alcoholic fatty liver disease (NAFLD) is a complex clinicopathological entity characterized by diffuse or focal fat accumulation in the hepatic parenchyma of patients who deny abusive alcohol consumption. This study aimed to assess idiopathic NAFLD in community-dwelling, middle-aged and older adults living in the Brazilian Federal District. Associations between NAFLD and components of metabolic syndrome and the whole syndrome were investigated. DESIGN AND SETTINGS This was a cross-sectional study on 139 subjects aged 55 years or older. METHODS NAFLD was diagnosed by means of clinical procedures, to exclude subjects with signs of liver disorders, abusive alcohol consumption and influence from hepatotoxic drugs. Phenotypes were graded based on ultrasound examination. Metabolic syndrome was defined using the NCEP ATP III criteria. Laboratory tests were performed to assist clinical examinations and define the syndrome. RESULTS NAFLD was present in 35.2% of the subjects. Taken together, the two most intense phenotypes correlated with increased serum fasting glucose, triglyceride and VLDL cholesterol levels. Metabolic syndrome was diagnosed in 25.9% of the sample. In addition to associating NAFLD with specific traits of metabolic syndrome, non-parametric analysis confirmed the existence of a relationship (p < 0.05) between the steatotic manifestation and the syndromic condition. CONCLUSION Compared with the literature, this study reveals greater frequency of idiopathic NAFLD among Brazilian middle-aged and older adults than is described elsewhere. The findings also suggest that impaired glycemic metabolism coupled with increased fat delivery and/or sustained endogenous biosynthesis is the most likely physiopathogenic mechanisms underlying the onset of NAFLD in this population.
Collapse
Affiliation(s)
- Mauro Karnikowski
- Stricto sensu postgraduate program in Gerontology, Universidade Católica de Brasília (UCB), Taguatinga, Federal District, Brazil
| | - Cláudio Córdova
- Stricto sensu postgraduate program in Gerontology, Universidade Católica de Brasília (UCB), Taguatinga, Federal District, Brazil
| | - Ricardo Jacó de Oliveira
- Stricto sensu postgraduate program in Gerontology, Universidade Católica de Brasília (UCB), Taguatinga, Federal District, Brazil
| | | | - Otávio de Tolêdo Nóbrega
- Stricto sensu postgraduate program in Gerontology, Universidade Católica de Brasília (UCB), Taguatinga, Federal District, Brazil
| |
Collapse
|
37
|
Velásquez-Meléndez G, Gazzinelli A, Côrrea-Oliveira R, Pimenta AM, Kac G. Prevalence of metabolic syndrome in a rural area of Brazil. SAO PAULO MED J 2007; 125:155-62. [PMID: 17923940 PMCID: PMC11020586 DOI: 10.1590/s1516-31802007000300006] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2006] [Revised: 05/08/2006] [Accepted: 05/23/2007] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Metabolic syndrome (MS) is recognized worldwide as an important public health concern. However, little information is available for rural populations in Brazil. The aim was to determine the prevalence and risk factors associated with MS in a rural village in Brazil in 2004. DESIGN AND SETTING Cross-sectional population-based study, in Virgem das Graças, a rural community in the Jequitinhonha Valley, State of Minas Gerais. METHODS MS was the dependent variable, defined as any three of these risk factors: arterial hypertension, high glucose or triglyceride concentrations, low high-density lipoprotein cholesterol and abdominal obesity. MS prevalence, according to selected socioeconomic and demographic variables (age, skin color, marital status, schooling and smoking habits), was determined in 251 subjects aged 20-88 years. Multivariate logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals. RESULTS MS prevalence was 21.6% (7.7% for men and 33.6% for women); the age-adjusted prevalence was 19.0%. The highest prevalences were observed for women > 60 years of age (52.9%) and women with body mass index (BMI) >or= 25 kg/m(2) (64%). Age, sex and BMI were associated risk factors for MS, while skin color was only significantly associated with MS for women. The models were adjusted for age, smoking habits, marital status, skin color and schooling. CONCLUSIONS BMI and age were independently associated factors for MS in this rural community. These findings provide important evidence on the prevalence of MS as a public health problem, particularly for women and overweight individuals.
Collapse
Affiliation(s)
- Gustavo Velásquez-Meléndez
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | | | | | | | | |
Collapse
|
38
|
Hsieh CH, Hung YJ, Wu DA, Kuo SW, Lee CH, Sheu WHH, Li JC, Yeh KH, Chen CY, Pei D. Impact of clinical characteristics of individual metabolic syndrome on the severity of insulin resistance in Chinese adults. J Korean Med Sci 2007; 22:74-80. [PMID: 17297255 PMCID: PMC2693573 DOI: 10.3346/jkms.2007.22.1.74] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The impact the metabolic syndrome (MetS) components on the severity of insulin resistance (IR) has not been reported. We enrolled 564 subjects with MetS and they were divided into quartiles according to the level of each component; and an insulin suppression test was performed to measure IR. In males, steady state plasma glucose (SSPG) levels in the highest quartiles, corresponding to body mass index (BMI) and fasting plasma glucose (FPG), were higher than the other three quartiles and the highest quartiles, corresponding to the diastolic blood pressure and triglycerides, were higher than in the lowest two quartiles. In females, SSPG levels in the highest quartiles, corresponding to the BMI and triglycerides, were higher than in all other quartiles. No significant differences existed between genders, other than the mean SSPG levels in males were greater in the highest quartile corresponding to BMI than that in the highest quartile corresponding to HDL-cholesterol levels. The factor analysis identified two underlying factors (IR and blood pressure factors) among the MetS variables. The clustering of the SSPG, BMI, triglyceride and HDLcholesterol was noted. Our data suggest that adiposity, higher FPG and triglyceride levels have stronger correlation with IR and subjects with the highest BMI have the highest IR.
Collapse
Affiliation(s)
- Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan, R.O.C
| | - Yi-Jen Hung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan, R.O.C
| | - Du-An Wu
- Buddhist Tzu Chi General Hospital, Xiandian, Taiwan, R.O.C
| | - Shi-Wen Kuo
- Buddhist Tzu Chi General Hospital, Xiandian, Taiwan, R.O.C
| | - Chien-Hsing Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan, R.O.C
| | | | - Jer-Chuan Li
- Buddhist Tzu Chi General Hospital, Xiandian, Taiwan, R.O.C
| | - Kuan-Hung Yeh
- Buddhist Tzu Chi General Hospital, Xiandian, Taiwan, R.O.C
| | - Cheng-Yu Chen
- Division of Family Practice, Buddhist Tzu Chi General Hospital, Xiandian, Taiwan, R.O.C
| | - Dee Pei
- Buddhist Tzu Chi General Hospital, Xiandian, Taiwan, R.O.C
| |
Collapse
|
39
|
Weinberg ME, Manson JE, Buring JE, Cook NR, Seely EW, Ridker PM, Rexrode KM. Low sex hormone-binding globulin is associated with the metabolic syndrome in postmenopausal women. Metabolism 2006; 55:1473-80. [PMID: 17046549 PMCID: PMC1633722 DOI: 10.1016/j.metabol.2006.06.017] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2005] [Accepted: 06/11/2006] [Indexed: 12/26/2022]
Abstract
Although an association between the metabolic syndrome and hyperandrogenism has been suggested in women with polycystic ovarian syndrome, few studies have investigated this relationship in postmenopausal women. We measured estradiol, testosterone, and sex hormone-binding globulin (SHBG) and calculated the free androgen index (FAI) in 212 postmenopausal women not using hormone therapy in the Women's Health Study. A modified definition of the metabolic syndrome (3 or more of the following: abdominal obesity, hypertriglyceridemia, low high-density lipoprotein, elevated blood pressure, and abnormal glucose metabolism) from the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults was used. Women with the metabolic syndrome had higher mean levels of estradiol, testosterone, and FAI values and lower SHBG levels. Higher FAI and lower SHBG were associated with all components of the metabolic syndrome. After adjustment for BMI and other factors, women in the highest tertile of FAI had an odds ratio of 12.6 (95% confidence interval, 3.8-41.6) for the metabolic syndrome, whereas those in the lowest SHBG tertile had an odds ratio of 7.3 (95% confidence interval, 2.7-19.8). When stratified by body mass index, the associations with high FAI and low SHBG remained significant even in women with body mass index less than 26.7 kg/m2. An androgenic hormone profile is associated with both the individual components of the metabolic syndrome and clustering of metabolic abnormalities in postmenopausal women.
Collapse
Affiliation(s)
- Melissa E Weinberg
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02215, USA.
| | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
Heart rate (HR) recovery after exercise is a function of vagal reactivation, and its impairment is a predictor of overall mortality and adverse cardiovascular events. While metabolic syndrome is associated with sympathetic overactivity, little is known about the relationship between metabolic syndrome and HR recovery. A symptom-limited exercise stress test in healthy subjects (n=1, 434) was used to evaluate HR recovery. Metabolic syndrome was defined according to the National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP-III) criteria. Seventeen percent of subjects had > or =3 criteria for metabolic syndrome. HR recovery was lower in men than women and in smokers than nonsmokers. The subject with metabolic syndrome (vs. without) showed lower HR recovery (10.3+/-11.6 vs. 13.6+/-9.7 per minute) and higher resting HR (64.3+/-10.3 vs. 61.6+/-9.1 per minute). HR recovery correlated inversely to age (r=-0.25, p<0.0001), but not to resting HR or maximal oxygen uptake. Delayed HR recovery was associated with metabolic syndrome after an adjustment for age, sex, resting HR and smoking (p<0.01). Metabolic syn-drome is associated with impaired vagal reactivation. Adverse cardiovascular out-comes associated with metabolic syndrome may be mediated by the failure of vagal reactivation in addition to sympathetic overactivity.
Collapse
Affiliation(s)
- Jidong Sung
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon-Ho Choi
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Bae Park
- Department of Medicine/Cardiology, Cheil General Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
41
|
Abstract
We investigated the cutoff values of surrogate of insulin resistance for diagnosing metabolic syndrome in Korean adults. The data from 976 non-diabetic individuals (484 men and 492 women) aged 30-79 yr were analyzed. We determined the odds ratios for the prevalence of metabolic syndrome according to the quartiles of fasting insulin, homeostasis model for insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) as independent variables, while adjusting for age, sex, and body mass index. The cutoff values of fasting insulin, HOMA-IR, and QUICKI were estimated by the areas under the receiver-operating characteristic (ROC) curves. The cutoff points for defining insulin resistance are a fasting insulin level of 12.94 microU/mL, HOMA-IR=3.04 as the 75th percentile value, and QUICKI=0.32 as the 25th percentile value. Compared with the lowest quartile, the adjusted odds ratios for the prevalence of metabolic syndrome in the highest quartiles of fasting insulin, HOMA-IR, and QUICKI were 1.95 (1.26-3.01), 2.27 (1.45-3.56), and 2.27 (1.45-3.56), respectively. The respective cutoff values for fasting serum insulin, HOMA-IR, and QUIC-KI by ROC analysis were 10.57 microU/mL (sensitivity 58.5%, specificity 66.8%), 2.34 (sensitivity 62.8%, specificity 65.7%), and 0.33 (sensitivity 61.2%, specificity 66.8%). Fasting insulin, HOMA-IR, and QUICKI can be used as surrogate measures of insulin resistance in Korean non-diabetic adults.
Collapse
Affiliation(s)
- Sihoon Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sunghee Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hae Jin Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Yoon-Sok Chung
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Kwan Woo Lee
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Hyun Chul Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kap Bum Huh
- Huh's Diabetes Center and the 21 Century Diabetes and Vascular Research Institute, Seoul, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| |
Collapse
|
42
|
Abstract
This research analyzes the prevalence of metabolic syndrome (MS) in Korea and examines how the presence of a familial history of diseases related to MS, such as hypertension/stroke, cardiovascular disease, and diabetes, affect the development of MS in Koreans. The prevalence of MS and its components, as defined by the Nation-al Cholesterol Education Program Adult Treatment Panel guidelines, were evaluated in nationally representative samples of non-institutionalized civilian Koreans. This analysis is based on the 2001 Korea National Health and Nutrition Examination Survey, which used a stratified multistage probability sampling design. The final study included 5,742 adults who had completed the necessary health examinations and met the diagnosis of MS. The prevalence of MS was 25.5% in men and 28.7% in women. Odds ratio for MS among men with a familial history of hypertension/stroke was higher than that among men who did not have this history. The OR for MS among women with a familial history of hypertension/stroke or diabetes was higher than that among women who had no familial history of these diseases. These results show that familial history of hypertension/stroke and diabetes was significantly related to the presence of MS in both young men and women.
Collapse
Affiliation(s)
- Kyung Won Paek
- Division of Social Welfare, Baekseok Unversity, Cheonan, Korea
| | | | | |
Collapse
|
43
|
Hillier TA, Rousseau A, Lange C, Lépinay P, Cailleau M, Novak M, Calliez E, Ducimetière P, Balkau B. Practical way to assess metabolic syndrome using a continuous score obtained from principal components analysis. Diabetologia 2006; 49:1528-35. [PMID: 16752171 PMCID: PMC3505191 DOI: 10.1007/s00125-006-0266-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Accepted: 03/20/2006] [Indexed: 11/24/2022]
Abstract
AIMS/HYPOTHESIS We devised a practical continuous score to assess the metabolic syndrome, and assessed whether this syndrome score predicts incident diabetes and cardiovascular disease. SUBJECTS AND METHODS Among 5,024 participants of the Data from an Epidemiological Study on the Insulin Resistance Syndrome (D.E.S.I.R.) cohort, we defined a metabolic syndrome score by the first principal component (PC1), using only the correlations between continuous metabolic syndrome measures (glucose, waist circumference, triglycerides, and systolic blood pressure). This metabolic syndrome score was highly correlated with a similar score also including insulin and HDL cholesterol (r ( s )=0.94). Over 9 years of follow-up, incident diabetes and cardiovascular disease (CVD) were predicted by logistic regression using the simpler metabolic syndrome score. RESULTS The means of the metabolic syndrome measures differed between men and women. Nevertheless, as the degree of variance explained and the PC1 coefficients were remarkably similar, we used a common metabolic syndrome score. The metabolic syndrome score explained 50% of the variance of the metabolic syndrome measures, and waist circumference had the highest correlation (0.59) with this score. Each standard deviation increase in the metabolic syndrome score was associated with a markedly increased age-adjusted risk of developing diabetes (odds ratios: men 3.4 [95% CI 2.6-4.4]; women 5.1 [3.6-7.2]) and with increased incident CVD of 1.7 (1.4-2.1) in men and 1.7 (1.0-2.7) in women. CONCLUSIONS/INTERPRETATION Our results, which should be confirmed in other populations, suggest that it is possible to evaluate the risk of the metabolic syndrome in a pragmatic fashion with a continuous score, obtained from principal components analysis of the basic, continuous syndrome measures.
Collapse
Affiliation(s)
- Teresa A. Hillier
- Epidémiologie cardiovasculaire et métabolique
INSERM : U258INSERM : IFR69Université Paris XI - Paris Sud16, Avenue Paul Vaillant-Couturier 94807 Villejuif Cedex,FR
- Center for Health Research Northwest/Hawaii
Kaiser PermanentePortland,US
| | - A. Rousseau
- Epidémiologie cardiovasculaire et métabolique
INSERM : U258INSERM : IFR69Université Paris XI - Paris Sud16, Avenue Paul Vaillant-Couturier 94807 Villejuif Cedex,FR
| | - Céline Lange
- Epidémiologie cardiovasculaire et métabolique
INSERM : U258INSERM : IFR69Université Paris XI - Paris Sud16, Avenue Paul Vaillant-Couturier 94807 Villejuif Cedex,FR
| | - P. Lépinay
- Centre d'examen de santé
Institut inter-régional pour la santé IRSAOrléans,FR
| | | | - M. Novak
- Centre d'examen de santé
Institut inter-régional pour la santé IRSAChateauroux,FR
| | - Etienne Calliez
- Centre d'examen de santé
Institut inter-régional pour la santé IRSAAngers,FR
| | - Pierre Ducimetière
- Epidémiologie cardiovasculaire et métabolique
INSERM : U258INSERM : IFR69Université Paris XI - Paris Sud16, Avenue Paul Vaillant-Couturier 94807 Villejuif Cedex,FR
| | - Beverley Balkau
- Epidémiologie cardiovasculaire et métabolique
INSERM : U258INSERM : IFR69Université Paris XI - Paris Sud16, Avenue Paul Vaillant-Couturier 94807 Villejuif Cedex,FR
- * Correspondence should be addressed to: Beverley Balkau
| |
Collapse
|
44
|
Rho YH, Choi SJ, Lee YH, Ji JD, Choi KM, Baik SH, Chung SH, Kim CG, Choe JY, Lee SW, Chung WT, Song GG. The prevalence of metabolic syndrome in patients with gout: a multicenter study. J Korean Med Sci 2005; 20:1029-33. [PMID: 16361817 PMCID: PMC2779304 DOI: 10.3346/jkms.2005.20.6.1029] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
It has been suggested that hyperuricemia and possibly gout are associated with the metabolic syndrome, but there have been no direct studies. This study was undertaken to obtain the prevalence of the metabolic syndrome in patients with gout and to compare it with those from the general population studies. This was a 4-institutional case-historical control study composed of 168 patients with gout. We assessed the prevalence of metabolic syndrome according to the ATP III criteria and compared the prevalence with that of the historical controls. To elucidate the factors in gout that were associated with metabolic syndrome, a multivariate analysis was done. The age-adjusted prevalence of metabolic syndrome in gout patients was 43.6%, which was significantly higher than that of the Korean control population (5.2%) from the previous studies. Patients with gout had more components of metabolic syndrome than did the controls. Body mass index (BMI, OR = 1.357 (95%CI 1.111-1.657)) and high density lipoprotein (HDL, OR = 0.774 (95%CI 0.705-0.850)) were the variables most significantly associated with the occurrence of metabolic syndrome in gout, but alcohol consumption did not show such associations. Gout is associated with the metabolic syndrome, and furthermore, obesity and dyslipidemia were the factors most associated with the syndrome in these patients.
Collapse
Affiliation(s)
- Young Hee Rho
- Division of Rheumatology, Korea University Anam Hospital, Seoul, Korea
| | - Seong Jae Choi
- Division of Rheumatology, Korea University Guro Hospital, Seoul, Korea
| | - Young Ho Lee
- Division of Rheumatology, Korea University Anam Hospital, Seoul, Korea
| | - Jong Dae Ji
- Division of Rheumatology, Korea University Anam Hospital, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology, Korea University Guro Hospital, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology, Korea University Guro Hospital, Seoul, Korea
| | - Seung-hie Chung
- Division of Rheumatology, Catholic University of Daegu, Daegu, Korea
| | - Chae-Gi Kim
- Division of Rheumatology, Catholic University of Daegu, Daegu, Korea
| | - Jung-Yoon Choe
- Division of Rheumatology, Catholic University of Daegu, Daegu, Korea
| | - Sung Won Lee
- Division of Rheumatology, Dong-A University, Busan, Korea
| | - Won Tae Chung
- Division of Rheumatology, Dong-A University, Busan, Korea
| | - Gwan Gyu Song
- Division of Rheumatology, Korea University Guro Hospital, Seoul, Korea
| |
Collapse
|
45
|
Abstract
This study aimed to estimate nationwide prevalence of the metabolic syndrome and to identify its association with cardiovascular diseases. The data on a national representative sample of 6,147 adults from 1998 Korea National Health and Nutrition Survey were analyzed. The syndrome was determined according to two kinds of modified definition from ATP III, in which abdominal obesity was determined by waist circumference (WC) standard for Asians and waist-to-hip ratio (WHR). Based on the former, prevalence was 22.1% in men and 27.8% in women. However, based on the latter, prevalence was 28.6% and 27.8%, respectively. Although age-specific prevalence was higher in men than in women among the younger group, it became higher in women among the older group because of its steeper rise with age. In multiple logistic regression, the syndrome was found to be positively associated with cardiovascular diseases (adjusted odds ratios (ORs)1.97 by WC and 1.48 by WHR in men, and 1.54 and 1.31 in women). Moreover, its effect size exceeded that of total cholesterol (adjusted ORs 1.21 in men, and 1.08 in women) or LDL cholesterol (1.58 in men and 1.22 in women). It is obvious that the metabolic syndrome prevails in Korea, and its importance regarding cardiovascular diseases is considerable. Prevention strategies should be implemented immediately to avoid cardiovascular epidemic in the near future.
Collapse
Affiliation(s)
- Myoung-Hee Kim
- Department of Preventive Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Mi-Kyung Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Bo-Youl Choi
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Young-Jeon Shin
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| |
Collapse
|
46
|
Abstract
The Third Report of the National Cholesterol Education Program Adult Treatment Panel III emphasized the importance of management of the metabolic syndrome. However, little information is available about the effect of weight reduction on the metabolic syndrome in obese patients among Koreans. A longitudinal clinical intervention study from the 12-week of weight reduction program, including life style modification and adjuvant appetite suppressants, in 78 obese persons was performed. Anthropometry and metabolic risk factors were measured before and after weight reduction. Visceral (VAT), subcutaneous (SAT), and total adipose tissue (TAT) on abdomen were determined by CT scan. Moderate decrease in weight (9.3%) induced significant reduction of waist circumference, systolic and diastolic blood pressure, and triglyceride. Weight reduction also resulted in significant decrease in total cholesterol, LDL-C, uric acid, fasting insulin, and HOMA score. The subjects with metabolic syndrome showed more improvements of metabolic components than those without metabolic syndrome through weight reduction. The reductions of visceral-subcutaneous fat ratio (VSR) and waist circumference were observed as for the predictable variables related to the improvement of metabolic component and insulin resistance in Korean obese patients.
Collapse
Affiliation(s)
- Hye Soon Park
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | | | | |
Collapse
|