Background Of Metabolic Syndrome Research Articles

The course of bronchial asthma associated with metabolic syndrome in children with different phenotypes depending on vitamin D3 level

Objective: to establish specific features of BA course in children with various phenotypes on the background of metabolic syndrome, depending on serum vitamin D 3 level. Subjects and methods. 106 children with BA participated in the study. 42 patients had BA associated with metabolic syndrome (MS), and 64 had BA with no MS. By the phenotype 61 (57.5 %) of patients had allergen-induced (allergic) asthma and 45 (42.5 %) – virus-induced (non-allergic) BA. The control group consisted of 44 children (the patients with MS and those without MS and BA), average age 15.5 ± 1.3 years. All the patients underwent a unified complex of diagnostic investigations: general physical examination, measurement of waist circumference and body mass index (BMI), clinical blood test, spirometry, lipid profile. Weight categories (normal weight, excess weight and obesity) were determined by percentiles (P) of BMI variation series with regard to age, as indicated in WHO recommendations. Serum 25(OH)D levels were determined by enzyme immunoassay. Vitamin D level ≥20 ng/ml was considered sufficient, 11–20 ng/ml – insufficient, ≤10 ng/ml – deficient. General and specific serum IgE levels were determined by enzyme immunoassay. The data obtained were processed with Statistica 8 program, P values of less than 0.05 were considered to indicate statistical significance. Results. In the group of patients with vitamin D 3 level below 20 ng/ml, 19.5 % had controlled BA and 41.3 % – uncontrolled BA, while among the children with vitamin D level over 20 ng/ml, 30.4 % had controlled BA and 8.6 % – uncontrolled BA (χ 2 = 9.12, P < 0.05). Mean value of vitamin D 3 concentration in the control group was significantly higher than in the patients with BA associated with MS and BA without MS (P < 0.05). The relationship between OW, obesity and atopy was confirmed by high serum level of sIgE antibodies in those weight categories. High sIgE levels to allergens from the pollen of meadow grass, weeds and trees, animal epithelium, household dust mite, food and fungal allergens were determined much more frequently in the children with OW and obesity than in those with NW. In the patients with BA associated with MS and vitamin D 3 level below 20 ng/ml, FEV1 and FVLC values appeared to be significantly lower as compared to those with vitamin D 3 level over 20 ng/ml (P = 0.002). Inverse relationship between the most important parameters of external respiration function and BMI was established: VLC (r xy = -0.45, P = 0.002), FVLC (r xy = -0.52, P = 0.001), FEV1 (r xy = -0.78, P = 0.000), respectively. Conclusions. The severity of BA as well as the degree of its control in the patients with different phenotypes was found to be influenced by both the presence of MS and vitamin D 3 level. Therefore, vitamin D deficiency can be one of the risk factors of BA and MS development, and can affect the severity of both BA and MS course. Vitamin D 3 deficiency and the presence of MS greatly influence FEV1, FVLC, PEF values, decreasing the indices of external respiration in children and leading to more severe obstruction.

A prophylaxis of relapses and rehabilitation in women of reproductive age underwent leiomyoma surgery on a background of metabolic syndrome

Аim – to work out the algorithm of prophylaxis of leiomyoma (LM) relapses and rehabilitation of women of reproductive age with metabolic syndrome (MS) in postoperative period. Materials and methods. In research group 130 women with LM and MS (research group) or without MS (comparison group) were involved. The control group consisted of 50 somatically healthy women with normal menstrual and reproductive functions. МS was set on according the following "combined" criteria – criteria of WHO 1999 (impaired glucose tolerance) and criteria of IDF (2009) taking into account the age-related levels of lipids and arterial blood pressure. In venous blood plasma we determined total testosterone, DHEA-S, estradiol, progesterone, FSH, LH, prolactin, using solid-phase ELISA on the "Cobas e 411" and reagents of DRG Diagnostics, Germany. The content of total cholesterol, triglycerides and high-density lipoproteins (HDLP) was determined by a colorimetry method using the "DiaSys" sets (Germany). Before operative interventions the histological and immunohistochemical research was conducted after the aspiration biopsy or separate diagnostic scraping of uterus. Endoscopic surgery was provided in research and comparison group using "Karl Storz" equipment (Germany) on the generally accepted methodology. Results and discussion. The volume of operative intervention and operative access was determined depending on the previous results of endometrial biopsy, sizes and localization of nodules. During the study of the hormonal homoeostasis we revealed increase of estradiol (research group – 429.4±31.2 and comparison group – 320.4±25.3 vs 228.3±24.1 nmol/l in control; р 0.05), but the decline of this index was determined in women of research group and comparison group on the 21-th day of cycle. In addition, pays attention on itself increase of androgens in women with LM and MS as compared to other groups of patients. Revealed increase of LDLP (1.2 times), triglycerides (1.7 times), total cholesterol (1.4 times) and decreased HDLP (1.4 times) reflect negatively on the reproductive function. The immunohistochemical research showed that in the case of MS there was a positive reaction on androgen receptors in leiomyoma cells, particularly in the vessel wall myocytes. We offered our patients the moderate hypocaloric diet and the individually worked out program of fitness. Metformin was added to traditional therapy. The treatment complex lasted from 3 to 6 months. As a result, we observed the decrease of body weight by 10.5±1.8 kg on average, that corresponded 11.4%. Waist circumference decreased in all patients and in average of group consisted 10.2±3.2 сm; hip circumference decreased by 6.6±4.2 сm suggesting the visceral fat lost. We established statistically significant decrease of LDLP cholesterol that undoubtedly is the additional positive result of provided therapy. Efficiency of the offered diagnostic and curative complex for women with LM and MS was estimated by absence of relapses of LM and by incidence of pregnancies. So at the first year of supervision there were no relapses of LM in ІА subgroup (aromatase inhibitor added to traditional treatment), indeed in ІІA subgroup (traditional treatment only) relapses occurred in 6 patients (20%). The pregnancy occurred in 6 (20.0±2.1%) women of ІІА subgroup, and frequency calculated for one cycle of stimulation consisted 16.7%. The stimulation of ovulation using the aromatase inhibitor 2.5 mg/d was more effective: the pregnancy occurred in 11 (36.6±2.4%) women of ІА subgroup, accordingly frequency calculated for one cycle of stimulation – 30.0 %, that 1.8 times more effective due to offered method of treatment. Conclusions. Comorbidity of benign diseases of uterus and MS in women of reproductive age takes place on a background of significant estradiol increase. Immunohistochemical feature of this comorbidity is expression of androgenic receptors in the separate stromal cells of endometrium and cellular myomas. Improvement in diagnostic and treatment algorithm (using aromatase inhibitor for stimulation of ovulation) resulted in prophylaxis of LM relapses and increase of pregnancies as compared to traditional treatment. We offer the algorithm of management of women of reproductive age with benign diseases of uterus and MS: I stage: complex clinical and laboratory assessment; ІІ stage: correction of revealed hormonal and metabolic violations at MS; ІІI stage: add the aromatase inhibitor to the standard treatment for restoration of reproductive function.

Показники жирової маси тіла при хронічному генералізованому пародонтиті на фоні метаболічного синдрому

Summary. Pathological changes in the periodontium are directly dependent on the violation of fat metabolism, which is one of the main components of the metabolic syndrome.The aim of the study – to determine the main indicators of fatty body mass of patients with chronic generalized periodontitis and metabolic syndrome.Materials and Methods. The study involved patients with diagnoses of chronic generalized periodontitis and metabolic syndrome. Patients of the main group received a treatment and prophylactic complex 2 times a year, normalizing fat metabolism, protein assimilation, reducing cholesterol and normalizing metabolism. The main indicators of fat metabolism were evaluated in patients with bioimpedance analyzers of the body composition components ABC-01 Medass (Russia) and OMRON BF511 (Japan).Results and Discussion. The results of the research of the main indicators of fat metabolism in the patient's body are presented as averaged percentage deviation from the norm, which was calculated for each particular patient according to the average statistical indicators, taking into account age, weight, height and specific basic metabolismConclusions. In patients with chronic generalized periodontitis on a background of metabolic syndrome, there was a significant excess of the norm of the main indicators of fat metabolism in the body. Use of the developed therapeutic and prophylactic complex led to a certain normalization of the fat mass that correlated with improvement of dental status.

BIOCHEMICAL INDICATORS OF BLOOD IN PATIENTS WITH CHRONIC GENERALIZED PARODONTITIS ON THE BACKGROUND OF METABOLIC SYNDROME DEPENDING ON THE DEGREE OF OBESITY

A complex examination of 110 patients with chronic generalized periodontitis was performed on the background of metabolic syndrome (MS) with various degrees of obesity. Glucose, immunoreactive insulin, C-peptide concentration, low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (OX) were determined. The high LDL-cholesterol levels were detected against the background of the HDL decrease, in proportion to the increase in the MT index, there is an increase in metabolic disorders, which is manifested by an increase in the level of basal, stimulated insulin.

Порушення вегетативного тонусу у хворих на лейоміому матки на тлі метаболічного синдрому

The objective: to examine the manifestations of autonomic nervous system dysfunction in women with uterine leiomyoma against the background of metabolic syndrome. Patients and methods. The study included 64 women (30 patients with uterine leiomyoma associated with metabolic syndrome, a group 1, and 34 healthy women, the control group). To characterize the state of the autonomic nervous system applied of A.M. Wayne was determined, index Kerdo, evaluated the degree of sleep according to the questionnaire of A.M. Wayne. Results. Kerdo index inclined in a positive direction and rate was 20.04. Established light sleep disturbances on tables A.M. Wayne in 36.7% of patients in normal – 2.94%, that indicate the presence of somaticaly-vegetative signs and an indication of dysfunctional deviations of the autonomic nervous system tone. Сonclusion. On the basis of subjective and objective signs of dominance tone of the sympathetic and parasympathetic nervous system in patients with uterine leiomyoma, associated with metabolic syndrome, found vahotonic option dysfunction of the autonomic nervous system. Kerdo index showed a negative sign, which is -3.6; in healthy individuals Key words: autonomic tone, uterine leiomyoma, the metabolic syndrome.

THE EFFECT OF INTERVAL NORMOBARIC HYPOXIC TRAINING ON QUALITY OF LIFE AND PSYCHO-VEGETATIVE STATUS OF PATIENTS WITH ESSENTIAL HYPERTENSION WITH METABOLIC SYNDROME

Objective: to clarify the dynamics of quality of life and psycho-autonomic profi le of patients with hypertension in combination with metabolic syndrome, with the use of interval normobaric hypoxic training. Materials and methods: examined 104 patients with essential hypertension stage I — III, 1 — 3 degrees on the background of metabolic syndrome, the average age 48,29±2.23 years. The observation group (54 patients) received a course of interval normobaric hypoxic training on the background of pharmaco- and diet therapy. The comparison group (50 patients) received drug therapy and diet therapy. Quality of life was assessed by SF-36 questionnaire (Russian version), psychological status scale CESD depression, vegetative disorders — according to the “Questionnaire to identify signs of vegetative changes Wayne”. The studied parameters were determined at baseline, after 1 and 6 months from initiation of therapy. Results: the dynamic monitoring of the surveyed showed positive changes in the clinical picture of the disease in both groups in the normalization of blood pressure, reduction of body mass index, more pronounced in patients of the observation group. The application course of interval normobaric hypoxic training provided signifi cantly earlier and more pronounced dynamics of quality of life, reducing the severity of depressive and vegetative disorders in patients. Conclusion: the course of interval normobaric hypoxic training in patients with essential hypertension and metabolic syndrome on the background of drug treatment provides the positive dynamics of quality of life, psychological and vegetative indices, exceeding the effi ciency of isolated pharmacological treatment. The estimation of these parameters can serve as an additional criterion in assessing the therapeutic effect of antihypertensive treatment.

Optimization of treatment of patients with chronic pancreatitis (CP) on the background of metabolic syndrome

Optimization of treatment of patients with chronic pancreatitis (CP) on the background of metabolic syndrome

DELETIONAL POLYMORPHISM OF GLUTATHIONE TRANSFERASE T1 AND M1 GENES IN PATIENTS WITH MYOCARDIAL INFARCTION AND METABOLIC SYNDROME

Aim. To study associations of deletional polymorphism of genes GSTM1 and GSTT1 with myocardial infarction (MI) development on the background of metabolic syndrome (MS).Material and methods. Totally 86 patients with STEMI were included (from those 45 had signs of MS) and 30 healthy persons as control. By polymerase chain reaction the data on deletional polymorphism was obtained on the genes coding glutathiontransferase GSTM1 and GSTT1 in both groups.Results. The significant increase of prevalence of genotype GSTT10/0 is ascertained in patients with MI and without MS; presence of the “null” genotype increases relative risk of infarction in both patients with and without MS. In the first group (without MS) presence of genotype GSTT10/0 leads to increase of MI risk irrespective of smoking status, though in MS patients — only in those who smokes.Conclusion. Diagnostic of homozygous deletional mutation GSTT1 can be used for individual prognosis of MI risk in patients with MI risk factors — smoking and MS.

The morphological peculiarities of the cerebrum arteries under the hemorrhagic and ischemic stroke in the patients with the metabolic syndrome

In this article, the results of the morphological study of the cerebral arteries in the patients with the hemorrhagic ischemic stroke on the background of metabolic syndrome were submitted. We established that under hemorrhagic stroke on the background of metabolic syndrome one could observe the atherosclerotic damages in the form of plaques, hyalinosis of vessels walls, destructive and necrotic changes of the middle coat of vessel wall, which are, in our opinion, the main reason in morphogenesis of hemorrhagic stroke. The atherosclerotic affection of the cerebral vessels with the lipidosis and fibrotic plaques in the vessel wall, which caused in disorganization of the vessel wall in the form intimae proliferation, structural reconstruction of the internal elastic membrane which resulted in narrowing of the vessel lumen and development of ischemia is the morphological basis for the ischemic stroke with the metabolic syndrome. Also diabetic microangiopathy with the development of the hyalinosis, vessels walls sclerosis, which provoked the microcirculatory and metabolism processes injury in the cerebral substance that complicate the disease course is the important factor of cerebral blood circulation damage.

Chronic Cerebrovascular Diseases on the Background of Metabolic Syndrome: New Approaches to Treatment

Metabolic syndrome is a risk factor for the development of acute and chronic cerebrovascular diseases. Oxidative stress developing in these conditions promotes progression of cerebral ischemia, generating the need to correct any biochemical abnormalities which may be detected. Use of antioxidants in patients with cerebrovascular diseases and metabolic syndrome aids reductions in these main signs of metabolic syndrome, such as insulin resistance, hypertriglyceridemia, and hyperglycemia. We present here the results of a clinical study of Mexidol in 40 patients, aged 50–70 years, with chronic cerebrovascular pathology. The potential for using agents of this group as universal neuroprotectors is discussed.

Primary hepatocellular carcinoma and metabolic syndrome: An update.

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. The incidence of hepatocellular carcinoma has increased dramatically by 80% over the past two decades in the United States. Numerous basic science and clinical studies have documented a strong association between hepatocellular carcinoma and the metabolic syndrome. These studies have documented that, in most patients, non-alcoholic fatty liver disease is the hepatic manifestation of the metabolic syndrome, which may progress to hepatocellular carcinoma through the cirrhotic process. However, minority of patients with non-alcoholic fatty liver disease may progress to hepatocellular carcinoma without cirrhosis. This review summarizes the current literature of the link between hepatocellular carcinoma and metabolic syndrome with special emphasis on various components of the metabolic syndrome including risk of association with obesity, diabetes mellitus, hyperlipidemia, and hypertension. Current understanding of pathophysiology, clinical features, treatments, outcomes, and surveillance of hepatocellular carcinoma in the background of metabolic syndrome and non-alcoholic fatty liver disease is reviewed. With the current epidemic of metabolic syndrome, the number of patients with non-alcoholic fatty liver disease is increasing. Subsequently, it is expected that the incidence and prevalence of HCC will also increase. It is very important for the scientific community to shed more light on the pathogenesis of HCC with metabolic syndrome, both with and without cirrhosis. At the same time it is also important to quantify the risk of hepatocellular carcinoma associated with the metabolic syndrome in a prospective setting and develop surveillance recommendations for detection of hepatocellular carcinoma in patients with metabolic syndrome.

Chapter 1: Prevention

Chapter 1: Prevention