Effect of L-arginine, L-citrulline and micronutrient supplementation on elevated triglyceride levels and metabolic syndrome severity score

BackgroundContinuous metabolic syndrome (MS) severity scores that can track metabolic risk in individuals over time have been developed for Western populations. The present study aimed to develop gender- and age-specific equations for MS severity scores in Korean adults.MethodsUsing data from the Korea National Health and Nutrition Examination Surveys (KNHANES) IV (2010–2012) and VI (2013–2015), we performed a confirmatory factor analysis of single MS factor that allowed for differential loadings across groups to generate gender- and age-specific, continuous MS severity scores. Then, we validated this equation in a different dataset of Korean adults.ResultsIn confirmatory analysis, waist circumference had the highest factor loading, indicating that waist circumference had the strongest correlation with MS among Korean adults. Lower factor loadings (< 0.4) among Korean adults aged 40–59 years were noted for systolic blood pressure and fasting glucose. MS severity score values were significantly correlated with metabolic parameters, including high-sensitivity C-reactive-protein, glycated hemoglobin, and homeostasis model assessment of insulin resistance. Furthermore, MS severity scores well predicted traditional MS according to receiver operating characteristic analysis in a validation dataset (KNHANES VII). In a longitudinal cohort dataset, participants diagnosed with Adult Treatment Program III (ATP-III) MS after an initial assessment had progressively higher baseline MS severity scores in relationship to their time until ATP-III MS diagnosis.ConclusionThe new MS severity score equations for Korean adults proposed in this study provide a clinically-accessible continuous measure of MS for potential use in identifying adults at higher risk for MS-related diseases and following changes within individuals over time.

A metabolic syndrome severity score: A tool to quantify cardio-metabolic risk factors

To examine Metabolic Syndrome (MetS) severity using a recently validated Metabolic Syndrome Severity Score (MetSSS) in order to explore the overall associations between MetSSS and the risk of mortality related to all-causes, heart disease, diabetes mellitus, and hypertension amongst American adults with gout. Mortality-linked data for 12,101 adults aged 18 to 90 years who participated in the National Health and Nutrition Examination Survey III by gout status was analysed. All 5 metabolic features were used to calculate gender-race/ethnicity-specific MetSSS Z-scores in gout patients. The calculated Z-scores are a continuous representation of all MetS conditions while accounting for gender-race/ethnicity disparities. A total of 3,381 deaths were observed, of which 215 had gout. The prevalence amongst adults was 2.59%. Moderate to high MetS severity was significantly prevalent amongst gout patients (47.33% vs. 21.16 % no gout; p-value <0.0001). The mean MetSSS Zscore for gout patients was significantly higher than those without gout (0.71 vs. -0.04 no gout; p-value <0.0001). A one-unit increase in MetSSS score was associated with significant increases in the risk of all-cause mortality, heart disease, diabetes- and hypertension-related mortalities. Moderate to high MetSSS is significantly prevalent amongst gout patients. A one-unit increase in MetSSS score was associated with significant increases in the risk of all-cause mortality, heart disease, diabetes- and hypertension-related mortalities. MetS is a clinically accessible tool for predicting mortality risks in gout patients with MetS.

Aims: Exercise interventions positively affect numerous cardiometabolic risk factors. To better evaluate the health effects of exercise training, it may be more appropriate to evaluate risk factors together. The Metabolic Syndrome Severity Score (MetSSS) is a composite score representing cardiometabolic risk. Purpose: To evaluate the relationships between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS in a heterogenous sample of people with complex chronic disease. Material and Methods: Fifty-three people with kidney or liver disease and at least one feature of the metabolic syndrome (MetS) were included. Pearson correlations were conducted between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS. Linear regressions were performed for multi-level categorical variables. Independent variables with an association with MetSSS (P ≤ 0.2) were included in a multiple regression analysis. Results: The 6-minute walk test (6MWT) distance was inversely and independently associated with MetSSS [standardized beta coefficient (β) = -0.31, P = 0.04]. No relationship was found between MetSSS and physical activity or neuromuscular fitness. Mean 6MWT in the highest tertile was 550 m (range: 505-620 m) and 346 m (range: 233-408 m) in the lowest. The analysis showed a medium-large between-group effect for the difference in MetSSS for the lowest and highest tertile of 6MWT [Eta squared (η2) = 0.16, P = 0.01]. Conclusions: Exercise capacity was inversely and independently associated with MetSSS in people with complex chronic disease. Clinical trials with exercise interventions are needed to further investigate if improvements in exercise capacity result in clinically significant changes in the MetSSS.

In the latter half of the nineteenth century, amyl nitrate, sodium nitrite, and nitroglycerin were each shown to relieve angina pectoris. These early observations, coupled with the rapid growth of the chemical and pharmaceutical industries, led to the development of nitrovasodilator drugs as the cornerstone of therapy for ischemic heart disease throughout most of the next century. Despite a rather thorough understanding of the pharmacology of these agents, only recently have the vascular actions of nitrovasodilators been placed in their proper biological context. The identification of nitric oxide (NO) as a product of the normal endothelium with smooth-muscle relaxing effects1‐3 led to the recognition that nitrovasodilators work by providing an exogenous source of NO to the diseased blood vessel. As such, nitrovasodilators may be viewed as replacement therapy for the ailing vasculature. See p 2160 Over the past 10 years, this paradigm has been strengthened by the observation that the normal endothelium can become dysfunctional when exposed to risk factors for atherothrombosis.4 In addition, in the setting of many vascular disorders, including essential hypertension and atherothrombosis itself, endothelial dysfunction is apparent. Dysfunctional endothelium is defined by a change in its essential phenotype 5 : the normal endothelial cell promotes vascular smooth muscle cell relaxation, inhibits platelet activation, limits leukocyte adhesion, and inhibits vascular smooth muscle proliferation; the dysfunctional endothelial cell, in the extreme, cannot support smooth muscle relaxation, cannot inhibit platelet activation, is avid for leukocytes, and cannot inhibit vascular smooth muscle cell proliferation. There are varying degrees of endothelial dysfunction, and these may be quantified by different functional assays, including endothelium-dependent vasodilator responses and adhesion molecule expression. Central to the development of endothelial dysfunction, regardless of its cause, is a loss of bioactive endothelial NO. NO is an important endothelial mediator for each of the principal properties of a normal endothelial cell, and a loss of bioactive NO is associated with endothelial cell dysfunction. The two fundamental mechanisms for the loss

BackgroundMetabolic syndrome (MetS) is common amongst gout patients. The MetS is diagnosed when a patient has at least 3 of the following 5 conditions of hyperglycemia, hypertension, hypertriglyceridemia, low high-density...

Background: We aimed to assess the association of sleep with metabolic syndrome in the 2013/2014 National Health and Nutrition Examination Survey (NHANES). Methods: Sample size included 2737 out of 2013 and 2014 NHANES surveys. Cross-sectional study of metabolic syndrome and sleep duration was conducted. Metabolic syndrome was defined according to NCEP ATPIII (National Cholesterol Education Program Adult Treatment Panel III) criteria. Metabolic syndrome severity score was calculated based on actual measurement of each component, adjusted for sex and race. The generalized additive model (GAM) was built to assess the smooth relationship between metabolic syndrome/metabolic syndrome severity score and sleep duration. Adjustment of models were done for age, sex, race, and sitting time. The value of effective degree of freedom (EDF) formed by the GAM model shows the degree of curvature of the relationship. A value of 1 for EDF is translated as the linear shape of relationship. Values larger than one denote a more complex relationship between the response variable and the predicting one. Results: There was a U-shaped association between sleep duration and metabolic syndrome in univariable GAM (EDF = 2.43, p = 0.06) and multivariable GAM (EDF = 2.03, p = 0.20). The lowest risk of metabolic syndrome was observed in people sleeping 7 hours/night. There was a significant U-shaped association between sleep duration and metabolic syndrome severity score in multivariable GAM (EDF = 2.94, p = 0.0004). Similarly, the lowest mean metabolic syndrome severity score was observed in people sleeping 7 hours/night. There was an effect modification of sex and sleep duration indicating strong U-shaped relationship of metabolic syndrome severity score and sleep duration in women (EDF = 3.43, p = 0.00002) and semi-linear association in men (EDF = 1.76, p = 0.04). Conclusion: Short and long sleep duration was associated with higher risk of metabolic syndrome and higher scores of metabolic syndrome severity score in women. Short sleep duration was associated with higher risk of metabolic syndrome and higher scores of metabolic syndrome severity score in men.

Metabolic syndrome, characterized by a combination of obesity, hypertension, and metabolic abnormalities (lipid and glucose dysregulation), significantly increases the risk of cardiovascular diseases. This study aimed to explore the association between body composition and severity of metabolic syndrome in obese individuals. This cross-sectional study analyzed data from 180 individuals who sought treatment at an obesity center. Key variables included body mass index (BMI), fat mass, muscle mass, and the metabolic syndrome severity score. Logistic regression was used to evaluate the relationship between body composition parameters and metabolic syndrome severity score. Of the 180 participants, 92.8% were female and 7.2% were male. Individuals with higher metabolic syndrome severity scores had significantly higher age, BMI, fat mass, muscle mass, and fat and muscle ratios. Logistic regression analysis revealed that each 1-unit increase in BMI was associated with a 1.288-fold increase in the risk of a higher metabolic syndrome severity score. However, fat and muscle mass as well as their percentages were not significantly associated with the score. BMI emerged as a key factor influencing the severity of metabolic syndrome in obese individuals, whereas other body composition parameters did not show a significant relationship. These findings highlight the importance of BMI in the management of obesity and metabolic syndrome, and underscore the need for further research with larger sample sizes.

The effects of L-citrulline or L-arginine supplementation on exercise performance are equivocal, and the effects on swimming performance are unclear. We aimed to assess whether 8-day supplementation with L-arginine or L-citrulline supplementation would improve 200 m and 100 m freestyle swimming time-trial performances. After the baseline trial (first visit), in a double-blind, randomised design, 15 trained/developmental (5 females) swimmers and triathletes were assigned to three groups and underwent an 8-day supplementation period, with a daily dose of either 8 gr L-arginine (Arg, n = 5) or L-citrulline (Cit, n = 5) or placebo (Pla, n = 5). On day 9, participants completed experimental trial (second visit). In each trial, after blood sampling, participants performed both 200 m and 100 m freestyle swimming time-trials, with 30 min recovery between trials. Plasma nitric oxide (NOx) and blood lactate concentrations (BLa) were collected immediately before and after 200 m and 100 m TTs, respectively. No significant difference was observed in NOx between groups (p = 0.201). There was no significant difference in 200 m (p = 0.226) and 100 m swimming time-trials (p = 0.993) between groups. There was a main effect of time on BLa concentration (p < 0.001), but no trial × group (p = 0.243) and trial × lactate × group interaction effect (p = 0.276) was present. Furthermore, 8-day either L-citrulline or L-arginine supplementation did not enhance middle (200 m) and short-distance (100 m) swimming performance in trained/developmental swimmers and triathletes. These findings do not support the use of L-citrulline or L-arginine supplementation as ergogenic aids for swimming performance.

Metabolic syndrome severity score (MetSSS) associates with metabolic health status in multi-ethnic Aotearoa New Zealand cohorts

Malaria affects around 228 million people all over the globe. Malaria causing parasite Plasmodium infection leads to activation of immune responses. The growth of parasite and immune activation requires semi essential amino acids like L-arginine. Malaria infection leads to condition of hyperargininemia and low availability of nitric oxide. However, the effect of L-arginine supplementation in malaria infected mice has not been explored in in-vivo studies. In this study we have compared the effect of oral supplementation of nitric oxide donor, L-arginine and L-citrulline, in malaria infected mice Methods: To examine the effect of oral supplementation of L-arginine and L-citrulline, Plasmodium berghei infected mice were divided in different groups and respective groups were fed with L- arginine and L-citrulline, parasitemia was measured on different days. Mice was sacrificed and immunophenotyping was done on 10 days post infection. our results show that supplementation of L-arginine induces conducive environment for Plasmodium growth due to which the infected mice dies earlier than control wild type infected mice whereas L-citrulline supplementation inhibits parasite growth and mice survives for longer period of time. Flow cytometric analysis shows that supplementation of L-arginine increases cTLA-4 on T cell population, increases Treg cells leading to immunosuppression while supplementation of L-citrulline does not have effect on T cells population and number of Treg cell decrease compared to P. berghei infected mice. our results show that L-citrulline can be a better alternative than L-arginine because of lower expression of inhibitory molecules and lower parasitemia as well as increased survival of infected mice.

A metabolic syndrome (MS) diagnosis was made when the criteria for three or more of five MS components were met. Due to some limitations in the traditional MS criteria, however, different health care societies have sought to develop applicable MS scoring systems instead. Continuous MS scores can be of meaningful value in the prevention, diagnosis, and treatment of MS at different life stages. Relatedly, this study used a database for 27,748 subjects aged 20 to 64 years who received health checks at a health screening institution in Taiwan from 2010 to 2015 to a similar end. Five components of MS (waist circumference, fasting plasma glucose, blood pressure, fasting triglycerides, and high-density lipoprotein) were used to formulate an MS severity score in different gender and age stratums, which was then used to evaluate the risks of various lifestyle habits. Those estimates were then compared with the results for traditional MS diagnosis. The MS severity scores for some behaviors relating to smoking, drinking, physical activity, and sweetened beverage consumption were found to have changed from 0.03 to 0.2; however, a logistic regression analysis with dichotomous diagnosis did not indicate significant links between these behaviors and MS. The models established by the MS severity scores can identify the risk factors for MS in a more sensitive manner than the traditional MS diagnosis can, especially with respect to specific lifestyle habits. MS severity score can serve as an indicator to explore the potential risk factors for subclinical conditions in the early stages of MS.

The study aimed to assess for an association between the degree of severity of the metabolic syndrome and risk of type 2 diabetes beyond that conferred by the individual components of the metabolic syndrome. We assessed HRs for an Adult Treatment Panel III (ATP-III) metabolic syndrome score (ATP-III MetS) and a sex- and race-specific continuous metabolic syndrome severity z score related to incident diabetes over a median of 7.8years of follow-up among participants of two observational cohorts, the Atherosclerosis Risk in Communities study (n=10,957) and the Jackson Heart Study (n=2137). The ATP-III MetS had an HR for incident diabetes of 4.36 (95% CI 3.83, 4.97), which was attenuated in models that included the individual metabolic syndrome components. By contrast, participants in the fourth quartile of metabolic syndrome severity (compared with the first quartile) had an HR of 17.4 (95% CI 12.6, 24.1) for future diabetes; in models that also included the individual metabolic syndrome components, this remained significant, with an HR of 3.69 (95% CI 2.42, 5.64). There was a race × metabolic syndrome interaction in these models such that HR was greater for black participants (5.30) than white participants (2.24). When the change in metabolic syndrome severity score was included in the hazard models, this conferred a further association, with changes in metabolic syndrome severity score of ≥0.5 having a HR of 2.66 compared with changes in metabolic syndrome severity score of ≤0. Use of a continuous sex- and race-specific metabolic syndrome severity z score provided an additional prediction of risk of diabetes beyond that of the individual metabolic syndrome components, suggesting an added risk conferred by the processes underlying the metabolic syndrome. Increases in this score over time were associated with further risk, supporting the potential clinical utility of following metabolic syndrome severity over time.

Objective: To compare polycystic ovarian syndrome and their defining criteria with metabolic syndrome severity score among females with and without polycystic ovarian syndrome. Study Design: Comparative cross-sectional study. Place and Duration of Study: Naval Hospital Islamabad, from Jan 2018 to Dec 2021. Methodology: We evaluated 293 female subjects for Poly Cystic Ovarian Syndrome after several exclusions who presented with an initial complaint of disturbances in menstrual cycles. These subjects underwent clinical examination including blood pressure and anthropometric indices and measurements of modified Ferriman Gallway score. Biochemical measurements included fasting plasma glucose, HDL cholesterol, triglycerides and insulin measurement. These parameters were measured for various components included in defining the Poly Cystic Ovarian Syndrome as per Rotterdam criteria and Metabolic Syndrome Severity Score equation to compare metabolic syndrome severity and insulin resistance among subjects with Poly Cystic Ovarian Syndrome and without Poly Cystic Ovarian Syndrome. Results: Mean age among participants were 29.46±6.74 years. Disturbances in menstrual cycle reporting oligo/anovulation was reported by (181/293) 61.8% in comparison to (112/293) 38.2%. Hirsutism (modified Ferriman Gallway score&gt;8) was present in (142/293) 48.5%. Radiological findings pointing towards Poly Cystic Ovarian Syndrome diagnosis were found in (72/293) 24.6%. Metabolic Syndrome Severity Score showed higher correlation with age, and insulin resistance in contrast to hirsutism and free androgen indices. Hirsutism was higher among oligo/anovulation females than participants without menstrual complaints (14.17+8.99 vs. 11.16+7.88, p=0.004). Similarly, bioc Conclusion: Metabolic Syndrome Severity Score equation does not associate with Poly Cystic Ovarian Syndrome criteria as defined by Rotterdam. Insulin resi

Background: Research suggests sleep duration can influence metabolic systems including glucose homeostasis, blood pressure, hormone regulation, nervous system activity, and total energy expenditure (TEE), all of which are related to cardiometabolic disease risk, even in young adults. The purpose of this study was to examine the relationship between sleep duration and metabolic syndrome severity scores (MSSS) in a sample of emerging adults (18–24 y/o). Methods: Data were collected between 2012 and 2021 from the College Health and Nutrition Assessment Survey, an ongoing, cross-sectional study conducted at a midsized northeastern university. Anthropometric, biochemical, and clinical measures were obtained following an overnight fast and used to assess the prevalence of metabolic syndrome (MetS). MetS severity scores (MSSS) were calculated using race- and sex-specific formulas. Sleep duration was calculated from the difference in self-reported bedtime and wake time acquired through an online survey. ANCOVA was used to examine the relationship between sleep duration and MetS severity score while adjusting for covariates (age, sex, BMI, physical activity level, smoking status, alcohol consumption, and academic major). Results: In the final sample (n = 3816), MetS (≥3 criteria) was present in 3.3% of students, while 15.4% of students presented with ≥2 MetS criteria. Mean MSSS was −0.65 ± 0.56, and the reported sleep duration was 8.2 ± 1.3 h/day. MSSS was higher among low sleepers (<7 h/day) and long sleepers (>9 h/day) compared to the reference sleepers (7–8 h/day) (−0.61 ± 0.02 and −0.63 ± 0.01 vs. −0.7 ± 0.02, respectively, p < 0.01). Conclusions: Our findings suggest short (<7 h/day) and long (>9 h/day) sleep durations raise the risk of MetS in a sample of emerging adults. Further research is needed to elucidate the impact of improving sleep habits on future disease risk.