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Metab Syndr Relat Disord [journal]
- Genetic and Environmental Relationships of Metabolic and Weight Phenotypes to Metabolic Syndrome and Diabetes: The Healthy Twin Study. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Oct 21.
Abstract Background: We aimed to examine the relationships, including genetic and environmental correlations, between metabolic and weight phenotypes and factors related to diabetes and metabolic syndrome. Design and Methods: Participants of the Healthy Twin Study without diabetes (n=2687; 895 monozygotic and 204 dizygotic twins, and 1588 nontwin family members; mean age, 42.5±13.1 years) were stratified according to body mass index (BMI) (<25 vs. ≥25 kg/m(2)) and metabolic syndrome categories at baseline. The metabolic traits, namely diabetes and metabolic syndrome, metabolic syndrome components, glycated hemoglobin (HbA1c) level, and homeostasis model assessment of insulin resistance (HOMA-IR), were assessed after 2.5±2.1 years. Results: In a multivariate-adjusted model, those who had metabolic syndrome or overweight phenotypes at baseline were more likely to have higher HbA1C and HOMA-IR levels and abnormal metabolic syndrome components at follow-up as compared to the metabolically healthy normal weight subgroup. The incidence of diabetes was 4.4-fold higher in the metabolically unhealthy but normal weight individuals and 3.3-fold higher in the metabolically unhealthy and overweight individuals as compared with the metabolically healthy normal weight individuals. The heritability of the metabolic syndrome/weight phenotypes was 0.40±0.03. Significant genetic and environmental correlations were observed between the metabolic syndrome/weight phenotypes at baseline and the metabolic traits at follow-up, except for incident diabetes, which only had a significant common genetic sharing with the baseline phenotypes. Conclusions: The genetic and environmental relationships between the metabolic and weight phenotypes at baseline and the metabolic traits at follow-up suggest pleiotropic genetic mechanisms and the crucial role of lifestyle and behavioral factors.
- Lifestyle Changes Followed by Bariatric Surgery Lower Inflammatory Markers and the Cardiovascular Risk Factors C3 and C4. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Oct 20.
Abstract Background: Morbidly obese patients are at risk of developing insulin resistance and cardiovascular disease. Low-grade systemic inflammation is an important factor for this development. We evaluated the effect of bariatric surgery on markers of inflammation, coagulation and glucose metabolism. Methods: Ninety-seven morbidly obese patients and 17 lean subjects (control group) participated. Anthropometric measurements as well as fasting blood samples were obtained at first admission, prior to surgery, and 1 year after surgery. Results: At admission, the morbidly obese group had significantly elevated levels of the complement components C3 and C4 compared to the lean control group (P<0.0001). Levels of C3 and C4 dropped significantly in the morbidly obese group over time (P<0.0001), and, 1 year after the operation, levels were comparable to those of the control group. The same changes were seen for markers of inflammation (high-sensitivity C-reactive protein, tumor necrosis factor-α, interferon-γ, interleukin-1 receptor antagonist, IL-6, and IL-13), coagulation (fibrinogen and plasminogen activator inhibitor-1), and glucose metabolism (leptin and insulin). There was a positive correlation between changes in C3 and body mass index, weight, coagulation parameters, inflammatory parameters, and leptin, respectively. Conclusions: Bariatric surgery in morbidly obese patients reduced weight effectively. Even more importantly, the increased levels of several risk factors associated with diabetes and cardiovascular co-morbidity normalized 1 year after surgery.
- Associations of Blood Lipid-Related Indices with Blood Pressure and Pulse Pressure in Middle-Aged Men. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Oct 16.
Abstract Introduction: Low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio is known as a classical atherogenic index. In addition, triglycerides to HDL-C (TGs/HDL-C) ratio and lipid accumulation product (LAP) have been proposed to be good discriminators for cardiometabolic risk. The aim of this study was to determine which lipid index is most strongly associated with blood pressure and pulse pressure. Methods: The subjects were 36,536 Japanese men aged 35-60 years who were not receiving drug therapy for dyslipidemia. Relationships of each lipid index with blood pressure and pulse pressure were investigated by using linear and logistic regression analyses. Results: There were significant positive correlations of systolic and diastolic blood pressure and pulse pressure with the lipid-related indices such as LDL-C/HDL-C ratio, TGs/HDL-C ratio, and LAP. The correlations with LAP were significantly stronger than those with the LDL-C/HDL-C ratio and the TGs/HDL-C ratio. Odds ratios (ORs) for hypertension and high pulse pressure in subjects with versus subjects without high levels of each lipid-related index were significantly higher than the reference level of 1.00. The ORs of subjects with versus subjects without high LAP tended to be higher than the ORs of subjects with versus subjects without high LDL-C/HDL-C ratio or high TGs/HDL-C ratio. In the linear and logistic regression analyses, the associations of the lipid-related indices with pulse pressure were weaker than the corresponding associations with blood pressure. Conclusion: LAP shows stronger associations with blood pressure and pulse pressure than the other lipid-related indices and is suggested to be better for discriminating the risk of hypertension.
- Non-High-Density Lipoprotein Cholesterol Changes in Middle-Aged Obese Men With and Without Metabolic Syndrome During Weight Loss. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Sep 23.
Abstract Non-high-density lipoprotein (non-HDL-C) is the best predictor of coronary artery disease and stroke. Studies have shown that weight loss decreases non-HDL-C levels. However, whether diet-induced weight loss in individuals with and without metabolic syndrome causes a reduction in non-HDL-C levels remains unclear. We investigated the effects of weight loss on non-HDL-C levels in 34 middle-aged obese men with and without metabolic syndrome classified using National Cholesterol Education Panel Adult Treatment Panel III criteria (metabolic syndrome, n=17; non-metabolic syndrome, n=17). We conducted a 12-week dietary intervention using a low-carbohydrate, -fat, and -protein diet to reduce body weight. A significant decrease in body weight and body mass index in both groups was observed. However, the non-HDL-C level after weight loss was significantly decreased in the metabolic syndrome group (151.9±6.8 to 131.4±6.2 mg/dL, P<0.01) but not in the non-metabolic syndrome group (152.1±8.2 to 141.2±8.1 mg/dL, P>0.05). Levels of apolipoprotein AII and B, but not AI, were similarly decreased in both groups (P>0.05). Pearson correlation analysis showed that the change in non-HDL-C levels in the metabolic syndrome group was strongly associated with levels of total cholesterol, fasting insulin, and alanine and aspartate transaminase, as well as homeostatic model assessment index, diastolic blood pressure, and maximal oxygen uptake (P<0.05). These results demonstrated that diet-induced weight loss without physical activity decreases non-HDL-C levels, an important factor associated with changes in cardiorespiratory fitness and insulin sensitivity, in obese individuals with metabolic syndrome.
- Prevalence of Metabolic Syndrome and Individual Criterion in US Adolescents: 2001-2010 National Health and Nutrition Examination Survey. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Sep 23.
Abstract Background: The prevalence of metabolic syndrome has increased in adolescents in previous years. The objectives of this study were to examine the prevalence in the past decade and the individual criteria in a nationally representative sample of US adolescents. Methods: This study was a descriptive analysis of 3495 US adolescents between the ages of 12 and 19 years using the National Health and Nutrition Examination Survey (NHANES) 2000-2010. Metabolic syndrome was defined as having three of the five following conditions: Waist circumference (WC),≥90(th) percentile (sex-specific); elevated resting blood pressure,≥90(th) percentile (age, height, sex-specific); elevated triglycerides (TGs); low high-density lipoprotein cholesterol; and/or impaired fasting glucose. Results: Approximately 73.2% of the participants had at least one criterion, with the estimated metabolic syndrome prevalence being 10.1%. Prevalence was higher in males than females (13.0% vs. 6.4%, P<0.05). Both Hispanic males and females had significantly greater odds of metabolic syndrome. Abnormal WC and abnormal TG levels were the most common individual criteria; in comparison, abnormal blood pressure was the least common across racial ethnic backgrounds. Conclusions: An estimated one in 10 US adolescents has metabolic syndrome. These findings have important public health implications due to the known cardiovascular disease risk factors associated with metabolic syndrome.
- Resveratrol Use in Metabolic Syndrome. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Sep 17.
- Changes in Fat Distribution in Children Following Severe Burn Injury. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Sep 11.
Abstract Background: Children with severe cutaneous burn injury show persistent metabolic abnormalities, including inflammation and insulin resistance. Such abnormalities could potentially increase their future risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). This could be related to changes in body composition and fat distribution. Methods: We studied body composition, fat distribution, and inflammatory cytokines changes in children with severe burn injury up to 6 months from discharge. Sixty-two boys and 35 girls (burn ≥30% of total body surface area) were included. Results: We found a decrease in total body fat and subcutaneous peripheral fat at 6 months (6% and 2%, respectively; P<0.05 each). An inverse correlation between the decrease in peripheral fat content at 6 months and the extent of burn injury (r=-041, P=0.02) was also observed. In addition, there was a 12% increase in serum tumor necrosis factor-α (TNF-α) (P=0.01 vs. discharge) and 9% decrease in serum interleukin-10 (IL-10) (P<0.0001 vs. discharge) over 6 months after burn. Conclusion: Severe burn injury in children is associated with changes in body fat content and distribution up to 6 months from hospital discharge. These changes, accompanied by persisting systemic inflammation, could possibly mediate the observed persistence of insulin resistance, predisposing burn patients to the development of T2DM and CVD.
- Hypoadiponectinemia As An Independent Predictor for the Progression of Carotid Atherosclerosis: A 5-Year Prospective Study. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Sep 11.
Abstract Background: Hypoadiponectinemia predicts the development of diabetes and hypertension, both being potent atherosclerotic risk factors. Whether adiponectin predicts the progression of early atherosclerosis remains unclear. In this 5-year prospective study, we examined the relationship between serum adiponectin and carotid intima media thickness (CIMT), a marker of subclinical atherosclerosis. Methods: A total of 265 subjects from the population-based Hong Kong Cardiovascular Risk Factor Prevalence Study, with no known cardiovascular disease, underwent CIMT measurement at baseline and at 5 years. Results: In all, 129 men and 136 women, aged 54.6±12.3 years, were studied. Median CIMT at baseline was 0.63 mm (interquartile range 0.52-0.73 mm) and increased to 0.67 mm (0.56-0.78 mm) after 5 years (P<0.001). CIMT increment correlated with baseline adiponectin, age, and smoking (all P<0.05) and baseline CIMT (P<0.001), but not with sex, fasting glucose, lipid profiles, hypertension, or diabetes. In multiple linear regression analysis, baseline serum adiponectin level was an independent predictor of CIMT increment β (standardized beta)=-0.17, P=0.015], after adjusting for age, smoking, baseline CIMT, hypertension, body mass index, fasting glucose, low-density lipoprotein cholesterol, and triglycerides. Conclusion: Hypoadiponectinemia predicted CIMT progression, independent of known predictive factors such as age, smoking, hyperlipidemia, and hypertension.
- Heterogeneous Vascular Responses to Lifestyle Intervention in Obese Latino Adolescents. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Aug 27.
Abstarct Background/Objectives: Among adolescents, obesity may increase the risk for premature cardiovascular disease (CVD). Lifestyle interventions may prevent or delay the onset of CVD through improvements in vascular health. The purpose of this study was to examine the effects of a 12-week lifestyle intervention on markers of vascular health in obese Latino youth. Subjects/Methods: Fifteen obese Latino adolescents [body mass index (BMI) percentile=96.3±1.1%, 15.0±1.0 year, 8 females and 7 males] participated in a 12-week lifestyle intervention consisting of nutrition education and physical activity. Markers of vascular health included oxidized low-density lipoprotein (oxLDL), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and soluble endothelial leukocyte adhesion molecule-1 (sE-Selectin). Results: Relative to baseline data, the intervention resulted in lower oxLDL (-21.8%, P=0.001) and sE-Selectin (-13.3%, P=0.008) concentrations; sICAM-1 and sVCAM-1 did not change significantly. When examining overall responsiveness to change for each marker, oxLDL was reduced in 93.3%, sE-Selectin was reduced in 78.6%, and sICAM-1 was reduced in 71.4% of participants, respectively, whereas sVCAM-1 was reduced in only 42.9% of participants following lifestyle. Using a composite change score (summed change in four markers) for each participant there was an improvement in at least three of four markers among 64% of participants; this was confirmed by principal component analysis. Conclusions: Therefore, although improvements in the vascular health of obese youth were observed, the vascular response to lifestyle intervention may be heterogeneous. Further investigation into the mechanisms mediating the heterogeneity in vascular response to lifestyle intervention is warranted.
- Increased Adipose Tissue Insulin Resistance in Metabolic Syndrome: Relationship to Circulating Adipokines. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Aug 27.
Abstract Background: Although hepatic insulin resistance has been documented in patients with metabolic syndrome using homeostasis model assessment of insulin resistance (HOMA-IR) as a measure, there is scanty data on adipose insulin resistance (Adipo-IR) and its relationship with the dysregulation of adipokines in metabolic syndrome. Thus, we examined whether Adipo-IR is increased in metabolic syndrome as well as its correlation with circulating adipokines. Methods: In 42 individuals including controls and participants with metabolic syndrome, we measured fasting plasma insulin and free fatty acids (FFA). Adipo-IR was calculated as the product of FFA×insulin. We examined the association between Adipo-IR, metabolic syndrome variables, and circulating adipokines, including leptin, adiponectin, chemerin, omentin-1, and retinol-binding protein-4. Results: Adipo-IR was higher in metabolic syndrome (n=19; median 68.7 mmol/L·pmol/L; 25(th)-75(th) percentile, 50.0-104.7) compared to controls (n=23; 22.9 mmol/L·pmol/L; 6.8-36.1; P<0.0001), and this difference was similar following adjustments for waist circumference or body mass index (BMI). Adipo-IR correlated significantly with certain adipokines: Leptin, r=0.45, P=0.004; adiponectin, r=-0.33, P<0.05; chemerin r=0.55, P=0.0008; omentin-1, r=-0.46, P=0.04, and with all features of metabolic syndrome. Conclusions: Adipo-IR is increased in metabolic syndrome following adjustment for adiposity and may be an important biomarker of adipose tissue dysregulation, including adipokine secretion and a potential relevant therapeutic target.