Metabolic Syndrome Abnormalities Research Articles

Effect of Metabolic Syndrome and Metabolic Abnormalities on Remission of Bipolar Disorder Inpatients: A Retrospective Chart Review Study

Effect of Metabolic Syndrome and Metabolic Abnormalities on Remission of Bipolar Disorder Inpatients: A Retrospective Chart Review Study

Comparison of anthropometric, metabolic, and body compositional abnormalities in Korean children and adolescents born small, appropriate, and large for gestational age: a population-based study from KNHANES V (2010-2011).

The impacts of growth restriction and programming in the fetal stage on metabolic and bone health in children and adolescents are poorly understood. Moreover, there is insufficient evidence for the relationship between current growth status and metabolic components. Herein, we compared the growth status, metabolic and body compositions, and bone mineral density in Korean children and adolescents based on birth weight at gestational age. We studied 1,748 subjects (272 small for gestational age [SGA], 1,286 appropriate for gestational age [AGA], and 190 large for gestational age [LGA]; 931 men and 817 women) aged 10-18 years from the Korean National Health and Nutrition Examination Survey (KNHANES) V (2010-2011). Anthropometric measurements, fasting blood biochemistry, and body composition data were analyzed according to birth weight and gestational age. The prevalence of low birth weight (14.7% vs. 1.2% in AGA and 3.2% in LGA, p<0.001) and current short stature (2.237 [1.296-3.861] compared to AGA, p=0.004) in SGA subjects was greater than that in other groups; however, the prevalence of overweight and obesity risks, metabolic syndrome (MetS), and MetS component abnormalities was not. Moreover, no significant differences were found in age- and sex-adjusted lean mass ratio, fat mass ratio, truncal fat ratio, bone mineral content, or bone density among the SGA, AGA, and LGA groups in Korean children and adolescents. Our data demonstrate that birth weight alone may not be a determining factor for body composition and bone mass in Korean children and adolescents. Further prospective and longitudinal studies in adults are necessary to confirm the impact of SGA on metabolic components and bone health.

Systemic Inflammation in Asthma: What Are the Risks and Impacts Outside the Airway?

Airway inflammation in asthma has been well recognized for several decades, with general agreement on its role in asthma pathogenesis, symptoms, propensity toward exacerbation, and decline in lung function. This has led to universal recommendation in asthma management guidelines to incorporate the use of inhaled corticosteroid as an anti-inflammatory therapy for all patients with persistent asthma symptoms. However, there has been limited attention paid to the presence and potential impact of systemic inflammation in asthma. Accumulating evidence from epidemiological observations and cohort studies points to a host of downstream organ dysfunction in asthma especially among patients with longstanding or more severe disease, frequent exacerbations, and underlying risk factors for organ dysfunction. Most studies to date have focused on cognitive impairment, depression/anxiety, metabolic syndrome, and cardiovascular abnormalities. In this review, we summarize some of the evidence demonstrating these abnormalities, highlight the proposed mechanisms and potential benefits of treatment in limiting these extrapulmonary abnormalities in patients with asthma. The goal of this commentary is to raise awareness of the importance of recognizing potential extra-pulmonary conditions associated with systemic inflammation of asthma. This area of treatment of patients with asthma is a large unmet need.

GPCRs involved in metabolic diseases: pharmacotherapeutic development updates.

G protein-coupled receptors (GPCRs) are expressed in a variety of cell types and tissues, and activation of GPCRs is involved in enormous metabolic pathways, including nutrient synthesis, transportation, storage or insulin sensitivity, etc. This review intends to summarize the regulation of metabolic homeostasis and mechanisms by a series of GPCRs, such as GPR91, GPR55, GPR119, GPR109a, GPR142, GPR40, GPR41, GPR43 and GPR120. With deep understanding of GPCR's structure and signaling pathways, it is attempting to uncover the role of GPCRs in major metabolic diseases, including metabolic syndrome, diabetes, dyslipidemia and nonalcoholic steatohepatitis, for which the global prevalence has risen during last two decades. An extensive list of agonists and antagonists with their chemical structures in a nature of small molecular compounds for above-mentioned GPCRs is provided as pharmacologic candidates, and their preliminary data of preclinical studies are discussed. Moreover, their beneficial effects in correcting abnormalities of metabolic syndrome, diabetes and dyslipidemia are summarized when clinical trials have been undertaken. Thus, accumulating data suggest that these agonists or antagonists might become as new pharmacotherapeutic candidates for the treatment of metabolic diseases.

Associated Factors with Changes of Metabolic Abnormalities among General Population in COVID-19 Pandemic

The coronavirus disease-2019 (COVID-19) pandemic has led to restrictions on daily living including social distancing. These restrictions had an impact on the individual's healthy lifestyle and health status. We investigated the associated factors with changes of metabolic abnormalities among general population in COVID-19.The participants were 43,639 people who received health check-ups twice in 2019 and 2021 during COVID-19 pandemic, at 16 health promotion centers. Metabolic abnormalities were identified according to the third report of the cholesterol education program criteria. Multiple logistic regression analysis was performed to confirm the factors related to changes of metabolic abnormalities during COVID-19.Metabolic syndrome and metabolic abnormalities increased overall during the COVID-19 pandemic. This increase was mostly appeared in males. The occurrence of metabolic syndrome during COVID-19 was associated with 50s and older age (odds ratio [OR], 1.130; 95% confidence interval [CI], 1.019-1.254), attempt to quit smoking (OR, 1.467; 95% CI, 1.171-1.839), start smoking (OR, 1.251; 95% CI, 1.110-1.412), decrease in aerobic exercise (OR, 1.328; 95% CI, 1.162-1.517), and increase in strength exercise (OR, 0.704; 95% CI, 0.592-0.838).The metabolic syndrome is closely related to smoking experience and lack of exercise during COVID-19.

Therapeutic potential of flavonoids in the management of obesity-induced Alzheimer's disease: an overview of preclinical and clinical studies.

Obesity is a global epidemic that affects people of all ages, genders, and backgrounds. It can lead to a plethora of disorders, including diabetes mellitus, renal dysfunction, musculoskeletal problems, metabolic syndrome, cardiovascular, and neurodegenerative abnormalities. Obesity has also been linked to neurological diseases such as cognitive decline, dementia, and Alzheimer's disease (AD), caused by oxidative stress, pro-inflammatory cytokines, and the production of reactive oxygen free radicals (ROS). Secretion of insulin hormone is impaired in obese people, leading to hyperglycaemia and increased accumulation of amyloid-β in the brain. Acetylcholine, a key neurotransmitter necessary for forming new neuronal connections in the brain, decreases in AD patients. To alleviate acetylcholine deficiency, researchers have proposed dietary interventions and adjuvant therapies that enhance the production of acetylcholine and assist in the management of AD patients. Such measures include dietary intervention with antioxidant and anti-inflammatory flavonoid-rich diets, which have been found to bind to tau receptors, reduce gliosis, and reduce neuroinflammatory markers in animal models. Furthermore, flavonoids like curcumin, resveratrol, epigallocatechin-3-gallate, morin, delphinidins, quercetin, luteolin, and oleocanthal have shown to cause significant reductions in interleukin-1β, increase BDNF levels, stimulate hippocampal neurogenesis and synapse formation, and ultimately prevent the loss of neurons in the brain. Thus, flavonoid-rich nutraceuticals can be a potential cost-effective therapeutic option for treating obesity-induced AD, but further well-designed, randomized, and placebo-controlled clinical studies are needed to assess their optimal dosages, efficacy, and long-term safety of flavonoids in humans. The main objectives of this review are to underscore the therapeutic potential of different nutraceuticals containing flavonoids that can be added in the daily diet of AD patients to enhance acetylcholine and reduce neuronal inflammation in the brain.

The Association between Metabolic Syndrome and Epithelial Cell Abnormalities Detected on Pap Smear: A Nationwide Population-Based Study.

Several epidemiologic studies have suggested the correlation between metabolic syndrome (MetS) and cervical cancer. The identification of epithelial cell abnormalities through cervical cytology implies lesions that may lead to cervical cancer in the long term, making screening a crucial measure for its prevention. We conducted a case-control study using data from the National Health Screening Programs under the Health Insurance System of South Korea between 2009 and 2017. Among women who underwent a Pap smear during this period, 8,606,394 tests reported negative results for epithelial cell abnormalities (controls, 93.7%), while 580,012 tests reported epithelial cell abnormalities (cases, 6.3%). Of these, the incidence of MetS was significantly higher in the case group, with 21.7% of cases and 18.4% of controls meeting the MetS criteria with p-Value of less than 0.0001; however, the effect size was small with odds ratio of 1.23. Logistic regression analysis revealed increased odds of epithelial cell abnormalities in women with MetS after adjusting for associated risk factors (AOR 1.202, 95% CI 1.195-1.210, p < 0.0001). These findings indicate that women with MetS have an elevated risk of developing epithelial cell abnormalities, reinforcing the importance of regular Pap smear screening to prevent cervical cancer progression in this population.

Metabolic Disorders and Metabolically Obese Normal-Weight in Burkinabe Adults: Increasing Prevalences Across Normal BMI Quartiles, Using the 2013 STEPS Database

<i>Background:</i> Majority of Burkinabè adults were normal-weight by body mass index (BMI). This study explored by gender, the metabolic abnormalities and “metabolic obesity with body weight” (MONW) throughout the normal BMI quartiles (Q) of Burkinabè adults. <i>Methods: </i>We performed a secondary-analysis of data from the first WHO Stepwise approach to surveillance survey conducted in 2013 in Burkina Faso, and only adults with BMI between 18.5 – 24.9 kg/m² were included. Metabolic disorders (individual abnormal metabolic syndrome component, having at least two abnormalities and MONW) were described in BMI’ quartiles, for each gender, and the risk of occurrence of having at least two abnormalities or MONW was analysed using quartiles as dependent variables, after adjustment on sociodemographic and lifestyle factors. <i>Results: I</i>n the 3112 adults with normal BMI and despite their gender, low high-density lipoprotein cholesterol was widespread (>75%) and its distribution did not differ across quartiles, as for raised fasting blood glucose (its prevalence was low ≈ 8%). Elevated blood pressure was the predominant abnormality in overall men (35.3%) with a significant increment starting at Q3 and reached 42.8% in Q4, while abdominal obesity was predominant in overall women (27.2%) with a significant increase starting at Q2, and reached 53.8% in Q4. In men, MONW was low (2.3%), while 30.6% had at least two abnormalities with an increasing pick starting at Q3, and prevalence was 38.0% in Q4. In women, the prevalence of MONW and those with at least two abnormalities was 8% and 39% respectively, with a common significant elevation beginning at Q3 and respectively reached 16% and 56% in Q4. Independently of sociodemographic and lifestyle factors, the number of metabolic abnormalities started to increase at Q3 in both sexes. <i>Conclusion:</i> Prevalence of adults with at least two metabolic abnormalities was considerable, and the number of abnormalities increased with normal BMI, and more severely in female gender in whom the prevalence of MONW was alarming. Abnormalities should also be early screened in normal-weight Burkinabè adults, more especially when their BMI reaches the Q3 cut-offs, i.e., 21.5 and 21.1 kg/m² respectively for men and women.

Metabolic syndrome- cardiac structure and functional analysis by echocardiography; a cross sectional comparative study.

Metabolic syndrome (MS) is a collection of metabolic disorders including hyperglycemia, hypertension and dyslipidemia. The outcome of metabolic syndrome depends on structural changes in heart like increased left atrial size or increased left ventricular mass. This study was done to determine the echocardiography abnormalities in metabolic syndrome. After obtaining informed consent, 75 subjects with metabolic syndrome and 75 controls were included in the study. 2D echo/M mode examination was performed for all. Aortic root, left atrial size, left atrial volume, septal wall thickness during systole (SWs) and diastole (SWd), posterior wall thickness during systole (PWs) and diastole (PWd), left ventricle dimension during systole (LVDs) and diastole (LVDd), and ejection fraction were measured. The values were compared between the groups. After adjustment for age, sex, smoking, alcohol and BMI; left ventricular diameter in systole and diastole was significantly more than controls (p<0.001); HR of 1.29 (95% CI 1.13-1.46), 1.29 (95% CI 1.15-1.45) respectively. Left ventricular mass and left atrial volume were increased significantly in subjects with metabolic syndrome (p<0.001); HR were 1.06 (95% CI 1.03-1.08), 1.13 (95% CI 1.06-1.19) respectively. Ejection fraction was low normal in subjects with metabolic syndrome compared to controls (p<0.05); HR 0.90 (95% CI 0.83-0.98). Cardiac abnormalities were common in subjects with metabolic syndrome, predominantly affecting the left ventricular mass, diameter and left atrial volume. Early life style modifications are essential to prevent these complications.

Insulin Resistance and its Detection Tools

Insulin resistance (IR) is a defining feature of obesity, diabetes, and cardiovascular disease, and it contributes to many of the metabolic syndrome's abnormalities. Although our understanding of IR has vastly increased over time, several parts of its assessment continue to elude researchers and doctors. Although the quantitative assessment of insulin sensitivity is not regularly utilized in biochemical investigations for diagnostic purposes, the growing importance of IR has led to further research into its application. IR must be assessed in a number of clinical situations when insulin sensitivity is reduced. IR is being studied more and more in numerous disease states to help researchers better understand its pathophysiology, etiology, and implications. The gold standard approach for determining insulin sensitivity is the hyperinsulinemic euglycemic glucose clamp, although it is impractical due to its labor- and time-intensive nature. As a result, a variety of surrogate indices have been used to make determining IR easier and more accurate. The goal of this study is to highlight different elements and approaches for present and future insulin sensitivity/resistance measurements. Understanding and exploiting the condition will be aided by a thorough understanding of these signs.

Comorbidities in Patients with Vitiligo: A Systematic Review and Meta-Analysis

Vitiligo has been reported to be associated with a variety of diseases, but it has not been systematically reviewed. Therefore, we aimed to identify prevalent diseases in patients with vitiligo and quantify their associations compared with healthy controls. A comprehensive search of the MEDLINE and EMBASE from the inception to June, 2022 was conducted. Observational studies on prevalent diseases in vitiligo patients compared to healthy controls were included, whereas studies limited to pediatrics or providing only laboratory results were excluded. A total of 78 studies were eligible for analyses. Patients with vitiligo showed higher risks of having comorbid autoimmune and connective tissue diseases, including alopecia areata (odds ratio [OR], 2.63; 95% confidence interval [CI], 2.50-2.78), discoid lupus erythematosus (OR, 2.54; 95% CI, 1.74-3.72), Sjogren's syndrome (OR, 2.50; 95% CI, 1.98-3.16), myasthenia gravis (OR, 2.30; 95% CI, 1.74-3.02), systemic lupus erythematosus (OR, 1.96; 95% CI, 1.52-2.52), and rheumatoid arthritis (OR, 1.82; 95% CI, 1.55-2.15). Thyroid diseases, diabetes mellitus, metabolic syndrome, sensorineural hypoacusis and ophthalmic abnormalities were also more prevalent in patients with vitiligo. In conclusion, vitiligo is associated with various systemic diseases. Physicians should evaluate and manage potential comorbid conditions in patients with vitiligo.

Visceral Obesity Is Associated with Shorter Progression-Free Survival in Well-Differentiated Gastro-Entero-Pancreatic Neuroendocrine Neoplasia.

The association of well-differentiated gastro-entero-pancreatic neuroendocrine neoplasia (WD GEP-NEN) with metabolic syndrome (MetS), abdominal obesity, and fasting glucose abnormalities was recently described. However, whether obesity and metabolic syndrome risk factors are associated with GEP-NEN adverse outcomes and the poorer prognosis was unknown. The present study aimed to evaluate whether the presence of MetS or any of its individual components at WD GEP-NEN diagnosis influenced disease outcomes. A cohort of patients with non-localized WD GEP-NETs (n = 81), was classified according to the primary tumor site (gastrointestinal or pancreatic), pathological grading (G1 (Ki67 ≤ 2%) and G2 (3% ≤ Ki67 ≤ 20%) (WHO 2010)), disease extension (loco-regional or metastatic disease), presence of hormonal secretion syndrome (functioning or non-functioning), and evaluated for the presence of MetS criteria at diagnosis. MetS was present in 48 (59.3%) patients. During a median follow-up of 95.0 months (16.8–262.5), 18 patients died of the disease (10 with MetS vs. 8 without MetS). Overall survival (OS) at 5 years was 87.1% (95% CI: 73.6–94.0) for MetS and 90.9% (95% CI: 74.4–97.0) for non-Mets group, while OS at 10 years was 72.5% (95% CI: 55.3–84.0) for MetS, and 76.4% (95% CI: 53.6–89.0) for non-MetS group. Progression-Free Survival (PFS) at 5 years was 45.9% (95% CI: 30.8–59.8) for MetS and 40.0% (95% CI: 21.3–58.1) for non-MetS group, and PFS at 10 years was 18.1% (95% CI: 7.0–33.5) for MetS and 24.4% (95% CI: 9.0–43.7) for non-MetS group. Waist circumference (WC), a surrogate measure for visceral obesity, was associated with significantly shorter PFS (HR = 1.03; 95% CI: 1.01–1.06), although did not influence OS (HR = 1.01; 95% CI: 0.97–1.06). The findings of this study reinforce a potential link between visceral obesity and GEP-NEN and further suggest that obesity could influence disease prognosis.

Immunohistochemical Demonstration of Interleukin-17 Positivity in Skin Biopsy Specimens of Patients with Chronic Plaque Psoriasis and its Correlation with Severity of Psoriasis and Associated Metabolic Syndrome and Cardiovascular Changes

Background: Psoriasis is a chronic inflammatory disease which can be associated with metabolic syndrome and cardiovascular abnormalities. Objectives: The aim and objective of the study are to demonstrate interleukin-17 (IL-7) positivity in histopathological sections of psoriatic plaques and to correlate with metabolic syndrome and cardiovascular changes. Materials and Methods: Forty-seven patients with chronic plaque psoriasis with body surface area &gt;10% and psoriasis area and severity index (PASI) score &gt;12, in whom skin biopsy showed munro's microabscesses, were evaluated for IL-17 positivity (intensity and proportion) with associated metabolic syndrome according to the National Cholesterol Education Program adult treatment panel III criteria and cardiovascular comorbidities. A co-relation with PASI score was made. IL-17 intensity and proportion were graded with a score ranging from 0 to 3. IBM SPSS version 16.0 was used for statistical analysis and independent t-test and Chi-square test were used for proportion. Results: The mean age of patients was 43 years. A total of 15 (31.9%) female and 32 (68.1%) male patients were enrolled. The mean PASI score was 21.6. Metabolic syndrome was seen in 31 (65.96%) patients. There was statistically significant association with raised diastolic blood pressure in patients with metabolic syndrome (P = 0.042). The total number of patients with IL-17 positivity with metabolic syndrome was 21 (63.6%). Of these, 9 (42.9%) cases showed IL-17 positivity in the munro's microabscess, 14 (66.7%) cases in the rest of the epidermis, and 18 (85.7%) cases in the dermis. Conclusion: In our study, there was no significant difference in IL-7 positivity between patients with or without metabolic syndrome. Further studies need to be done with large sample size to confirm the significance.

Surrogates Markers of Insulin Resistance

Insulin resistance is a fundamental feature of obesity, diabetes, and cardiovascular diseases and contributes to many of the metabolic syndrome's abnormalities. It is defined as a subnormal reaction to normal insulin concentrations or a situation in which greater than normal insulin concentrations are necessary for normal response.

Liver Steatosis: A Marker of Metabolic Risk in Children.

Obesity is one of the greatest health challenges affecting children of all ages and ethnicities. Almost 19% of children and adolescents worldwide are overweight or obese, with an upward trend in the last decades. These reports imply an increased risk of fat accumulation in hepatic cells leading to a series of histological hepatic damages gathered under the acronym NAFLD (Non-Alcoholic Fatty Liver Disease). Due to the complex dynamics underlying this condition, it has been recently renamed as ‘Metabolic Dysfunction Associated Fatty Liver Disease (MAFLD)’, supporting the hypothesis that hepatic steatosis is a key component of the large group of clinical and laboratory abnormalities of Metabolic Syndrome (MetS). This review aims to share the latest scientific knowledge on MAFLD in children in an attempt to offer novel insights into the complex dynamics underlying this condition, focusing on the novel molecular aspects. Although there is still no treatment with a proven efficacy for this condition, starting from the molecular basis of the disease, MAFLD’s therapeutic landscape is rapidly expanding, and different medications seem to act as modifiers of liver steatosis, inflammation, and fibrosis.

The Prevalence of Polycystic Ovary Syndrome, Its Phenotypes and Cardio-Metabolic Features in a Community Sample of Iranian Population: Tehran Lipid and Glucose Study.

ObjectivesThe aim of the present study was to evaluate the prevalence of polycystic ovary syndrome (PCOS), its phenotypical and cardio-metabolic features in a community sample of the Iranian population in comparison to healthy eumenorrheic, non-hirsute women without polycystic ovaries. The second aim was to assess the cardio-metabolic characteristics of women who suffered from one criteria of PCOS compared to those healthy eumenorrheic, non-hirsute women.MethodsIn this cross-sectional population-based study, a total of 1,960 eligible women, aged (18–45 years) were recruited from the Tehran-Lipid and Glucose-Study participants and were classified as the three groups of (i) women with PCOS by the Rotterdam criteria, (ii) non-PCOS women with one criteria of PCOS and (iii) healthy eumenorrheic, non-hirsute women without polycystic ovaries morphology (PCOM) as the control group. Further PCOS women were extended to four phenotypes of hyperandrogenism, oligo-anovulation, polycystic ovaries (phenotype A), hyperandrogenism, oligo/anovulation (phenotype B), hyperandrogenism, polycystic ovaries (phenotype C) and oligo-anovulation, polycystic ovaries (phenotype D). Cardio-metabolic profiles and the prevalence of comorbidities of metabolic syndrome (MetS) and lipid abnormalities were compared among these groups linear, and the median regression models adjusted for age and body mass index.ResultsThe prevalence of PCOS according to the diagnostic criteria of the NIH, Rotterdam and AE-PCOS Society were 13.6, 19.4, and 17.8, respectively. Among those who met the Rotterdam criteria, 23.9, 46.3, 21.6, and 8.2% had phenotypes A, B, C, and D, respectively. Among the remaining 1,580 women who did not fulfil the PCOS criteria, 108 (6.8%) suffered from only oligo/anovulation, 332 (21%) only hyperandrogenism/hyperandrogenemia, 159 (16.2%) only PCOM in ultrasound and 981 (62%) were healthy eumenorrheic, non-hirsute women without PCOM. The study revealed that some adiposity indices and lipid abnormalities in PCOS phenotypes with hyperandrogenism (A, B, and C) were worse than in healthy women. By contrast, women with phenotype D did not differ from the healthy ones in terms of adiposity and lipid abnormalities. However, the respective values for other cardio-metabolic profiles and MetS rates in different phenotypes of PCOS were similar to the healthy women. Only the prevalence of MetS in phenotype A was significantly higher than in the healthy women. There were no statistically significant differences between participants with one criteria of PCOS and healthy counterparts in terms of most adiposity indexes, cardio-metabolic factors, and comorbidity of MetS and its components. However, women with hyperandrogenism had a significantly higher level of the waist to height ratio (WHtR) and hypertriglyceridemia than their healthy counterparts.ConclusionPCOS, mainly classical phenotypes A and B, are common among Iranian women of reproductive age. Women with PCOS who had androgen excess exhibited the worst lipid profile, and those who had full three criteria of the syndrome exhibited the higher rate of MetS. However, women with only ovulatory dysfunction and only PCOM had similar cardio-metabolic characteristics, compared to healthy subjects. These data suggest that routine screening for metabolic disturbances may be needed in the prevention of cardio-metabolic disorders in patients with more serious phenotypes of PCOS.

An Expert Opinion on the Management of Type 2 Diabetes Mellitus in Children and Adolescents

Type 2 diabetes mellitus (T2DM) is an emerging epidemic among children and adolescents. There is a lack of comprehensive guidance to clinicians for the management of T2DM in this patient population. An expert panel of diabetes specialists from India reviewed the available literature, discussed, and proposed six recommendations on the identification of risk factors leading to the development of T2DM, diagnosis of T2DM, and non-pharmacological and pharmacological management of T2DM in children and adolescents. According to these recommendations, the most common risk factors leading to T2DM in children are obesity, metabolic syndrome, insulin resistance, family history, puberty, and genetic abnormalities. Diagnosis of T2DM in children and adolescents should be based on plasma glucose levels, with recommendation to test glycated hemoglobin levels quarterly. Lifestyle modifications may help in improving outcomes. Among pharmacological treatments, insulin and metformin are currently the approved first-line therapies and liraglutide is recommended if glycemic targets are no longer met with metformin or insulins. Early identification of risk factors, along with early diagnosis and initiation of insulin therapy with lifestyle modifications, may help in delaying the chronic complications associated with T2DM in children and adolescents.

The impact of metabolic syndrome components on urinary parameters and risk of stone formation.

To investigate the relationship between metabolic syndrome (MS) and urinary abnormalities in stone-forming patients. Additionally, to delineate whether severity of urinary derangements is impacted by the number of co-occurring MS components. Stone-forming patients who underwent initial metabolic workup prior to medical intervention at a comprehensive stone clinic were retrospectively reviewed and included in the study. Patients were given a six point (0-5) Metabolic Syndrome Severity Score (MSSS) based on the number of co-occurring MS components and split into six respective groups. Baseline clinical characteristics and metabolic profiles were compared between groups. Four-hundred-ninety-five patients were included in the study. Median age and median BMI was 58years and 27.26kg/m2, respectively. Several significant metabolic differences were noted, most notably a downward trend in median urinary pH (p < 0.001) and an upward trend in median urinary supersaturation uric acid (p < 0.001) across groups as MSSS increased. Multivariate analysis demonstrated an independent association between higher MSSS and increasing number of urinary abnormalities. A second multivariate analysis revealed that all MS components except hyperlipidemia were independently associated with low urinary pH. Additionally, obesity was independently associated with the greatest number of urinary abnormalities and had the strongest association with hyperuricosuria. Prior research has attributed the strong association of nephrolithiasis and MS to high prevalence of UA nephrolithiasis and low urinary pH. Our findings indicate that all MS components with the exception of hyperlipidemia were independently associated with low urinary pH suggesting a mechanism independent from insulin resistance.

The relationship and significance between lipoprotein abnormalities and HDL dysfunction in severely obese people

Obesity and dyslipidemia may have a role in the development of cardiovascular disease. Neuropathy has also been linked to obesity. The existence of peripheral nerve injury and the presence of metabolic syndrome and lipoprotein abnormalities were evaluated in patients with severe obesity who did not have type 2 diabetes. Detailed proteomics of neuropathic and an evaluation of lipoproteins and HDL-functionality were performed on 49 patients with extreme obesity and 35 age-matched healthy controls. Compared to healthy controls, participants with extreme obesity exhibited a more excellent neuropathy symptom portfolio, lower sural and peroneal nerve impedance, aberrant temperature thresholds, heart rate with controlled breathing, and corneal nerve characteristics. People with significant obesity suffer from little nerve fiber injury. In comparison to controls, obese patients have abnormal lipoproteins and impaired HDL activity. Obese patients with minor nerve fiber injury showed significantly higher serum triglycerides, decreased PON-1 activity, and a higher frequency of obesity than those without.

Modulatory Effect of Whole Flour and Hydroalcoholic Extract of Finger Millet (Elusine coracana) on the Abnormalities Associated with Metabolic Syndrome in Hyperlipidemic Diabetic Rats

The present study was designed toevaluate the effect of whole flour andhydroalcoholic extract of finger millet (Elusinecoracana) in high fat diet (HFD) andstreptozotocin induced metabolic syndrome inrats. The HFD was fed to the rats for a period of45 days to induce hyperlipidemia. Diabeteswas induced by single intraperitoneal injectionof streptozotocin (65mg/kg i.p) in 0.1M citratebuffer pH 4.5. Animals with fasting blood sugarlevel of 250 mg/dl were considered ashyperlipidemic diabetic rats (HDR) and wereselected for the study. The HDR were dividedinto five groups with six animals in each groupand one group of normal animals. The HDRreceived whole flour and hydroalcoholicextract of Elusine coracana at a dose of 100,200 and 400 mg/kg for a period of 21 days.Body weight, body mass index, fasting bloodsugar level, lipid profile and the level ofoxidative stress was measured in animals afterthe treatment. All treatments significantlydecreased body weight, BMI, fasting bloodsugar and also improved lipid profile in HDR ascompared to the toxicant control. Thetreatments significantly reduced the level oflipid peroxidation and improved superoxidedismutase and reduced glutathione in thepancreas of HDR. Whole flour andhydroalcoholic extract of Elusine coracana at adose of 200 and 400 mg/kg caused significantalleviation of the abnormalities of metabolicsyndrome in rats.