Metabolic Syndrome Cardiovascular Risk Research Articles

Effect of aerobic training versus core circuit exercises on cardiovascular risk in metabolic syndrome

Effect of aerobic training versus core circuit exercises on cardiovascular risk in metabolic syndrome

Efficacy of IVRS-based mHealth intervention in reducing cardiovascular risk in metabolic syndrome: A cluster randomized trial

AimsEfficacy of mobile-phone based intervention for reducing cardiovascular risk in metabolic syndrome (MetSyn). MethodsWe screened adults 20–60 years in 10 villages in India for MetSyn using stratified cluster sampling. Lifestyle and biochemical risk factors were assessed. International Harmonized Criteria were used for diagnosis. Villages were randomized with 5 each in control and intervention groups. Interactive voice response system (IVRS) in Hindi was developed. In intervention clusters two messages for promotion of healthy lifestyle and medical treatment were broadcast daily over 12-months and risk factors reassessed. Results1012/1200(84%) persons were screened and MetSyn diagnosed in 286(28.3%). Villages were divided into 5 control(n = 136) and 5 intervention(n = 147) clusters. Baseline characteristics in both clusters were similar. Acceptability of intervention was >60% in 80% participants. At 12 months, significantly greater participants in intervention vs control clusters had healthier lifestyle (healthy diet 28.8vs14.7%, physical activity 25.9vs13.1%, tobacco 13.7vs32.5%), anthropometry (waist circumference 85.7 ± 6.3vs88.6 ± 14.0 cm, body mass index 21.9 ± 2.8vs23.1 ± 2.9 kg/m2), systolic BP 123.6 ± 7.7vs128.6 ± 14.1 mmHg, fasting glucose 95.6 ± 19.4vs109.4 ± 43.7 mg/dl, cholesterol 175.5 ± 36.5vs186.4 ± 43.3 mg/dl, and triglycerides 147.6 ± 48.3vs159.5 ± 60.7 mg/dl (p < 0.01). Prevalence of metabolic syndrome declined in intervention group by 22.3%vs3.9%, p < 0.001). ConclusionAn interactive voice response system based technology significantly reduced multiple cardiovascular risk factors and prevalence of metabolic syndrome.

Serum uric acid is no more a by-stander for risk of cardiovascular diseases in metabolic syndrome: a prospective study

Background: Cardiovascular diseases have become the fastest growing health issue in India and worldwide. Population with metabolic syndrome is known to be pre-disposed to several chronic disorders along with higher risk of experiencing cardiovascular events. The role of uric acid as a cardiovascular risk factor in metabolic syndrome was not well studied in the literature, which made us to undertake the present study.Methods: All the patients aged between 18 to 75 years (both gender) who approached Madhavbaug cardiac care clinics located in Maharashtra, India for assessing risk of heart disease from January 2015 to January 2017 were screened. Risk factors for metabolic syndrome have been evaluated among the study population and categorised into metabolic syndrome positive (³3 risk factors) and negative groups (&lt;3 risk factors). Statistical analysis was done using SPSS software version: 21.0.Results: Our study includes 2294 subjects who met the inclusion and exclusion criteria. Males outnumbered the females and sex ratio was 2.89:1. Females had lower serum uric acid levels compared to males irrespective of metabolic component. Gender and serum uric acid levels (high and low) were used stratification of the subjects. Serum uric acid is an independent predictor of cardiovascular diseases with an Odds ratio of 1.13 (95% confidence interval).Conclusions: Serum uric acid level is one of the important predictor for cardiovascular risk in metabolic syndrome. Raised uric acid is not an innocent by-stander and one of the major contributors in development of cardiovascular diseases.

Evaluation of serum endocan levels in relation to epicardial fat tissue thickness in metabolic syndrome patients.

IntroductionMetabolic syndrome has been recognized as a predictor of cardiovascular diseases. Epicardial fat tissue (EFT) thickness has recently been shown to be a predictor of cardiovascular diseases in metabolic syndrome patients. Endocan is a novel molecule which is considered to be an early marker of endothelial dysfunction. Our aim was to evaluate endocan serum levels for the first time in metabolic syndrome patients, in relation to EFT thickness.Material and methodsThe study included 44 patients with metabolic syndrome who had neither chronic kidney disease nor chronic inflammation and 26 healthy controls. Fasting blood samples were obtained from the groups. The serum levels of endocan were measured with a Sunred ELISA kit. EFT thickness of patients was measured by echocardiography.ResultsThe serum endocan levels were significantly lower in the metabolic syndrome patients compared to the healthy controls (120.71 ±90.17 pg/ml vs. 414.59 ±277.57, p < 0.001). Metabolic syndrome patients demonstrated significantly higher EFT (p = 0.042). EFT thickness had a positive correlation with age (r = 0.397, p = 0.008) and weight (r = 0.010). However, there was no correlation with serum endocan (r = –0.021, p = 0.893) or other parameters. Regression analysis revealed that waist circumference is the parameter among metabolic syndrome criteria having the strongest relationship with serum endocan levels (β = –0.499, p = 0.21).ConclusionsEFT thickness was high in metabolic syndrome patients and can be a useful marker for cardiovascular risk assessment. However, serum endocan levels were found to be low and there was no correlation with EFT thickness. Large sample sized prospective studies are needed to clarify the relation of endocan levels with the other clinical indicators of cardiovascular risk in metabolic syndrome.

The Gravitostat theory: Body fat is lost but is fat-free mass preserved?

The Gravitostat theory: Body fat is lost but is fat-free mass preserved?

Role of Chemerin as a Putative Biomarker of Cardiovascular Risk in Metabolic Syndrome: A Brief Review

Cardiovascular disease (CVD) is one of the major alarming causes of morbidity and mortality with widespread prevalence around the world. The major risk factor for cardiovascular disease is metabolic syndrome (MetS) and is most prevalent among obesity-related comorbidities. The main causative factors linking metabolic syndrome and cardiovascular disease are assumed to involve the expansion of adipose tissue and chronic inflammation. In addition to storing surplus fat, adipose tissue also produces adipokines which act through autocrine, paracrine and endocrine functions in the body. Increasing evidence suggests that the altered secretion of adipokines may play a role in the pathogenesis of metabolic syndrome but the mechanisms underlying are not fully known. To date, only leptin and adiponectin are the best-studied adipokines among the variety of adipokines secreted by adipose tissue. However, recent studies have implicated the novel adipokine chemerin as a regulator of adipogenesis, inflammation and glucose metabolism which demonstrates its multifaceted actions. Furthermore, they also found that elevated circulating levels of chemerin in metabolic syndrome acts as a significant risk factor for cardiovascular disease. Chemerin has gained considerable interest due to its role as a pro- or anti-inflammatory mediator is still controversial and the effect of chemerin on glucose metabolism is a matter of debate. Thus, the purpose of this review is to focus primarily on chemerin expression, processing, signaling of receptors, biological actions and pathophysiological implications and the role of chemerin as a biomarker of cardiovascular disease in metabolic syndrome.

Association between Cognitive Function and Clustered Cardiovascular Risk of Metabolic Syndrome in Older Adults at Risk of Cognitive Decline.

Metabolic syndrome (MetS) represents a cluster of obesity and insulin resistance-related comorbidities. Abdominal obesity, hypertension, elevated triglyceride and glucose levels are components of MetS and may have a negative effect on cognitive function, but few cognitive studies have examined the combined risk severity. We sought to determine which specific cognitive abilities were associated with MetS in older adults at risk of cognitive decline. Cross-sectional study. 108 AIBL Active participants with memory complaints and at least one cardiovascular risk factor. Cardiovascular parameters and blood tests were obtained to assess metabolic syndrome criteria. The factors of MetS were standardized to obtain continuous z-scores. A battery of neuropsychological tests was used to evaluate cognitive function. Higher MetS z-scores were associated with poorer global cognition using ADAS-cog (adjusted standardized beta=0.26, SE 0.11, p<0.05) and higher Trail Making B scores (adjusted beta=0.23, SE 0.11, p<0.05). Higher MetS risk was related to lower cognitive performance. Combined risk due to multiple risk factors in MetS was related to lower global cognitive performance and executive function. A higher MetS risk burden may point to opportunities for cognitive testing in older adults as individuals may experience cognitive changes.

Circulating Undercarboxylated Osteocalcin as Estimator of Cardiovascular and Type 2 Diabetes Risk in Metabolic Syndrome Patients

Undercarboxylated osteocalcin (ucOC) could be a biomarker of glucose disturbances and cardiovascular risk. Our study aimed to determine the association between serum levels of ucOC and cardiovascular risk in metabolic syndrome (MetS) patients and to analyse its potential role as estimator of type 2 diabetes (T2D) risk in this population. This cross-sectional study included 235 patients with MetS, 53.2% women, aged 55–75 years. Circulating ucOC levels were measured by ELISA. Cardiovascular risk was determined as Z-score of the diagnostic criteria for MetS (CV-ZS). Linear regression model was performed to analyse the association between circulating ucOC and CV-ZS. A receiver operating curve (ROC) was performed to analyse the usefulness of ucOC as T2D risk estimator. Patients above the CV-ZS median showed significant lower ucOC levels. We found an inverse association between ucOC levels and CV-ZS in MetS patients without T2D. Patients with ucOC levels below the 25th percentile showed worse cardiometabolic profile and higher cardiovascular and T2D risk. The area under the curve performed better when ucOC levels were included along with the classic T2D risk factors. The measurement of circulating ucOC could be a useful tool to identify increased cardiovascular and T2D risk in MetS patients without T2D.

Correction to: Role of C-Reactive Protein in Contributing to Increased Cardiovascular Risk in Metabolic Syndrome

A portion of this article was previously published as part of an article titled "Human C-reactive protein and the metabolic syndrome" in the following journal: Curr Opin Lipidol. 2009 Jun;20(3):182-9. doi: 10.1097/MOL.0b013e32832ac03e. https://insights.ovid.com/crossref?an=00041433-200906000-00007.

Indicators of Cardiovascular Risk in Metabolic Syndrome: Long Term Follow-up in Italian Patients.

Cardiovascular risk (CV) factors associated with the metabolic syndrome (MetS) may vary in different populations. In some, hypertension may be the major determinant, in others are low high-density lipoprotein cholesterol (HDL-C), high triglycerides, or another component. Subjects included in this analysis were identified in 2006, among those attending the Lipid Clinic of the Niguarda Hospital, and followed up through to 2013. Patient characteristics (including the occurrence of CV events) were obtained from electronic medical records. MetS was diagnosed according to the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) guidelines. The carotid intima media thickness (cIMT) was also followed in these patients over the years. After 7 years a total of 858 subjects had a complete follow-up; 271 of those had MetS. Patients developing a CV event showed elevated baseline cIMT (e.g. cIMTmax ≥ 2.4 mm in males and ≥ 2.2 mm in females); moreover the cIMT in MetS patients was higher at baseline and the rise over 7 years was larger compared with patients without MetS. By examining each body variable for MetS we found that a waist to height ratio (WHtR) ≥ 0.5 was present in nearly all subjects with a CV event. The follow-up data of a series of Italian patients with and without MetS, clearly indicates that the former have a raised cIMT and their arterial IMT progression is greater and the presence of a larger WHtR is apparently linked to a higher incidence of CV events.

Acute changes in arterial stiffness following exercise in people with metabolic syndrome

BackgroundThis study aims to examine the changes in arterial stiffness immediately following sub-maximal exercise in people with metabolic syndrome. MethodsNinety-four adult participants (19–80 years) with metabolic syndrome gave written consent and were measured for arterial stiffness using a SphygmoCor (SCOR-PVx, Version 8.0, Atcor Medical Private Ltd, USA) immediately before and within 5–10min after an incremental shuttle walk test. The arterial stiffness measures used were pulse wave velocity (PWV), aortic pulse pressure (PP), augmentation pressure, augmentation index (AI), subendocardial viability ratio (SEVR) and ejection duration (ED). ResultsThere was a significant increase (p<0.05) in most of the arterial stiffness variables following exercise. Exercise capacity had a strong inverse correlation with arterial stiffness and age (p<0.01). ConclusionAge influences arterial stiffness. Exercise capacity is inversely related to arterial stiffness and age in people with metabolic syndrome. Exercise induced changes in arterial stiffness measured using pulse wave analysis is an important tool that provides further evidence in studying cardiovascular risk in metabolic syndrome.

PM308 Metaboreflex Activation by Rhythmic Exercise as a Cardiovascular Risk in Metabolic Syndrome and Obesity

PM308 Metaboreflex Activation by Rhythmic Exercise as a Cardiovascular Risk in Metabolic Syndrome and Obesity

Association of hs-CRP with various components of metabolic syndrome

Background: Metabolic syndrome is a known risk factor for atherosclerosis. Chronic inflammation plays a key role in the pathogenesis of metabolic syndrome Objectives - The inflammatory marker C-reactive protein and its association with various components of metabolic syndrome needs further study. Methods – In this case control study, we studied the relationship between high-sensitivity C-reactive protein (hs-CRP) with various components of metabolic syndrome in 60 subjects. 30 of them have metabolic syndrome according to adult treatment panel III (ATP III) criteria. We compared various components of metabolic syndrome like blood pressure, fasting blood sugar, waist circumference and insulin resistance with hs-CRP levels by linear regression analysis. Results: hs-CRP levels show significant increase in metabolic syndrome group. But there is no significant correlation between hs-CRP levels and various components of metabolic syndrome like blood pressure, waist circumference and insulin resistance except for fasting blood sugar. Conclusions: hs-CRP level in the test population explains the increased cardiovascular risk in metabolic syndrome. Maintaining normal blood sugar level might help manage metabolic syndrome.

Does red yeast rice and olive extract reduce cardiovascular risk in metabolic syndrome?

Does red yeast rice and olive extract reduce cardiovascular risk in metabolic syndrome?

Can red yeast rice and olive extract improve lipid profile and cardiovascular risk in metabolic syndrome?: A double blind, placebo controlled randomized trial.

BackgroundMetabolic syndrome (MetS) comprises a spectrum of clinical phenotypes in which dyslipidemia, dysglycemia and hypertension are clustered and where all share a high level of oxidative stress and an increased risk of cardiovascular disease. This study examines the effect of a nutritional supplement combining red yeast rice and olive fruit extract on the lipid profile and on oxidative stress in a population of patients with MetS.MethodsIn a double blind placebo controlled randomized trial, 50 persons with MetS, as defined by the ATPIII criteria, received the study product or placebo for 8 weeks. The study product contained 10.82 mg of monacolins and 9,32 mg of hydroxytyrosol per capsule, and is commercialized as Cholesfytol plus. The primary outcome measure was the difference in LDL reduction between intervention and control groups. Furthermore, differences in changes of CH, HDL, ApoA1, ApoB, HbA1c and oxLDL were measured, as well as side-effects, CK elevation, changes in clinical parameters and in cardiovascular risk.ResultsIn the intervention group, LDL cholesterol was lowered by 24% whereas it increased by 1% in the control group (p < 0.001). Other effects observed were a change in total cholesterol (−17% in the intervention group vs +2% in the control group, p < 0.001), apolipoprotein B (−15% vs +6%, p < 0.001), and TG (−9% vs + 16%, p = 0.02). Oxidized LDL decreased by 20% vs an increase of 5% in the control group (p < 0.001). Systolic and diastolic arterial blood pressure decreased significantly by 10 mmHg (vs 0% in the control group, p = 0.001) and 7 mmHg (vs 0% in the control group, p = 0.05) respectively. One person in the intervention group, who suffered from Segawa’s syndrome, dropped out because of severe muscle ache.ConclusionsThe combination of active products in this study may be an alternative approach to statins in people who do not need, or cannot or do not want to be treated with chemical statins. Side effects, effects on oxidative stress and on glucose metabolism need to be examined more thoroughly.Trial registrationClinicaltrials.gov NCT02065180 (February 2014).

Pharmacological approach to cardiovascular risk in metabolic syndrome

Metabolic syndrome is not a discrete entity with a single pathogenesis, but different complex mechanisms, especially those inducing oxidative stress, play a major role in the genesis of this condition. This consideration suggests that treatment of recognized cardiovascular risk factors alone cannot be enough to prevent cardiovascular events in patients with a diagnosed metabolic syndrome. However, it has been reported that oxidative stress is involved in the transduction of the effects of haemodynamic and metabolic pathological conditions. Thus, drugs acting on the renin-angiotensin system [angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers], or on the glucose or lipid metabolism as substrate of oxidative mechanisms (statins and nutraceuticals) in association with a dietary restriction may be taken in account, because they play a synergistic effect in preventing functional and structural changes responsible for the high cardiovascular risk in metabolic syndrome.

Different modalities of exercise to reduce visceral fat mass and cardiovascular risk in metabolic syndrome: the RESOLVE* randomized trial

Opinions differ over the exercise modalities that best limit cardiovascular risk (CVR) resulting from visceral obesity in individuals with metabolic syndrome (MetS). As little is known about the combined effects of resistance and endurance training at high volumes under sound nutritional conditions, we aimed to analyze the impact of various intensities of physical activity on visceral fat and CVR in individuals with MetS. 100 participants, aged 50-70 years, underwent a diet restriction (protein intake 1.2g/kg/day) with a high exercise volume (15-20 h/week). They were randomized to three training groups: moderate-resistance-moderate-endurance (re), high-resistance-moderate-endurance (Re), or moderate-resistance-high-endurance (rE). A one-year at-home follow-up (M12) commenced with a three-week residential program (Day 0 to Day 21). We measured the change in visceral fat and body composition by DXA, MetS parameters, fitness, the Framingham score and carotid-intima-media-thickness. 78 participants completed the program. At D21, visceral fat loss was highest in Re (-18%, p<.0001) and higher in rE than re (-12% vs. -7%, p<.0001). Similarly, from M3, visceral fat decreased more in high-intensity-groups to reach a visceral fat loss of -21.5% (Re) and -21.1% (rE)>-13.0% (re) at M12 (p<.001). CVR, MetS parameters and fitness improved in all groups. Visceral fat loss correlated with changes in MetS parameters. Increased intensity in high volume training is efficient in improving visceral fat loss and carotid-intima-media-thickness, and is realistic in community dwelling, moderately obese individuals. High-intensity-resistance training induced a faster visceral fat loss, and thus the potential of resistance training should not be undervalued (ClinicalTrials.gov number: NCT00917917).

Inflammation Is a Key Pathophysiological Feature of Metabolic Syndrome

Inflammation Is a Key Pathophysiological Feature of Metabolic Syndrome

Independent Association between Nonalcoholic Fatty Liver Disease and Cardiovascular Disease: A Systematic Review and Meta-Analysis

Nonalcoholic fatty liver disease (NAFLD) is closely correlated with insulin resistance and several metabolic syndrome features, but whether it could increase the risk of cardiovascular disease remains undefined. To assess the association between NAFLD and the risk of cardiovascular outcomes, we systematically searched the MEDLINE, Embase, and the Cochrane Library database (1947 to October 2012) by using Medical Subject Heading search terms and a standardized protocol. Randomized controlled trials, case-control, and prospective studies carried out in human adults, in which the unadjusted and multivariate adjusted odds ratios with corresponding 95% confidence interval (CI) for cardiovascular disease with NAFLD were reported. The search yielded 4 cross-sectional studies and 2 prospective cohort studies including 7,042 participants. The pooled effects estimate showed that NAFLD was a predictor of cardiovascular disease (odds ratio 1.88, 95% CI, 1.68 to 2.01; P < 0.001). The random effects summary estimate indicated that NAFLD retained a significant association with cardiovascular outcomes independent of conventional risk factors after adjustment for established cardiovascular risk factors (odds ratio 1.50, 95% CI, 1.21 to 1.87; P < 0.001). These results indicate that NAFLD is a strong independent predictor of cardiovascular disease and may play a central role in the cardiovascular risk of metabolic syndrome.

Abstract 461: Role of Physical Training Intensity in Metabolic and Cardiovascular Dysfunctions in a Fructose Overload Model

This study evaluated the chronic effects of the run and walk in the metabolic and cardiovascular parameters of a metabolic syndrome experimental model. Male Wistar rats were divided into 4 groups(n=8): Control (C),Sedentary Fructose (SF), Fructose Run (FR) and Fructose Walk (FW, n= 8). Metabolic syndrome (MS) induction was performed with D-fructose in drinking water for 18 weeks. The exercise training was initiated after the nineth week of treatment with fructose and was held for 8 weeks (60 minutes/day, 5 times / week). The FW and FR were performed on a treadmill (1 h/day; 5 days/wk for 8 wk), with ∼20% and 60% intensities respectively of the maximum speed in a maximal exercise test. Plasma glucose, triglycerides, insulin resistance, adipose tissue, blood pressure, heart rate, baroreceptor sensitivity and sympathetic and parasympathetic tone, were evaluated at the end of protocol. The results showed that run and walking decreased the adipose tissue (FR: 2.97±0.2; FW: 4.26±0.9; SF: 6.49±0.6; C: 3.23±0.2 g). The glycemia values remained within the normal range,(FR: 86.7±2.3; WF: 91.0±1.4; SF: 70.2±1.9; C: 84±2.3 mg/dl), however only the FR group decreased the triglycerides levels (FR: 133±8.8; FW: 159±10.2; SF: 220±6.3; C: 96± 4.2 mg/dl), and the insulin resistance (FR: 4.37±0.1; FW: 3.55±0.2; SF: 2.79±0.3; C: 4.86±0.3 %/min). The FR group showed a reduction in mean arterial pressure (FR: 111±4.5, FW: 125±4.1; SF: 137±2.6, C: 113±1.5 mmHg) and increased of bradycardic (FR 1.76±0.08; FW 1.31±0.10; SF 1.37±0.10; C 1.72±0.14 bpm/mmHg) and tachycardic response to BP changes (FR 4.02±0.32; FW 2.56±0.16; SF 1.97±0.15; C (and C 3.25±0.37 bpm/mmHg). Finally we observed that only the FR group showed an increase of the vagal tone (FR: 72.3±8.1, FW: 47.3±6.7; FS: 40.3±4.6, C: 60.7±6.5 bpm). In conclusion, our results suggest that training walk (FW), a practice widely recommended, is especially effective for the treatment of metabolic disorders, whereas controlled exercise (FR) seems to encompass hemodynamic and metabolic aspects. This application is easy and within reach of the majority of the population, indicating that this practice should be encouraged and may be effective in managing cardiovascular risk in MS as start therapeutic. Sources of Funding:FAPESP.