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Metab Syndr Relat Disord [journal]
- Metabolic Syndrome: Prevalence and Association with Electrocardiographic Abnormalities in Nigerian Hypertensive Patients. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Jul 29.
Abstract Background: Hypertension is an important component of metabolic syndrome, and a third of hypertensive patients have metabolic syndrome, with the common mechanistic pathway believed to be insulin resistance. It is probable that hypertensive patients with metabolic syndrome will have more severe cardiac abnormalities than those without. Similarly, electrocardiogram (ECG) abnormalities have serious implications for cardiovascular disease outcome. Data on association between metabolic syndrome and ECG abnormalities are scarce in Nigeria. This study aimed to assess the prevalence of metabolic syndrome and its components in hypertensive patients and possible association of metabolic syndrome with ECG abnormalities in them. Materials and Methods: One hundred and thirty-five new adult hypertensive patients were studied in a hospital-based cross-sectional study. Metabolic syndrome prevalence was estimated by National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. ECG abnormalities were divided into minor and major abnormalities based on Novacode. SPSS IBM 20 was used to analyze data. Results: Mean age was 59.19±13.33 (30-75 years). Metabolic syndrome prevalence was 40.74% (28.85% in males; 48.19% in females). Abnormal waist circumference (58.51%) was the commonest additional component of metabolic syndrome in these patients. ECG abnormalities were in 77.78% of the population, with 49.63% and 28.15% being minor and major abnormalities, respectively. There was no significant association between metabolic syndrome and ECG abnormalities in these patients. Conclusion: Prevalence of metabolic syndrome in hypertensive patients was high, central obesity being the commonest component of the syndrome. The high prevalence of ECG abnormalities may be more a reflection of the presence of hypertension than any other component of the syndrome.
- Evaluation of Clinical and Inflammatory Markers of Nonalcoholic Fatty Liver Disease in Postmenopausal Women with Metabolic Syndrome. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Aug; 12(6):330-338.
Abstract Background: The aim of this study was to assess clinical and inflammatory markers in nonalcoholic fatty liver disease (NAFLD) in postmenopausal women with metabolic syndrome. Methods: This cross-sectional study included 180 Brazilian women (age ≥45 years and amenorrhea ≥12 months). Metabolic syndrome was diagnosed by the presence of at least three of the following indicators: Waist circumference (WC) >88 cm, triglycerides (TGs) ≥150 mg/dL, high-density lipoprotein (HDL) <50 mg/dL; blood pressure ≥130/85 mmHg; and glucose ≥100 mg/dL. NAFLD was diagnosed by abdominal ultrasound. Participants were divided into three groups: Metabolic syndrome alone (n=53); metabolic syndrome+NAFLD (n=67); or absence of metabolic syndrome or NAFLD (control, n=60). Clinical, anthropometric, and biochemical variables were quantified. The inflammatory profile included adiponectin, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). Data were submitted to statistical analysis using a Tukey test, analysis of variance (ANOVA), chi-squared, Pearson correlation, and logistic regression (odds ratio, OR). Results: Women with metabolic syndrome+NAFLD, abdominal obesity, high glucose, and insulin resistance by HOMA-IR were compared to women with metabolic syndrome alone and controls (P<0.05). High values of IL-6 and TNF-α and low values of adiponectin were observed among women with metabolic syndrome alone or metabolic syndrome+NAFLD when compared to controls (P<0.05). In multivariate analysis, the variables considered as risk of NAFLD development were: High systolic blood pressure (SBP) [(OR 1.02, 95% confidence interval (CI) 1.0-1.04]; large WC (OR 1.07, 95% CI 1.01-1.13); insulin resistance (OR 3.81, 95% CI 2.01-7.13); and metabolic syndrome (OR 8.68, 95% CI 3.3-24.1). Adiponectin levels reduced NAFLD risk (OR 0.88, 95% CI 0.80-0.96). Conclusion: In postmenopausal women, metabolic syndrome, abdominal obesity, and insulin resistance were risk markers for the development of NAFLD, whereas higher adiponectin values indicated a protection marker.
- Do n-3 Polyunsaturated Fatty Acids Increase or Decrease Lipid Peroxidation in Humans? [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Jul 21.
Abstract Background: Despite many known health benefits of n-3 polyunsaturated fatty acids (PUFA), there is a concern that their high degree of unsaturation may actually increase oxidative stress, lipid peroxidation (LPO), and chronic inflammatory diseases. Methods: In this review, we have analyzed results from published human studies regarding the effects of n-3 PUFA supplementation on markers of lipid peroxidation. Results: Of the 22 published human studies, nine found no change, eight a decrease, and five an increase in markers of LPO. These inconsistencies may be due to methods, subject characteristics, dose, duration, fatty acid and antioxidant composition of supplements, and basal diets. Methods used for analysis seem to be the most significant factor. Six of eight studies with a decrease in LPO determined F2-isoprostanes produced in vivo, and two determined plasma antioxidant capacity or hydroperoxides. n-3 PUFA can serve as scavengers for free radicals and also modulate expression of genes that determine the balance between oxidative and antioxidative status. Recent studies that monitored oxidation products of cholesterol and fatty acids support the hypothesis that n-3 PUFA decrease LPO. Most of the studies showing no change or increase in LPO determined markers that involved ex vivo sample preparation or oxidation (malondialdehyde, low-density lipoprotein oxidation, lipid hydroperoxides). Conclusion: A majority of studies do not indicate that n-3 PUFA increased LPO. Future studies need to investigate the effects of dose, duration, and composition of n-3 PUFA with standardized diets and methods on concentrations and types of LPO products produced.
- Race and Gender Disparities in Nutrient Intake Are Not Related to Metabolic Syndrome in 20- to 59-Year-Old US Adults. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Jul 21.
Abstract Background: The goal of this study was to examine the relationship between macronutrient and micronutrient intake and metabolic syndrome within race and gender cohorts of young US adults. Methods: The 2007-2010 National Health and Nutrition Examination Survey (NHANES) data for adults (n=2440) aged 20-59 were analyzed. Two 24-hr dietary recalls were used to measure intake of total calories, macronutrients, and 20 vitamins and minerals. Metabolic syndrome and its components were defined by the National Heart, Lung and Blood Institute criteria. Differences in statistical tests were noted when significant at P<0.05. Results: Prevalence of metabolic syndrome among 20- to 59-year-old adults was 30.4% [95% confidence interval 27.6-33.2]. Among cohorts, metabolic syndrome was highest in black women and white men, and lowest in black men and white women. Regression analysis indicated that no macronutrients were associated with greater risk of metabolic syndrome. For relative macronutrient intake, men with metabolic syndrome consumed more polyunsaturated fats, whereas women with metabolic syndrome consumed more total, saturated and monounsaturated fats and less fiber and starch than women without metabolic syndrome. Among races, white men and women consumed greater absolute quantities of all macronutrients except carbohydrates and sugar. Micronutrient intake was greatest for white men and women; women without metabolic syndrome had greater micronutrient adequacy than women with metabolic syndrome. Conclusion: Nutrient intake varied between race/gender cohorts; however, there were few clinically significant differences in nutrient intake between those with and without metabolic syndrome. Diet may be marginally related to diagnosis of metabolic syndrome.
- Lack of Association of Body Composition and Functionality Variables with Metabolic Syndrome in the Elderly. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Jul 14.
Abstract Background: The aging process causes alterations in body composition (decrease in lean mass and increase in fat mass), diminution of functionality (strength, mobility, and physical performance), and an increased prevalence of chronic diseases such as metabolic syndrome and obesity. The aim of this study was to investigate the association of body composition and functionality with metabolic syndrome in the elderly. Methods: A cross-sectional study was conducted in the Outpatient Clinic of the Geriatric Service of Hospital São Lucas of Pontifical Catholic University of Rio Grande do Sul (PUCRS) involving 74 patients (14 males and 60 females). The patients were separated into two groups: Group 1=elderly with metabolic syndrome [through the National Cholesterol Education Program Adult Treatment Panel III (NECP ATP III) criteria; n=34], group 2=elderly without metabolic syndrome (n=40). The variables evaluated included age, gender, body composition (circumferences, skinfold thickness, BMI, muscle and fat thickness and muscle mass), functional variables [hand grip strength, Timed Up and Go Test (TUGT), and Sit-to-Stand Test]. Results: The results showed that elderly individuals with metabolic syndrome had a higher mean of the anthropometric measures (except abdominal skinfold thickness) compared to subjects without metabolic syndrome (P<0.005). We observed significant differences for muscle mass index (higher, P=0.029), TUGT (longer time, P=0.008), and hand grip strength (lower, P=0.015) in elderly with metabolic syndrome compared with subjects without metabolic syndrome. However, when these variables were adjusted for gender, age, and body mass index (BMI), none showed a significant association with metabolic syndrome. Conclusion: We did not observe associations among metabolic syndrome, body composition, and functionality variables.
- Metabolic Syndrome Among Urban Indian Young Adults: Prevalence and Associated Risk Factors. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Jul 9.
Abstract Background: We estimated the prevalence of metabolic syndrome among urban Indian young adults (18-25 years) as defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), Internation Diabetes Federation (IDF), and Indian consensus statement criteria. Method: We included 473 urban young adults through simple random sampling methodology to estimate the prevalence and associated risk factors for metabolic syndrome. Results: Prevalence of metabolic syndrome was estimated to be 3.6 [95% confidence interval (CI) 2.2-5.8], 6.6% (95% CI 4.6-9.1), and 8.7% (95% CI 6.4-11.6) using the NCEP ATP III, IDF, and Indian consensus statement criteria, respectively. Men had significantly higher waist circumference, systolic blood pressure, fasting blood glucose, and triglycerides, whereas mean concentrations of both high-density lipoprotein cholesterol (HDL-C) and total cholesterol were significantly higher among women. Low HDL-C (38.9%), high blood pressure (26%), and central obesity (16.1%) were the most common component risk factors. Although less than 4% of normal weight adults met the criteria for metabolic syndrome, rates increased in overweight individuals and reached a prevalence of 87% in the obese participants. In all, 61.3% of the total population had one or more risk factors for metabolic syndrome. Conclusion: The prevalence of metabolic syndrome is high among urban young adults in India, and it increased with increase in body mass index (BMI). Each component risk factor in isolated form-increased BMI, smoking, and history of hypertension-is an associated risk factor for metabolic syndrome. Although it is unclear whether metabolic syndrome screening in young Indians as a means to prevent adverse cardiovascular health outcomes is appropriate, healthy lifestyles should nevertheless be encouraged, and young adults should be considered as an important group for cardiovascular risk reduction programs.
- Baseline Levels, and Changes Over Time in Body Mass Index and Fasting Insulin, and Their Relationship to Change in Metabolic Trait Clustering. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Jul 9.
Abstract Background: Multiple abnormal metabolic traits are found together or "cluster" within individuals more often than is predicted by chance. The individual and combined role of adiposity and insulin resistance (IR) on metabolic trait clustering is uncertain. We tested the hypothesis that change in trait clustering is a function of both baseline level and change in these measures. Methods: In 2616 nondiabetic Framingham Offspring Study participants, body mass index (BMI) and fasting insulin were related to a within-person 7-year change in a trait score of 0-4 Adult Treatment Panel III metabolic syndrome traits (hypertension, high triglycerides, low high-density lipoprotein cholesterol, hyperglycemia). Results: At baseline assessment, mean trait score was 1.4 traits, and 7-year mean (SEM) change in trait score was +0.25 (0.02) traits, P<0.0001. In models with BMI predictors only, for every quintile difference in baseline BMI, the 7-year trait score increase was 0.14 traits, and for every quintile increase in BMI during 7-year follow-up, the trait score increased by 0.3 traits. Baseline level and change in fasting insulin were similarly related to trait score change. In models adjusted for age-sex-baseline cluster score, 7-year change in trait score was significantly related to both a 1-quintile difference in baseline BMI (0.07 traits) and fasting insulin (0.18 traits), and to both a 1-quintile 7-year increase in BMI (0.21 traits) and fasting insulin (0.18 traits). Conclusions: Change in metabolic trait clustering was significantly associated with baseline levels and changes in both BMI and fasting insulin, highlighting the importance of both obesity and IR in the clustering of metabolic traits.
- Metabolic Syndrome Appears Early After Hematopoietic Cell Transplantation. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Jul 9.
Abstract Background: Improved survival after allogeneic hematopoietic cell transplantation (allo-HCT) enables us to learn more about potential late complications after HCT, one of which is metabolic syndrome. There are no studies investigating the prevalence or development of metabolic syndrome within the first year post-HCT in adult myeloablative transplant recipients. Methods: In this retrospective study, we evaluated the prevalence of and risk factors associated with metabolic syndrome early post-HCT in human subjects. Due to lack of complete information regarding all the factors that define metabolic syndrome, we evaluated metabolic characteristics using available objective data referred to as modified metabolic syndrome (MMS). The cohort included 785 patients. Results: We demonstrated that the incidence of MMS was 34% pre-HCT, 48% at day 80 post-HCT, and 40% at 1 year post-HCT. MMS at day 80 post-HCT was predictive of having MMS at 1 year post-HCT. Conclusion: These results support the need for nutrition and lifestyle intervention to prevent and treat metabolic abnormalities among patients who survive the acute transplant period.
- Comparing the Predictive Abilities of Different Metabolic Syndrome Definitions for Acute Coronary Syndrome: A Case-Control Study in Chinese Adults. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Jun 24.
Abstract Background: Different institutions have proposed various definitions for metabolic syndrome, which is a combination of risk factors for cardiovascular diseases (CVD). This study aimed to compare the feasibilities and abilities of different metabolic syndrome definitions in predicting acute coronary syndrome (ACS) in Chinese adults. Methods: A case-control study was designed. This study recruited 162 newly diagnosed ACS patients (the case group) and 162 non-ACS patients (the control group) according to the study criteria. Metabolic syndrome definitions proposed by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), International Diabetes Federation (IDF), American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), Chinese Diabetes Society (CDS), and Joint Committee for Developing Chinese Guidelines on Dyslipidemia in Adults (JCDCG) were studied. After collecting demographic and clinical data, sensitivity, specificity, positive and negative predictive values (PPV, NPV), the likelihood ratio of a positive test and a negative test (LR+, LR-), odds ratios (OR), diagnostic accuracy, and the Youden index (YI) were compared. Results: Of the 324 participants, the mean age was 59.1±10.5 years, and 56.8% were males. The AHA/NHLBI and IDF definitions had better sensitivity (53.09%, 48.77%). The CDS definition was more specific (76.54%), but less sensitive (25.93%). The IDF definition performed better in PPV (53.74%), NPV (53.11%), LR+ (1.15) and LR- (0.89), OR (1.32), and diagnostic accuracy (53.4%). The IDF definition also provided optimal cutoff points with the biggest YI. Conclusion: The IDF definition performed better in detecting the onsets of nonfatal ACS in the northwestern Chinese population. All studied definitions were feasible in Chinese clinical settings.
- Lipoprotein Insulin Resistance Index: A Lipoprotein Particle-Derived Measure of Insulin Resistance. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Jun 24.
Abstract Background: Lipoprotein particle sizes and concentrations are characteristically altered in patients with insulin resistance (IR) or type 2 diabetes mellitus (T2DM). This study assessed the ability of an IR score, based on nuclear magnetic resonance (NMR)-derived lipoprotein information, to detect IR in otherwise healthy individuals. Methods: Lipoprotein subclass and size information were evaluated for strength of association with IR, as measured by homeostasis model assessment of insulin resistance (HOMA-IR) in the Multi-Ethnic Study of Atherosclerosis (MESA). To increase the likelihood of identifying subjects with IR, six lipoprotein measures were combined into a single algorithm. The resulting assay [Lipoprotein Insulin Resistance Index (LP-IR)] was developed using HOMA-IR in 4972 nondiabetic subjects from MESA and verified independently using glucose disposal rates (GDRs) measured during hyperinsulinemic-euglycemic clamps in 56 insulin-sensitive, 46 insulin-resistant, and 46 untreated subjects with T2DM. Results: LP-IR exhibited stronger associations with HOMA-IR (r=0.51) and GDR (r=-0.53) than each of the individual lipoprotein parameters as well as the triglycerides/high-density lipoprotein cholesterol (TGs/HDL-C) ratio (r=0.41 and -0.44, respectively). In MESA, associations between the LP-IR score and HOMA-IR were strong in men (r=0.51), women (r=0.52), European Americans (r=0.58), African Americans (r=0.48), Chinese Americans (r=0.49), and Hispanic Americans (r=0.45). When LP-IR was categorized by HOMA-IR and either body mass index (BMI) or fasting plasma glucose (FPG), subgroups were revealed whose LP-IR scores were high (≥50), despite having normal BMIs (<24 kg/m(2)) or FPG (<100 mg/dL). Conclusions: LP-IR scores had strong associations with multiple measures, HOMA-IR, and GDR, the former being more reflective of hepatic and the latter of peripheral insulin sensitivity, and may represent a simple means to identify individuals with IR.