Metabolic Syndrome Cases Research Articles

Sex-specific associations among neck circumference, the rs9939609 FTO gene polymorphism, and the 14-year risk of metabolic syndrome.

Limited data exist on the relation between neck circumference (NC) and the risk of developing metabolic syndrome (MS). This study investigated sex-specific associations between NC and the 14-year risk of MS and explored the impact of the FTO rs9939609 polymorphism on these associations. This population-based prospective cohort study involved 2,666 participants (1,301 men and 1,365 women), who were free of MS at baseline (2005-2006). Incident MS cases, defined by the presence of 3 or more criteria regarding blood pressure and blood levels of glucose, triglycerides, and high-density lipoprotein cholesterol, were identified through biennial examinations until 2020. NC measurements taken at baseline and between 2013 and 2014 were analyzed using Cox proportional hazard regression to determine sex-specific associations with MS risk. Controlling for potential confounders such as waist circumference (WC), significant associations were observed in both sexes. Individuals in the highest NC quartile exhibited more than a 2-fold higher MS risk than those in the lowest quartile; with hazard ratios of 2.37 (95% CI, 1.74 to 3.22) for men and 2.65 (95% CI, 1.89 to 3.72) for women (p-value for trend <0.001). No significant interaction was found between the FTO polymorphism and NC. In diagnostic test analyses, NC and WC demonstrated comparable area under the curve values in both sexes. The findings suggest that NC is as effective as WC for predicting the incidence of MS.

Increasing incidence and prevalence of metabolic syndrome in people living with HIV during the COVID-19 pandemic.

The aim of this study was to analyze the impact of COVID-19 pandemic restrictions on the prevalence and incidence of metabolic syndrome (MS), and to identify predictors of new MS cases in people living with HIV (PLWH). This cohort study included PLWH followed at the IRCCS San Raffaele, Milan, Italy, with at least one body mass index (BMI) determination during the pre-pandemic period (1 December 2018 to 29 February 2020) and the pandemic period (1 March 2020 to 31 May 2021). MS diagnosis was based on NCEP ATP III 2005 criteria. Univariable Poisson regression model was used to compare MS incidence rates. Univariable mixed linear models estimated the crude mean change in metabolic parameters during each time period. Multivariable Cox proportional hazards model was used to assess risk factors for MS. This study included 1,564 PLWH, of whom 460 and 1,104 were with and without a diagnosis of MS, respectively, at the beginning of the pre-pandemic period, with an overall prevalence of MS of 29.4%. During the pre-pandemic period, 528/1,564 PLWH had MS, with a prevalence of 33.8% (95%CI = 31.5%-36.1%), while during the pandemic period, the number of PLWH with a diagnosis of MS increased to 628/1,564, with a prevalence of 40.2% (95%CI 37.8%-42.6%; McNemar's test: p < 0.0001). Similarly, the MS incidence rate increased from 13.7/100 person-years of follow-up (PYFU; 95%CI = 11.7-16.0) in the pre-pandemic period to 18.5/100 PYFU (95%CI = 16.2-21.1) in the pandemic period (p = 0.004), with 201 subjects developing MS during the pandemic period. In addition, we observed a significant increase in the crude mean change during the pandemic period compared with the pre-pandemic period for: total cholesterol, LDL cholesterol, plasma glucose, blood pressure, and atherosclerotic cardiovascular disease (ASCVD) risk score. Finally, after adjustment for HIV risk factors, HBV, HCV, ART duration, duration of virologic suppression and use of INSTIs, age [adjusted hazard ratio (AHR) per 3 years older = 1.12 (95%CI = 1.08-1.17)], sex [AHR female vs. male = 0.62 (95%CI = 0.44-0.87)] and CD4+ cell count [AHR per 100 cells/μL higher = 1.05 (95%CI = 1.01-1.09)] were associated with the risk of MS. The COVID-19 pandemic affected the metabolic profile of PLWH and increased the prevalence and incidence of MS.

Mask parathyroid adenoma in morbid obese woman with secondary adrenal insufficiency

Abstract Introduction Primary hyperparathyroidism (PHPT) and metabolic syndrome (MS) are independently increase cardiovascular morbidities; however, this association is still controversial. The pathogenic mechanisms of MS among PHPT are not completely clear and the association with calcium metabolism is being studied, since calcium is pivotal for many metabolic processes. The association between these entities is complex and may be a source of additional morbidity and mortality. Objective is to highlight the mask features of parathyroid adenoma in morbid obese woman with secondary adrenal insufficiency. Clinical case A 33-year-old female presented with discomforting polyarthralgia and weight gain for the last 2 years that was labelled as nonspecific arthritis and treated by multiple intra-articular injections of glucocorticoids. After a careful history and examination with baseline analysis, she was discovered to have MS (dysglycemia, high insulin resistance and hypertension). A feature glucocorticoid induced adrenal insufficiency was documented and work up for any evidence of osteoporosis was initiated. A high parathyroid hormone with hypercalcemia was documented and an established osteoporosis was evident. Furthermore, a large left side parathyroid adenoma was observed by a neck sonography and confirmed by a four-dimension computed tomography of the neck. Surgical exploration with excision of the parathyroid adenoma was performed, following which the patient recovered uneventfully. The patient was initially managed as a case of MS with secondary adrenal insufficiency due to glucocorticoid misuse. Although not suspected initially, an extensive work up for osteoporosis screening and accidental hypercalcemia increase the chance of high index of suspicion for hyperparathyroidism. Further investigations then revealed the presence of a solitary parathyroid adenoma with coexistent hyperparathyroidism which was then managed surgically. Conclusion Despite the majority of PHPT is asymptomatic and over masked by MS, Active surveillance for any evidence of hypercalcemia and bone metabolism have to be judged carefully to reduce further morbidity and mortality.

Assessment of plasma catecholamines in patients with dysmetabolic iron overload syndrome.

Dysmetabolic iron overload syndrome (DIOS) is characterized by hyperferritinemia and normal transferrin saturation level with components of metabolic syndrome (MS). Among cases of MS, we determined those with DIOS and their characterizations, then we evaluated the association between plasma catecholamines status and hypertension in DIOS. We compared 101 hypertensive patients with 50 healthy participants (control group). Iron (iron, transferrin, and ferritin), insulin, and plasma catecholamine (adrenaline, noradrenaline, and dopamine), profiles were measured for both groups. Homeostasis model assessment of insulin resistance index and transferrin saturation were also calculated. Out of 101 hypertensive patients, 64 were diagnosed with MS, and 6 of the latter met the DIOS diagnostic criteria. Significantly, DIOS patients were older and had lower body mass index (BMI) compared with hypertensive non-DIOS patients with p-values of (0.026), and (0.033), respectively. Adrenaline, noradrenaline, and dopamine levels did not differ significantly between DIOS and non-DIOS patients. Of the MS patients, 9.3% were diagnosed with DIOS. Accordingly, complete iron profiling should be performed routinely in the cases of MS for early diagnosis of DIOS, to prevent future complications. Further studies are required to test the hypothesis linking older age and lower BMI with the pathogenesis of DIOS.

Atherogenic indices in pediatric population in South-Southeast region of Mexico

Atherosclerosis is a cardiovascular disease, highly predictable, and associated with different atherogenic indices (AI) in adults. However, such indexes in the pediatric population are far less explored. The objective of this study was to evaluate the AI and the cardiovascular factors in the pediatric population in the South-Southeast of México. A total of 481 children between 2 and 17 years old were recruited. Anthropometric evaluation, blood pressure (BP), lipid profile, apolipoprotein A-I (ApoA-I) and apolipoprotein B (ApoB) were measured, and AI were calculated. The population was grouped by age, binary logistic regression analysis was performed to analysis for associations of AI and cardiovascular risk factors. Sensibility and specificity of AI to detect metabolic alteration were evaluated for curve ROC. The atherogenic risk presented a high prevalence in the pediatric population, such as LDL-c/ApoB (86.9%), AIP (78%) and AC (36.6%). Preschoolers showed a higher risk of ApoB/ApoA-I and ApoB/LDL-c, while adolescents have a high risk of AIP. CRI-I and AC were associated with elements of lipid profile and body mass index (BMI). ROC curves analysis shows that AIP is the best index evaluating metabolic syndrome (MS) (0.87) and dyslipidemia (0.91). Such pediatric population showed a high risk of AI, mainly by LDL-c/ApoB and AIP. The BMI was the cardiovascular risk factors most frequently related to AI, AIP is the best index for detecting cases of MS and dyslipidemia. This is the first study carried out in the pediatric population from the South-Southeast of Mexico that evaluated the AI.

Serum uric acid is a predictive biomarker of incident metabolic syndrome at the Brazilian longitudinal study of adult Health (ELSA – Brasil)

AimTo investigate whether serum uric acid (SUA) levels and hyperuricemia can be predictive biomarkers of incident metabolic syndrome(MS) among different body mass index(BMI) categories, and to investigate SUA cutoffs that best discriminate individuals with incident MS. MethodsWe analyzed 7,789 participants without MS at baseline of ELSA-Brasil study. Logistic regression models were performed to evaluate associations between incident MS and SUA levels/hyperuricemia, expressed by odds ratios(ORs) and confidence intervals(95 % CI). ResultsWe found 1,646 incident MS cases after a median follow-up of 3.8[3.5–4.1] years. Incident MS was present among 8.3 % (n = 290) of participants with normal weight, 28.3 % (n = 850) with overweight, 39.8 % (n = 506) with obesity. Among incident MS participants of total sample, 33.0 % had hyperuricemia [SUA > 6.0 mg/dL (356.9 μmol/L)]. After all adjustments, SUA was independently prognostic of incident MS: for each 1 mg/dL increase in SUA the odds of incident MS were 45 % higher (OR1.45[CI95 %1.34–1.55 p <.01]). Associations were found for those presenting normal weight, overweight and obesity (OR1.43[CI95 %1.31–1.57 p <.01; OR1.22[CI95 %1.13–1.32 p <.01]; and OR1.16[CI95 %1.04–1.29 p <.05]) respectively. Hyperuricemia was independently associated with incident MS (OR1.88[CI95 %1.49-0.2.36 p <.01]). The SUA cut point level maximizing sensitivity and specificity in the discrimination of incident MS was 5.0 mg/dL. ConclusionsSUA level is an independent predictive biomarker of incident MS at all BMI categories.

Serum vascular endothelial growth factor b and metabolic syndrome incidence in the population based cohort Di@bet.es study

Background/ObjectivesAlthough vascular endothelial growth factor b (VEGFb) might have an impact on the development of obesity, diabetes and related disorders, the possible relationship between VEGFb serum levels and the incidence of these metabolic complications in humans is still unknown. The aim of our study was to evaluate the association between VEGFb serum levels and the new-onset of metabolic syndrome (MS) and its components in the Spanish adult population after 7.5 years of follow-up.Subjects/MethodsA total of 908 subjects from the Di@bet.es cohort study without MS at cross-sectional stage according to International Diabetes Federation (IDF) or Adult Treatment Panel III (ATP-III) criteria were included. Additionally, five sub-populations were grouped according to the absence of each MS component at baseline. Socio-demographic, anthropometric and clinical data were recorded. The Short Form of International Physical Activity Questionnaire (SF-IPAQ) was used to estimate physical activity. A fasting blood extraction and an oral glucose tolerance test were performed. Serum determinations of glucose, lipids, hsCRP and insulin were made. VEGFb levels were determined and categorized according to the 75th percentile of the variable. New cases of MS and its components were defined according to ATPIII and IDF criteria.ResultsA total of 181 or 146 people developed MS defined by IDF or ATP-III criteria respectively. Serum triglyceride levels, hs-CRP and systolic blood pressure at the baseline study were significantly different according to the VEGFb categories. Adjusted logistic regression analysis showed that the likelihood of developing MS and abdominal obesity was statistically reduced in subjects included in the higher VEGFb category.ConclusionLow serum levels of VEGFb may be considered as early indicators of incident MS and abdominal obesity in the Spanish adult population free of MS, independently of other important predictor variables.

Lean non-alcoholic fatty liver disease (Lean-NAFLD) and the development of metabolic syndrome: a retrospective study

Lean NAFLD is a special phenotypic closely correlated with metabolic syndrome (MS). The aim of this study is to investigate the MS development and the gender differences in lean NAFLD population. Participants were divided into 4 groups by BMI and NAFLD status. Descriptive analysis was performed to characterize baseline information. A total of 18,395 subjects were participated, and 1524 incident cases of MS were documented. Then, Kaplan–Meier curves were used to present the MS outcomes in different groups, and the NAFLD was found to be a riskier factor than obesity for MS. Subgroup analysis showed significantly higher MS incidence in female than male among lean NAFLD group, which is different from other groups. Although with higher prevalence in male, lean NAFLD seems to be a more harmful phenotype for females according to the TG, ALT and GGT levels. The logistic regressive analysis was performed to show the impact of NAFLD status and BMI changes on MS risk. Lean non-NAFLD subjects merely developed to NAFLD with no BMI status changes exhibited highest MS risk (ORs = 1.879, 95% CI 1.610–2.292) than that with both BMI increase and NAFLD development (ORs = 1.669, 95% CI 1.325–2.104). It also suggests the metabolic specificity of this population.

STUDY OF ASSOCIATION OF INFLAMMATORY MARKERS WITH METABOLIC SYNDROME IN PREDIABETIC PATIENTS AT TERTIARY CARE CENTER OF RAJASTHAN, INDIA

Background: Metabolic syndrome (MS) is associated with the risk of developing cardiovascular disease and type 2 diabetes mellitus. The preferred clinical approach to cardiovascular prevention is to treat all the metabolic risk factors. Objective: The objectives is study of acute-phase reactants in MS patients. Methods: This study was conducted on 250 subjects and controls at Government Medical College and Associated Group of Hospitals Kota, Rajasthan from October 2019 to September 2021. The study group had 125 MS cases and an equal number of healthy controls. Demographic characteristic of all participants noted including age, sex, weight, and height. Results: We observed a significant rise in blood glucose, total cholesterol, S. triglyceride, S. low-density lipoprotein (LDL). S. Very LDL S. C-reactive protein (CRP), and ferritin level in MS cases when compared to control subjects, while serum high-density lipoprotein level found to be decreased in MS patients as compared to control group. Conclusion: In this study, both CRP and ferritin level are increased as the number of components of MS increased. Therefore, these inflammation parameters could accurately and timely discriminate patients with MS, according to IDF criteria, who are at increased risk for future cardiovascular events. There was a significant correlation between inflammation and the diabetic complications.

Prevalence of metabolic syndrome in chronic obstructive pulmonary disease and its correlation with severity of disease.

ABSTRACTIntroduction:The understanding of chronic obstructive pulmonary disease (COPD) has changed considerably over the past decade. The metabolic syndrome (MS) represents a cluster of risk factors that increases the risk for developing various noncommunicable diseases. In COPD, it is associated with worsening respiratory symptoms, increasing lung function impairment, pulmonary hypertension, and increasing hospitalizationsAims:To determine the prevalence of MS in patients with COPD and correlate it with disease severityMethodology:The present study was a cross-sectional observational study. Patients confirmed by spirometry to have COPD were included in the study. All demographic data and anthropometric, radiological, and laboratory parameters were recorded. The definition stated by modified NCEP ATP III criteria proposed by the AHA/NHLB (2005) was followed to identify patients with MS. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 20 for WindowsResults:A total of 76 patients were included in the study. MS was recorded in 42.1% of COPD cases. The average number of exacerbations and hospitalizations due to COPD in MS cases (1.38 ± 1.95 and 0.97 ± 1.51) were more than the patients without MS (1.27 ± 1.30 and 0.68 ± 0.96). The majority of patients with MS exhibited grade 3 dyspnea based on modified medical research council grading (MMRC). MS was commonest in patients with GOLD stage III disease. High serum triglyceride level was observed in an increasing trend (25%, 30%, 35.5%, and 75%) in GOLD stages I, II, III, and IV, respectivelyConclusion:Patients with MS present with more severe disease and frequent exacerbations. All COPD patients should be screened for MS at the primary level.

Anthropometry and Liver Function Parameters in Individuals with Metabolic Syndrome

Metabolic syndrome (MS) is a metabolic condition commonly associated with central adiposity and altered liver function parameters (LFPs). Several studies have suggested these altered LFPs as a result of fatty liver diseases (e.g., non-alcoholic fatty liver diseases) often prevalent in MS. Since altered LFPs are very common in MS, there is a possibility they can be used as predictors of MS. However, only a few studies have been carried out to evaluate this possibility. This study, therefore, aimed to evaluate the potential of LFPs as predictors or risk factors of MS. The study groups included 50 individuals diagnosed with MS (case group) and 50 apparently normal individuals (control) from Ibadan, Oyo State, Nigeria. Anthropometric measurements, phlebotomy, liver function tests, and lipid profile estimations were done using standard procedures. (The result and conclusion section has been omitted).

Effect of Triphala Kajjali tablet - an Ayurvedic herbomineral formulation for the management of metabolic syndrome: a single case study

Metabolic syndrome (MS) is a group of disorders that includes abdominal obesity, diabetes, hypertension, and elevated cholesterol. Approximately 25% of the adult populations are affected by MS. Gradually this number is increasing because of poor lifestyles, faulty dietary pattern, physical inactivity, stressful life and rapid urbanization. A 50-year-old female patient visited to OPD of Kayachikitsa department ITRA, Jamnagar, with the complaints of gradual weight gain with excess body fat around the abdomen and waist region, numbness and burning sensation at bilateral feet, and breathlessness on exertion. After investigation, she was diagnosed as a case of MS as per National Cholesterol Education Program (NCEP), adult treatment panel III (revised in 2005) guideline. She was treated with Triphala Kajjali tablet for 12 weeks along with lifestyle modification. After completion of treatment, investigations revealed reduction in fasting blood sugar from 113 mg/dL to 80 mg/dL, serum cholesterol level was decreased to 148 mg/dl from 216 mg/dl, serum triglycerides level was reduced to 150 mg/dL from 187 mg/dL and serum LDL was reduced to 68.3 mg/dl from 118.7 mg/dl. Her weight reduced to75 kg from 85 kg, and waist circumference reduced to 92 cm from 100cm, and blood pressures also reduced up to 122/82 mmHg from 140/90 mmHg. Hence, it can be concluded that Triphala Kajjali tablet along with lifestyle modification are effective in the management of MS, as it possesses Kapha Medohara properties.

The role of LEPR, PPARG and PPARGC1A genes polymorphisms in the development of metabolic disorders in patients with vibration diseases

Introduction. Patients with vibration disease (VD) often have obesity and metabolic syndrome (MS), which increase the risk of developing type 2 diabetes, hypertension, and other conditions predisposing to a decrease in the quality and longevity of life. Genetic predisposition, overnutrition, environmental factors, including industrial ones, and others are factors influencing the formation of MS. The aim of the study is to identify associations between polymorphisms of the LEPR, PPARG and PPARGC1A genes, metabolic syndrome and obesity in VD patients caused by exposure to local vibration and the combined effects of local and general vibration. Material and methods. We examined 248 VD male patients exposed to local vibration and the combined impact of the local and general vibration. We have identified a subgroup of MS and obesity cases. The distribution of genotypes of the LEPR, PPARG and PPARGC1A genes in groups was studied. Results. In the group of VD and MS patients exposed to the combined effect of local and general vibration, the Gln/Gln genotype of the Arg223Gln polymorphic locus of the LEPR gene was less common, and the Arg / Gln genotype in MS cases was detected more often than in patients without it. Among patients with VD caused by exposure to local vibration with a waist circumference of more than 102 cm, the Gly / Ser genotype of the Gly482Ser polymorphism of the PPARGC1A gene was more common than among those with lower values of this indicator. Conclusion. In patients with VD caused by combined exposure to local and general vibration, the Gln/Gln genotype carrier of the Arg223Gln polymorphism of the LEPR gene may play a protective role in the formation of MS. Among individuals with VD caused by exposure to local vibration, carriers of the heterozygous genotype of the Gly482Ser polymorphism of the PPARGC1A gene may have a predisposition to the development of obesity. The obtained results are preliminary and require further research.

A Comparison of the Prevalence of Metabolic Syndrome According to Different Definitions in Climacteric Women.

Background: The prevalence of metabolic syndrome (MS) varies according to the different definitions available for clinical practice. The study aimed to estimate and compare the prevalence of MS according to the definitions of the American Heart Association (AHA)/National Heart, Lung, and Blood Institute (NHBI), International Diabetes Federation (IDF), and Joint Interim Statement (JIS) in a sample of climacteric women in Brazil. Methods: A population-based cross-sectional study, using a probabilistic sampling by clusters, involved 874 climacteric women. Clinical and anthropometric variables were acquired while fasting, and MS was defined according to three recommendations. To define the agreement between different definitions on MS, we calculated the sensitivity and specificity for the diagnosis of MS based on AHA/NHBI and IDF in relationship to the JIS definition. Results: The prevalence of MS was 56.9% according to the AHA/NHBI definition, 61.6% by the IDF, and 64.8% by the JIS definition, without statistical significance. When prevalence of MS was stratified by climacteric stages, the ability of the different definitions identifying MS was also similar among groups. It was observed that the MS definition proposed by AHA/NHBI identified 87.4% of MS cases from the total cases diagnosed by JIS, with agreement levels by the Kappa index of 0.835. The IDF detected 95.3% of MS cases compared to the JIS definition and the agreement level was 0.934. Conclusions: The study indicates a high prevalence of MS in climacteric women regardless of the definition used (AHA/NHBI, IDF e JIS). We did not observe significant divergences between definitions.

Association between the FINDRISC score and the risk of metabolic syndrome and hepatic steatosis

Abstract Introduction The Finnish Diabetes Risk Score (FINDRISC) was developed in Europe to predict type 2 diabetes mellitus (T2DM) risk without need of laboratory tests. Small cross-sectional studies analyzed the association between RF with metabolic syndrome (MS) or hepatic steatosis (HS). Our objective was to test the association of FINDRISC with MS or HS, in a transversal and longitudinal way. Methods In 41,668 individuals (age 41.9±9.7 years; 30.8% women) who underwent health evaluation between 2008 and 2016 in a single centre in Brazil, we tested the transversal association between FINDRISC and MS or HS, in multivariate models. The same analyzes were performed longitudinally in non-diabetic subgroups, followed for 5±3 years, to test the predictive value of FINDRISC and the incidental risk of MS (n=10,075 individuals) or HS (n=7,097 individuals), using logistic regression. Models were adjusted for confounders such as sex, use of medications for dyslipidemia, smoking, and baseline plasma levels of glucose, creatinine and lipids. A receiver operating characteristic (ROC) curve was used to evaluate the discriminative and predictive values of FINDRISC for MS and HS. Results In the cross-sectional analysis, 2,252 (5%) individuals had MS and 14,176 (34%) HS. In the longitudinal analysis, there were 302 cases of incidental MS (2%) and 1,096 cases of HS (15%). FINDRISC was independently associated with MS and HS in the cross-sectional analysis (respectively, OR 1.27, 95% CI: 1.25–1.28, P&amp;lt;0.001; and OR 1.21, 95% CI: 1.20–1.22, P&amp;lt;0.001, per FINDRISC unit) and in longitudinal analysis (respectively, OR of 1.18, 95% CI: 1.15–1.21, P&amp;lt;0.001; and OR of 1.10, 95% CI: 1.08–1.11, P&amp;lt;0.001, per FINDRISC unit). In comparison with individuals with low FINDRISC, those with moderate, high and very high values showed significant and proportional increases of the 12 to 77 fold in the chance of current SM (P&amp;lt;0.001) and 3 to 10 fold in the chance of HS (P&amp;lt;0.001). During follow-up, these increases were 3 to 10 fold in the chance of incidental MS (P&amp;lt;0.001) and 1 to 3 fold in the chance of HS (P&amp;lt;0.001). The AUC from cross-sectional analysis for MS and HS were respectively 0.82 (95% CI 0.81–0.83) and 0.76 (95% CI 0.75–0.76), and in longitudinal analysis 0.73 (95% CI 0.70–0.76) and 0.63 (95% CI 0.61–0.65), respectively. Conclusion FINDRISC was associated with the presence and onset of MS and HS, but it predicted better metabolic syndrome risk than hepatic steatosis. Therefore, this simple, practical and low-cost score can be useful for population screening and identification of subgroups of individuals at higher risk future metabolic diseases. Funding Acknowledgement Type of funding source: None

A study on association of hyperuricemia among patients of metabolic syndrome attending outpatient department of North Bengal Medical College and Hospital

Background: Metabolic syndrome (MS) refers to a group of modifiable risk factors consisting of insulin resistance, glucose intolerance, increased triglyceride and decreased high-density lipoprotein (HDL) cholesterol levels, and arterial hypertension, occurring in some individuals and associated with an increased risk of developing cardiovascular disease and type 2 diabetes mellitus. The raised serum uric acid level as a marker for generalized metabolic derangement is on the rise. An independent effect of elevated serum uric acid on atherosclerosis, as measured by such a surrogate marker, has been suggested for the influence of MS and other factors. Asymptomatic hyperuricemia is also found to have an independent association with a cardiovascular disorder. Metabolic disturbances such as visceral obesity, dyslipidemia, hyperglycemia, and hypertension are risk factors for cardiovascular disease. Aims and Objectives: The study was conducted to find out any association between MS and hyperuricemia which would be relevant as a biomarker to diagnose the fatal but avoidable cardiovascular complication and to treat them at the earliest. Materials and Methods: Height, weight, blood pressure, waist circumference, body mass index (BMI), blood uric acid levels, fasting blood sugar levels, serum triglyceride, and serum HDL cholesterol measured among a group of 298 subjects (198 cases and 100 controls) attending outpatient department of North Bengal Medical College and Hospital. Results: Hyperuricemia significantly increases with an increase in age and BMI. Subjects of MS (Cases) significantly have more systolic and diastolic blood pressure, fasting plasma glucose, raised serum triglyceride, uric acid, and low HDL than their healthy counterparts (control). Hyperuricemia is significantly associated with MS cases irrespective of sex after menopause of females, but males are more affected than females when the age group is not considered. Conclusion: An association was found between MS and uric acid level that may help the medical community to include the uric acid level measurement to be a routine diabetic, hypertensive care level, and decrease the burden of cerebrovascular disorder arising out of complication due to hyperuricemia. Association of serum uric acid level with MS and its relevance as a biomarker as cardiovascular risk outcome will have significant clinical importance.

Factor and Cluster Analysis for TCM Syndromes of Real-World Metabolic Syndrome at Different Age Stage.

Background Traditional Chinese medicine (TCM) has the characteristics of multitarget and overall regulation, which has certain advantages in preventing and treating of metabolic syndrome (MS). The aim of the present study was to evaluate the similarities and differences of TCM syndrome distribution in different age groups to promote the optimization of treatment strategies. Methods This study was based on a real-world survey conducted in 3 hospitals in China. There are 1262 collected cases of MS meeting the inclusion criteria, which were divided into the young group, middle-aged group, and elderly group. Factor analysis (FA) was conducted for syndrome element extraction, and K-means cluster analysis was processed for syndrome type classification. Frequency analysis and Chi-square test were used to compare the syndrome characteristics of each group. Results Common factors extracted were assigned to 18 syndrome elements including 11 nature syndrome elements and 7 location syndrome elements. Phlegm and dampness are the most frequent syndrome elements in general. Compared with the middle-aged group and elderly group, the young group has more obvious nature syndrome elements in heat and Qi deficiency, and location syndrome elements in the stomach. As for the middle-aged group, the frequency of location syndrome in kidney syndrome was higher than that in other groups. When it comes to the elderly group, it is shown that the symptoms of Yin deficiency and blood deficiency increase with age and the old patients may have more location syndrome elements in the lung and gallbladder. Conclusion The TCM syndrome of MS is complex in that there may be the characteristics of deficiency and excess syndrome simultaneously. The main pathological factors of MS were phlegm and dampness. Besides, MS patients at different age periods may have their own syndrome distribution features. So, it is reasonable to adhere to the method of resolving phlegm and removing dampness and, at the same time, adopt the ways of clearing heat, promoting Qi, nourishing Yin, supplementing blood as well as regulating the liver, promoting the lung, transporting the spleen, nourishing the heart, and nourishing the kidney based on the syndrome feature of MS in different age stages.

ANÁLISE DA EFETIVIDADE DE ESTRATÉGIA NUTRICIONAL EM MULHERES COM SÍNDROME METABÓLICA

O objetivo deste estudo foi analisar a efetividade de uma estratégia nutricional em mulheres obesas com Síndrome Metabólica (SM). Estudo longitudinal caso-controle estruturado com dois grupos, sendo mulheres obesas com diagnóstico clínico de SM (Grupo Caso) e mulheres obesas sem diagnóstico de SM (Grupo Controle), em acompanhamento nutricional na Clínica Escola de Nutrição da Unicentro. A coleta de dados ocorreu em duas etapas, com intervalos de um mês, sendo realizadas medidas antropométricas, análise do consumo alimentar e exames bioquímicos. A estratégia nutricional utilizada foram orientações nutricionais e plano alimentar individualizado. Foram avaliadas 20 mulheres, cada grupo com número equivalente. Pacientes com SM apresentaram valores de CC e glicemia em jejum superiores ao grupo controle (p

Abstract P114: Genetic Polymorphisms of CD36 Associated With Metabolic Syndrome in Chinese Han Population: A Nested Case-Control Study

Aims: CD36 , an important gene involved in cholesterol and fatty acid metabolism,, has been associated with many metabolic-related traits, including diabetes, hypertension, and obesity in different populations. However, the association of this gene with metabolic syndrome (MS) has not been well-studied. We aimed to investigate the association of CD36 with the risk of MS and longitudinal changes of its components in among participants of the Rural Chinese Cohort Study (RCCS). Materials and Methods: The RCCS enrolled 20,194 participants aged 2 18 years old between July of 2007 and August of 2008. A total of 17,265 participants (response rate 85.5%) were examined in the follow-up survey between July of 2013 and October of 2014. During the six years, 729 new incident cases of MS were ascertained. We conducted a nested case-control study within the RCCS. Specifically, 408 MS randomly cases and 408 one-to-one matched controls were included in the current study. In addition to follow-up time, non-MS controls were matched to MS cases on age, gender, marital status, and residence village. Human genomic DNA was extracted using a standard method from blood samples collected at the baseline. After quality control, 4 single nucleotide polymorphisms (SNPs) within the CD36 were successfully genotyped. MS was defined according to the 2009 criteria proposed by IDF and AHA/NHLBI. Multivariate conditional logistic regression was used to determine additive associations of SNPs and SNP-haplotype with MS adjusting for body mass index (BMI), smoking, drinking, and physical activity at baseline. Multivariate linear regression models were conducted among the control group to examine association of SNPs and SNP-haplotypes with MS components, controlling for age, gender, BMI, smoking, drinking and physical activity. Multiple testing was corrected by false positive discovery rate (FDR) method. Results: Two SNPs, rs7755 and rs1049673, were associated with risk for MS. Per minor allele increase in rs7755 and rs1049673 was associated with 2.29 (95% confidence interval [CI]: 1.24-4.24, p =0.008) and 2.30 (95% CI: 1.24-4.26, p =0.008) times higher odds of MS, respectively. In addition, rs1194197 was associated with changes of triglycerides level (β=0.151, p =0.014), and rs7755 (β=-0.065, p =0.028) and rs1049673 (β=-0.067, p =0.025) were associated with changes of high density lipoprotein cholesterol in the control group. One haplotype of the four SNPs, AGAG, was associated with the change of waist circumference (β=-1.773, p =0.048). Conclusions: We identified important SNPs and SNP-haplotypes of the CD36 associated with MS and changes of MS components in a Han Chinese population.

Eruptive lichen planus, a marker of metabolic syndrome

Background:Chronic inflammatory diseases take an important place in dermatology and their effects range from mild itching to grave metabolic complications. In psoriasis, association with metabolic syndrome (MS) has been proved in many studies. Chronic inflammation is a trigger of MS, and in turn, the components of MS, namely obesity and dyslipidemia, promote a pro-inflammatory milieu. Thus, chronic inflammation causes MS and vice versa. Hence, the study focuses on association of MS with lichen planus (LP), another chronic inflammatory disease.Aim:The aim of this study is to find the association of MS with all variants of LP.Materials and Methods:An observational study for MS in all patients with LP who attended skin outpatient department (OPD) for 6 months from February 2016. International Diabetes Federation criteria 2005 were used. The confounding variables of MS such as smoking, alcohol, and physical activity were assessed for its significance in the association of LP with MS.Results:Out of 113 cases, 21 cases were found to be associated with MS. Among them, 8 cases (38.09%) were of eruptive LP, which showed significant association with MS when compared to other variants. MS cases were significantly high in females and in the age group of 41–50 (57.1%). Due to unequal distribution of smoking and alcohol habits, they were not taken into account for analysis. Physical activity had no significant association with MS in our study population. Waist circumference (WC) being the mandatory criterion in all variants associated with MS, dyslipidemia was the next frequently encountered criteria except in eruptive LP. High BP was less commonly noted criteria.Conclusion:Eruptive LP showed significant association with MS. Further studies with large sample size in each variant and control group are needed to confirm it which are the limitations in our study.