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Metab Syndr Relat Disord [journal]
- Plasma Levels of Lysine, Tyrosine, and Valine During Pregnancy Are Independent Risk Factors of Insulin Resistance and Gestational Diabetes. [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Nov 24.
Abstract Background: This study compared plasma concentrations of amino acids in pregnant women with and without gestational diabetes mellitus (GDM) and identified the association between plasma amino acid levels and GDM, insulin resistance, and insulin secretion at 24-28 weeks of pregnancy. Methods: Circulating amino acid levels were evaluated using high-performance liquid chromatography at 24-28 weeks of pregnancy in 25 non-GDM and 64 GDM women after adjusting for covariates such as maternal age, body mass index (BMI) before pregnancy, BMI and gestational age at screening GDM, and daily caloric intake. Backward stepwise logistic regression analysis was used to identify the predictors of developing GDM, and homeostatic model assessments for insulin resistance (HOMA-IR) and β-cell function (HOMA-B). Results: Circulating levels of amino acids except threonine and tyrosine were significantly higher in GDM women than non-GDM women. Along with the intakes of energy, protein, and fat from animal sources, the intakes of each amino acid were significantly higher in the GDM group without a direct correlation to plasma amino acid levels. The variation in GDM development was explained by maternal age, diastolic blood pressure, and plasma lysine levels (R(2)=0.691). Height, BMI before pregnancy, systolic blood pressure, and plasma tyrosine and valine levels accounted for the variation in HOMA-IR (R(2)=0.589). The 53.3% variation of HOMA-B was explained by maternal age, BMI at GDM screening, plasma insulin level at 1 h during the oral glucose tolerance test (OGTT), and plasma valine level. Conclusions: Circulating concentrations of lysine, tyrosine, and valine were independently and positively associated with GDM through modifying insulin resistance and secretion.
- Type 2 Diabetes Mellitus, Metabolic Syndrome, and Mixed Dyslipidemia: How Similar, How Different, and How to Treat? [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Nov 17.
Abstract Individuals with mixed atherogenic dyslipidemia, type 2 diabetes mellitus (T2DM), and metabolic syndrome are at high risk of developing cardiovascular disease (CVD) and can often benefit greatly from preventive lifestyle and medical interventions. These conditions typically co-exist in an individual, and the lipid profiles associated with them have several features in common. The worldwide prevalence of T2DM, atherogenic dyslipidemia, and metabolic syndrome is increasing, particularly in southern Asia and the Middle East. Statins can lower low-density lipoprotein-cholesterol and reduce the risk of CVD in these high-risk individuals, but there is a residual risk of CVD associated with additional lipid abnormalities, such as high levels of triglycerides and low levels of high-density lipoprotein cholesterol. These abnormalities are commonly found in patients with T2DM and metabolic syndrome. Additional lipid-modifying therapies that target these abnormalities, such as fibrates and omega-3 polyunsaturated fatty acids, may be able to improve lipid profiles and further reduce the risk of CVD in these patients.
- Are Metabolic Syndrome and Its Components Associated with 5-Year Mortality in Chronic Obstructive Pupmonary Disease Patients? [JOURNAL ARTICLE]
- Metab Syndr Relat Disord 2014 Oct 29.
Abstract The aim of this study was to evaluate the risk of mortality according to the presence of metabolic syndrome in chronic obstructive pulmonary disease (COPD) patients who were followed for 5 years. We did not establish the influence of metabolic syndrome on mortality rate. However, an increase of 100 mg of triglycerides was associated with a 39% increase in the probability of death in the period of the study (hazard ratio 1.39, 95% confidence interval 1.06-1.83).
- 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 Dec; 12(10):527-32.
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.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.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.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 Dec; 12(10):493-5.
- 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.