Combination Of Abdominal Obesity Research Articles

Clinical variants of the metabolic syndrome in young people living in the Khanty-Mansiysk autonomous region – Yugra

Currently the “rejuvenation” and an increase in the number of components of the metabolic syndrome (MS) determine its clinical significance in the earlier development of diabetes mellitus, cardiovascular diseases and related complications. Aim of the study was to investigate the features of the MS clinic picture in a population of young men and womenliving in the Khanty-Mansiysk autonomous region – Yugra.Material and methods. The study included 863 young people between 18 and 44 years of age, including 344 men and women with MS and 519 people in the comparison group. Studied subgroups are represented by non-indigenous men and women living in urban and rural areas, and indigenous rural residents. The analysis of MS clinical and laboratory parameters was carried out and its clinical variants in ethnic groups were identified.Results and its discussion. According to the results of the survey of young people with metabolic syndrome, it was revealed that the combination of abdominal obesity and two components of MS were most common in young people with MS (in 50.0 % men and in 55.5 % women). The study defined regression models for each MS group and threshold values for waist circumference were set, which changes in lipid and carbohydrate metabolism were predicted.Conclusions. In groups with MS, hypertriglyceridemia was determined as its most common component. The study identified the most frequent association of abdominal obesity with hyper-LDL cholesterol and hypertriglyceridemia in patients with metabolic syndrome, in ethnic groups, this combination is more common in indigenous rural men (53.3 %) and in non-indigenous urban women (54.3 %).

VITAMIN D DEFICIENCY AND FACTORS OF METABOLIC SYNDROME IN OVERWEIGHT AND OBESE ADOLESCENTS

Introduction. Vitamin D deficiency is widespread worldwide and rises with increasing passive lifestyles and bad habits. Vitamin D metabolites are associated with cell differentiation and apoptosis and influence carbohydrate and lipid metabolism. Both changes in lipid and carbohydrate metabolism, as well as a recent increase in sedentary lifestyle, contribute to metabolic syndrome development. The aim of the study was to investigate the relationship between vitamin D status and metabolic syndrome criteria in overweight and obese adolescents. Methods. The study included 196 adolescents, aged 12-17 years. 136 children with overweight and obesity and 60 children with normal body weight, which formed the control group. Auxological and biochemical parameters were studied in all children. Vitamin D status was evaluated and determined according to the International Society of Endocrinology recommendations. The criteria for metabolic syndrome were determined according to the consensus of the International Diabetes Federation. Results. Among enrolled children predominantly was found vitamin D insufficiency and deficiency. Vitamin D deficiency increased with increasing of body weight in adolescents, and it reached up to 74,3% in overweight and obese children. In addition to the relationship with body mass index, was found an association between increased vitamin D deficiency and increased abdominal fat, which is also a predictor of metabolic syndrome. In children with vitamin D deficiency was defined increase by 52,4% atherogenic index, as well as decreased alpha lipoprotein levels by 11,4% at vitamin D levels < 20 ng/ml, and by 25,70% at < 10 ng/ml, respectively. It was found that the level of 25(OH)D in the blood serum was inversely associated with insulin (r=-0,501; p=0,001) levels and HOMA-IR (r=-0,511; p=0,001). Adolescents with vitamin D deficiency have shown more often hyperinsulinemia and insulin resistance. In 49,6% of obese and overweight children, there was a combination of abdominal obesity with two or more criteria of metabolic syndrome. Conclusions. In this study, we found low levels of vitamin D in adolescents and its association with body mass index and metabolic syndrome criteria. Vitamin D deficiency in adolescence can contribute to the development of diseases associated with obesity, insulin resistance, type 2 diabetes mellitus, hypertension, and cardiovascular disease

ASSESSMENT OF THE EFFECT OF DIFFERENT CLUSTERS OF THE METABOLIC SYNDROME ON THE EXPRESSION OF DEPRESSIVE DISORDERS

The purpose of the study. To study the influence of various metabolic syndrome clusters on the severity of depressive disorders according to the CES-D scale.
 Materials and methods. 136 male patients were examined, including 60 with metabolic syndrome. Metabolic syndrome was diagnosed based on the criteria of clinical recommendations of the All-Russian Scientific Society of Cardiology in 2009. The severity of depression was assessed using the Center for Epidemiological Studies Depression Scale - CES-D.
 Results. It was found that among the surveyed men with metabolic syndrome, depressive disorders of varying severity on the CES-D scale were found in 40% of the surveyed, while among men with MS, the number of people with severe depression on the CES-D scale was higher. Among persons with a four-component metabolic syndrome cluster, patients with severe depression were more common (57,1%). In men with depression on the CES-D scale of varying severity, a three-component cluster of metabolic syndromes was more common, consisting of abdominal obesity, arterial hypertension, and an elevated level of low-density lipoprotein cholesterol.
 Conclusion. The combination of abdominal obesity, arterial hypertension, and lipid disorders characterized by high levels of low-density lipoprotein was the most common metabolic syndrome cluster among men with depressive disorders of varying severity on the CES-D scale.

Heterogeneous Comorbidity in Individuals With Different Phenotypes of Obesity.

Introduction The prevalence of obesity is steadily increasing worldwide. Obesity is one of the most potent risk factors for various diseases and is simultaneously a heterogeneous condition. Different types of obesity could be identified according to body mass index (BMI), waist circumference, and visceral fat level; these conditions may present individually or in combination and pose a risk of developing certain comorbidities. However, the current obesity classification systems do not allow for accurate diagnosis and prediction of the comorbidity risk of patients, which is crucial for their clinical management. This points to the importance of studying obesity phenotyping in the context of body composition. Our study aimed to determine the contribution of obesity phenotypes in forming various comorbidities. Materials and methods This case-control study was conducted at the Clinical and Diagnostic Center of the Aviastroitelny District, Kazan. Patients were selected based on BMI per inclusion and exclusion criteria. A total of 151 patients with a median age of 43 [34.5-50] years were included in the study. The participants were distributed into six groups according to BMI and a combination of abdominal obesity (AO) and excess visceral fat. Results The participants were distributed in the following phenogroups: The first group - normal BMI without AO and excess visceral fat (n=47; 31.1%); the second group - overweight without AO and excess visceral fat (n=26; 17.2%); the third group - normal BMI with AO and without excess visceral fat (n=11; 7.3%); fourth group - overweight with AO and without excess visceral fat (n=34; 22.5%); fifth group - general obesity with AO and without excess visceral fat (n=20; 13.2%); sixth group - general obesity with AO and excess visceral fat (n=13; 8.6%). The five most frequently observed conditions in the general cohort were dyslipidemia (71.5%; n=108), disorders of the gastrointestinal tract (53.0%; n=80), cardiovascular disease (46.4%; n=70), musculoskeletal diseases (40.4%; n=61) and impaired carbohydrate metabolism (25.2%; n=38). The median number of pathological combinations in the general cohort was 5 [IQR: 3-7]. As the group number increased, the median number of comorbidities also increased. While BMI was significantly associated only with arterial hypertension, the level of visceral fat was associated with most comorbidities (obstructive sleep apnea syndrome, non-alcoholic fatty liver disease, chronic pancreatitis, hypertriglyceridemia, and prediabetes), followed by abdominal obesity (gastroesophageal reflux disease, hypertriglyceridemia, arterial hypertension, hypercholesterolemia). Conclusions In working-age people, group 1 and 4 phenotypes were more frequent than others. Abdominal obesity and visceral fat were associated with the most comorbid conditions. However, the individual types of these comorbidities were not the same.

Gender features of metabolic syndrome components in young age

The article analyzes the clinical and laboratory features of young men and women with abdominal obesity and metabolic syndrome. The study was carried out on 173 patients of both sexes aged 18-45 years. The patients were divided into 3 groups: group 1 – isolated abdominal obesity (AO); group 2 – combination of abdominal obesity with 1 of the metabolic syndrome components (AO+1); group 3 – metabolic syndrome (MetS). It was found that in young men, the values of carbohydrate (glucose, insulin) and lipid metabolism (HDL cholesterol, LDL cholesterol, triglycerides), insulin resistance indices (HOMA-IR, TyG) in the AO and AO+1 groups were homogeneous. However, the ratio of TG/HDL in the AO+1 group exceeded the value of the AO group. Women in the AO+1 group showed changes relative to the group of women with isolated AO that are hyperglycemia, increased LDL cholesterol, insulin resistance (increased TG/HDL) and dysfunction of visceral adipose tissue (increased VAI). Young men with MetS are characterized by excess body weight, hyperglycemia, dyslipidemia (increased LDL cholesterol and triglycerides), insulin resistance (as measured by TyG and TG/HDL), and dysfunction of visceral adipose tissue. The gender feature of women is the development of MetS on the background of obesity, dysfunction of visceral adipose tissue and insulin resistance in combination with deeper changes in lipid metabolism (increased LDL cholesterol and triglycerides, as well as a decrease in HDL cholesterol).

Padrões de síndrome metabólica e fatores associados em mulheres do ELSA-Brasil: uma abordagem com análise de classes latentes

Abstract: This study aimed to identify patterns of metabolic syndrome among women and estimate their prevalence and relationship with sociodemographic and biological characteristics. In total, 5,836 women were evaluated using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Patterns of metabolic syndrome were defined via latent class analysis, using the following metabolic abnormalities as indicators: abdominal obesity, hyperglycemia, hypertension, hypertriglyceridemia, and reduced HDL cholesterol. The relationship between these patterns and individual characteristics was assessed using latent class analysis with covariates. Three patterns of metabolic syndrome were identified: high metabolic expression, moderate metabolic expression, and low metabolic expression. The first two patterns represented most women (53.8%) in the study. Women with complete primary or secondary education and belonging to lower social classes were more likely to have higher metabolic expression. Black and mixed-race women were more likely to have moderate metabolic expression. Menopausal women aged 50 years and older were more often classified into patterns of greater health risk. This study addressed the heterogeneous nature of metabolic syndrome, identifying three distinct profiles for the syndrome among women. The combination of abdominal obesity, hyperglycemia, and hypertension represents the main metabolic profile found among ELSA-Brasil participants. Sociodemographic and biological factors were important predictors of patterns of metabolic syndrome.

Metabolic syndrome in children: algorithms of diagnostic and therapeutic and preventive measures

There is an increase in the incidence of obesity and metabolic syndrome (MS) among children and adolescents. The purpose of the study: to improve the algorithms of diagnostic and therapeutic and preventive measures for MS in obese children. Materials and methods. A comprehensive examination of 483 children with exogenous constitutional obesity aged 6-17 years (285 boys and 198 girls) (SDS BMI ≥ 2.0) was conducted. Results. MS (IDF, 2007) was diagnosed in 49% of the examined children. Adolescents aged 12-17 prevailed (77%). Boys 61%, girls 39% (p<0.05). 61% of adolescents were obese for 5 years or more. 54% of children had a combination of abdominal obesity with two additional components (an incomplete version of MS), 33% - with three, 13% of adolescents had complete MS (a combination of all five components). The analysis of hereditary burden has established a high incidence of obesity, type 2 diabetes, diseases of the cardiovascular system in the mother and maternal grandmother. An increase in blood pressure was detected in 79% of children with MS, arterial hypertension of the I degree - in 34%, hypertension of the II degree - in 22%. Pronounced disorders of glucose metabolism were revealed in the form of a high frequency of IR (81%) and compensatory hyperinsulinemia (55%). Changes in the lipid profile were recorded in 77% of children with MS. An increase in the level of TG and a decrease in HDL cholesterol, which are components of MS, were in 48% and 55% of children, respectively, and their combination was in 27%. Non-alcoholic fatty liver disease was diagnosed in 70% of children with MS, signs of non-alcoholic steatohepatitis - in 13%. In 29%, cholesterosis of the gallbladder was detected, in 34% - biliary sludge, in 7% - gallstones. Conclusion. Based on a comprehensive examination, a diagnostic algorithm and a three-level MS prevention program have been developed, as well as a mathematical model for predicting MS based on the assessment of indicators such as the size of the pancreatic head, thyroid volume, serum alanine aminotransferase (ALT) level, fasting serum glucose level, increased liver echogenicity, according to which it is possible to predict the development of MS in children at the outpatient level at the early stages metabolic disorders.

THE LIPID PARADOX IN POSTOPERATIVE ATRIAL FIBRILLATION

The combination of abdominal obesity and elevated triglycerides (TG), i.e. hypertriglyceridemic waist, is a known risk factor for coronary heart disease. Abdominal adiposity is also known to increase the risk of atrial fibrillation (AF). Yet, a lipid paradox has been described, where lower levels of low-density lipoproteins (LDL) and TG were associated with a higher risk of AF. We evaluated the role of the lipid profile on the incidence of postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting (CABG) and its interaction with abdominal obesity.

Diagnosis and management of the metabolic syndrome with pulmonary and liver diseases

Introduction: The metabolic syndrome is a condition characterized by a cluster of alterations including glucose intolerance/ insulin resistance, abdominal obesity, atherogenic dyslipidemia (low concentrations of high-density lipoprotein-cholesterol and high concentrations of triglycerides), elevated blood pressure, a proinflammatory and a prothrombotic state. It increases morbidity and mortality, especially due to cardiovascular disease. Material and Method: This study has been performed in 90 consecutive patients referred to our metabolic outpatient clinic for suspected metabolic disorders. This study conducted among patients attending at Tertiary care teaching hospital over a period of 1 year. Patients underwent a complete clinico-pathology and biochemical work-up, including a liver ultrasonographic scanning (US), as part of the routine clinical examination. MetS was defined by a combination of abdominal obesity, impaired fasting glucose, atherogenic dyslipidemia, and elevated blood pressure. Results: A total of 90 participants (53 males) were included in the study. The characteristics of the eligible subjects stratified by gender and the presence of metabolic syndrome. The BMI, SBP, DBP, waist circumference was statically significant between male and female (all of the parameters, p&lt;0.05).

Dynapenic Abdominal Obesity as a Risk Factor for Falls

BackgroundObesity and low muscle strength (dynapenia) are independently associated with greater falls risk. It remains unclear whether dynapenia and obesity have an additive effect on falls risk, greater than either phenotype alone. Objectives: To determine whether a combination of abdominal obesity with dynapenia, dynapenic abdominal obesity (DAO), confers a greater risk of falls than either obesity or dynapenia alone in both men and women.DesignAn observational cohort study was conducted. Setting and Participants: Data from English adults (n=4239, 60–87 years) who took part in the English Longitudinal Study of Ageing were included.MeasurementsDynapenia, was defined as hand-grip strength <20kg (female), <30kg (male). Abdominal obesity was defined as waist circumference >88cm (female), >102cm (male). Data on falls and fall-related injuries over a 2-year follow-up were collected. Multiple logistic regression analyses were performed adjusting for age and sex, with results expressed as odds ratios (OR) and areas under the receiver operating characteristic curve (AUC).ResultsFalls occurred in 1049 participants, with 284 reporting a related injury during follow-up. DAO was associated with greater OR of falls in men (OR 2.1, 95% Confidence Intervals (CI) 1.3–3.2). Dynapenia rather than obesity was associated with falls in women, with greatest OR observed in those with low hand-grip strength (OR 1.4, 95% CI 1.1–1.7). Individual discrimination was low for measures of obesity or dynapenia either alone or in combination (AUC 0.51–0.58). There was no relationship between fall-related injuries and obesity or dynapenia.ConclusionOur findings suggest a synergistic effect of obesity with dynapenia on falls risk in men but not women.

Зниження маси тіла — наріжний камінь терапії метаболічного синдрому в підлітків

Актуальність. В останнє десятиліття активно обговорюється зв’язок метаболічного синдрому (МС) з ожирінням. Раннє виявлення порушення жирового обміну і лікування здорових підлітків є важливим компонентом первинної профілактики МС. Мета дослідження: вивчити клініко-епідеміологічну характеристику ожиріння у підлітків та встановити ефективність первинної профілактики МС. Матеріали та методи. У процесі дослідження було проаналізовано медичні форми 026/о «Медична карта дитини (для дошкільного та загальноосвітнього навчальних закладів)» 656 підлітків 16–18 років, які навчаються в коледжах ВДНЗ України «Буковинський державний медичний університет» упродовж 2014–2016 рр. За результатами аналізу була сформована група підлітків із надлишковою масою тіла та ожирінням із 50 осіб, які становили групу дослідження. Порушення жирового обміну верифікували з використанням перцентильних таблиць: індекс маси тіла у межах 85–95-го перцентилів оцінювався як надлишок маси, понад 95-го перцентиля — як ожиріння. Серед лабораторних показників аналізу підлягали рівні холестерину, гормонів щитоподібної залози, глюкози крові натще і після проведення глюкозотолерантного тесту, рівень еластази-1 в калі, а також результати додаткових інструментальних досліджень. Серед підлітків була сформована клінічна група із 20 осіб, яким проводився комплекс заходів, зокрема категоричне виключення з харчування рафінованих легкозасвоюваних вуглеводів, дозоване фізичне навантаження, корекція режиму дня. Результати. Аналіз даних медичної документації 656 підлітків встановив порушення фізичного розвитку у 50 (7,6 %) осіб, серед них надлишок маси тіла у 28 (56 %), ожиріння — у 22 (44 %). Клінічно у половини обстежених із надлишковою масою тіла та ожирінням визначалися ознаки гормонального дисбалансу (стрії, гіпергідроз, чорний акантоз, гіперкератоз, акне, гірсутизм, гінекомастія, жирна себорея). Підвищення артеріального тиску встановлено у 72,6 % підлітків. Різні варіанти порушення вуглеводного обміну встановлено у 42,7 % осіб. Майже у половини підлітків виявили зміни ліпідного спектра крові, у кожного сьомого виявлено порушення в системі гемокоагуляції, у 17,1 % підлітків відзначалося зниження функціональної активності підшлункової залози, що проявлялося зниженням еластази-1 в калі. Абсолютна більшість підлітків мали спадкову обтяженість щодо ожиріння, цукрового діабету 2-го типу та артеріальної гіпертензії. У 92,5 % підлітків із ожирінням визначені окремі компоненти МС. Поєднання ожиріння з одним із компонентів МС становить 56,4 %, з двома — 32,2 %, з трьома — 11,2 % випадків. Із 20 пацієнтів, які перебували в програмі, у 12 (60 %) осіб маса тіла нормалізувалася, у 8 (40 %) залишилось ожиріння. Ефективність програми підтверджена зниженням поширеності модифікованих факторів ризику: нераціонального харчування — на 13 %, куріння — на 6,9 %, порушення фізичної активності — на 25,2 %, підвищенням інформованості — на 54 %, зниженням компонентів МС (маса тіла — на 30 %, артеріальна гіпертензія — на 33,7 %, порушення вуглеводного обміну — на 20 %, дисліпопротеїнемія — на 33,3 %). Висновки. Порушення жирового обміну серед підлітків становить 7,6 %, зокрема надлишок маси тіла — 56 %, ожиріння — 44 %. Компоненти МС мають 92,5 % підлітків із ожирінням. Поєднання абдомінального ожиріння з одним із компонентів МС — 56,4 %, із двома — 32,2 %, із трьома — 11,2 % випадків. Ефективність запропонованої програми щодо зниження маси тіла становить 60 % і підтверджена зниженням поширеності модифікованих факторів ризику розвитку МС.

CURRENT UNDERSTANDING OF THE PEDIATRIC METABOLIC SYNDROME (review)

According to the World Health Organization 68% of the causes of global mortality are due to noncommunicable diseases, that include cardiovascular pathology obesity, atherosclerosis and diabetes mellitus. The combination of abdominal obesity, hypertension, hyperglycemia and hyperlipidemia on the background of insulin resistance and chronic subclinical inflammation are components metabolic syndrome (MetS). MetS in pediatric population is also complex problem associated with the potential cardiovascular risk in young adults. There are lot of debates around definitions and diagnostic cut-offs for the MetS components due to age dependent fluctuations of the metabolic and cardiovascular parameters. This leads to the unclear incidence of the syndrome in children. Meantime, healthy lifestyle, nutrition and sleep are best strategies for both preventing and treating MetS in children and adolescents. Despite the large number of studies in this area, pediatric metabolic syndrome remains the subject of controversy.

Metabolic syndrome in haemodialysis patients: prevalence, determinants and association to cardiovascular outcomes

BackgroundIn the general population, metabolic syndrome (MetS) is predictive of major adverse cardiovascular events (MACE). Waist circumference (WC), a component of the MetS criteria, is linked to visceral obesity, which in turn is associated with MACE. However, in haemodialysis (HD) patients, the association between MetS, WC and MACE is unclear.MethodsIn a cross-sectional study of 1000 HD patients, we evaluated the prevalence and characterised the clinical predictors of MetS. The relationship between MetS and its components, alone or in combination, and MACE (coronary diseases, peripheral arteriopathy, stroke or cardiac failure), was studied using receiver operating characteristics (ROC) curves and logistic regression.ResultsA total of 753 patients were included between October 2011 and April 2013. The prevalence of MetS was 68.5%. Waist circumference (> 88 cm in women, 102 cm in men) was the best predictor of MetS (sensitivity 80.2; specificity 82.3; AUC 0.80; p < 0.05). In multivariate analysis, MetS was associated with MACE (OR: 1.85; 95CI 1.24–2.75; p < 0.01), but not WC alone. There was a stronger association between the combination of abdominal obesity, hypertriglyceridaemia and low high-density lipoprotein cholesterol with MACE after exclusion of impaired fasting glucose and hypertension.ConclusionsMetS is frequent and significantly associated with MACE in our haemodialysis cohort and probably in other European dialysis populations as well. In HD patients, a new simplified definition could be proposed in keeping with the concept of the “hypertriglyceridaemic waist”.

Dynapenic Abdominal Obesity And The Incidence Of Falls In Older Women: An 18-month Follow-up Study

PURPOSE: To assess the association between dynapenic abdominal obesity (DAO) and the incidence of falls over 18 months in older community-dwelling women. METHODS: A total of 188 older women (67.97±6.02 years; 27.70kg/m2) underwent waist circumference (WC) measurement and had handgrip strength assessed at the dominant arm using a hydraulic dynamometer. Dynapenia was classified using the lower tertile of handgrip strength as cut-off value (20.7kgf), while obesity was considered as a WC > 88cm. DAO was the combination of both aforementioned criteria. Therefore, volunteers were divided into 4 groups: Eutrophic, Dynapenic, Obese, and DAO. Participants were tracked by phone calls for ascertainment of falls during a follow-up period of 18 months. Chi-square and modified Poison regressions were conducted. RESULTS: Proportions of each classification were 17.6%, 46.8%, 13.3%, and 22.3% for eutrophic, obese, dynapenic, and DAO, respectively. The incidence of falls over 18-month follow-up period was 24.5%. Thus, the proportion of fallers regarding each classification were 12.1%, 12%, 25%, and 40.5% for eutrophic, dynapenic, obese, and DAO, respectively (X2=10.662; p=0.014). Noteworthy, only DAO was consistently associated with a higher risk of falls (relative risk: 3.339; 95% CI: 1.242-8.979), even after adjustments for age, body mass index, physical activity level, regular use of four or more medications, reduced peripheral sensation, presence of two or more chronic diseases, and history of lower-limbs pain. CONCLUSIONS: These results provide support for the concept that the combination of abdominal obesity and dynapenia has clinical implications and might be an useful supplement to other routine falls risk assessment tools. These relationships were stronger than obesity or dynapenia alone.

Study of Platelet Indices in Patients with Metabolic Syndrome

Abstract Introduction Metabolic syndrome (MetS) is a combination of abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. MetS patients have higher chances of developing insulin resistance, visceral adiposity, atherogenic dyslipidemia, and thus coronary artery disease and stroke. Alteration of platelet indices in diabetes mellitus, atherosclerosis, and other proinflammatory states has been described in multiple studies. Thus, this study was carried out to assess platelet indices in MetS. Objectives This study was carried out to assess platelet indices in MetS. Methods A cross-sectional study was carried out at Acharya Vinoba Bhave Rural Hospital, a tertiary care center over a period of 2 months from June 1, 2018 to July 31, 2018. Fifty patients diagnosed as having MetS, and 50 healthy controls were chosen. Estimation of anthropometric parameters including waist circumference; measurement of blood pressure; biochemical parameters including lipid profile; and platelet indices including plateletcrit, mean platelet volume (MPV), and platelet distribution width (PDW) were carried out. Statistical Analysis Statistical analyses were carried out using inferential statistics, including chi-square test and Student's unpaired t-test, and software SPSS version 22.0 (IBM Corporation, Armonk, New York, United States) with GraphPad Prism version 6.0 (Informer Technologies, Inc. Los Angeles, California, United States) was used, with p &lt; 0.05 being considered as significant. Results A statistically significant, positive correlation was found between the waist circumference, systolic blood pressure, serum triglyceride levels, and plateletcrit, with the MetS status of patients (p &lt; 0.05). Conclusion This study revealed that MetS is a proinflammatory and prothrombotic state, characterized by alteration of platelet indices. Plateletcrit was shown to be a statistically significant biomarker along with other parameters such as waist circumference, systolic blood pressure, and serum triglyceride levels. Early detection and follow-up of patients using these markers can lead to an overall decline in morbidity and mortality owing to MetS.

Small Degree of Lumbar Lordosis as an Overlooked Determinant for Orthostatic Increases in Blood Pressure in the Elderly: The Nagahama Study

Orthostatic hypertension was associated with worse cardiovascular outcomes, although the factors responsible for an orthostatic rise in blood pressure (BP) are uncertain. We investigated a possible relationship between a stooping posture and orthostatic BP change. Study participants consisted of 1,992 older individuals. Orthostatic BP change was calculated by systolic BP measured at sitting position, and again 1 and 3 minutes after standing up. Spinal alignment and curvature was assessed by guiding the SpinalMouse device on the surface of the skin along the spine. Mean lumbar lordosis at standing position was 13.4° ± 12.4°. The degree of lumbar lordosis was significantly smaller in orthostatic hypertensive individuals (systolic BP change, ≥+20 mm Hg: 3.3° ± 15.6°, ≥+10 mm Hg: 10.4° ± 14.3°) than in individuals who were orthostatic normotensive (14.2° ± 11.9°). Multiple linear regression analysis identified lumbar lordosis (β = -0.171, P < 0.001) and thoracic kyphosis (β = 0.062, P = 0.007), but not sacral inclination (β = 0.033, P = 0.303), as independent determinants for orthostatic BP change. As waist circumference was another independent determinant, the frequency of orthostatic hypertensive individuals was linearly increased with the combination of abdominal obesity and small degree of lumbar lordosis (control: 9.9%, abdominal obesity: 17.4%, small degree of lordosis: 19.4%, both: 24.1%, P < 0.001). Participants who sustained orthostatic hypertension for 3 minutes after standing up had the smallest degree of lumbar lordosis (5.2° ± 16.4°). Stooped posture was an overlooked determinant for orthostatic increases in BP.

Observational Study on Implementation and Effectiveness of Cognitive Behaviour Therapy Targeting Eating Behaviour for Patients with Abdominal Obesity in an Ordinary Primary Health Care Setting

Objective: To describe the implementation of Cognitive Behavioural Therapy Targeting Eating Behaviour (CBT-TEB) and to determine the short-term effectiveness in reducing abdominal obesity and body mass index (BMI) where the therapy was provided in ordinary primary care centres. Methods: A screening questionnaire was given to consecutive patients and after that a health dialogue, blood pressure and plasma glucose check were offered. Eightythree persons aged 18-69 years consented to participate in the CBT-TEB intervention. Inclusion criteria were the combination of abdominal obesity and BMI ≥ 25. Primary outcome measures were changes from baseline to six months after end of therapy in waist circumference (WC), waist-to-hip ratio (WHR), weight, and BMI. Changes in eating behaviours: emotional eating and uncontrolled eating, obesity related psychosocial problems as well as patients´ and group leaders´ experiences of the CBT-TEB programme were also assessed. Pulse, systolic and diastolic blood pressure, total cholesterol, high-density lipoproteins (HDL-C), low-density lipoproteins (LDL-C) and triglycerides were measured. Results: Mean reductions after six months (total sample, last observation carried forward): WC 4.8 (sd 7.0) cm, WHR 0.027 (sd 0.04), weight 4.4 (sd 4.9) kg, BMI 1.6 (sd 1.8) kg/m2. Mean reductions after six months in therapy completers: WC 5.5 (7.3) cm, WHR 0.031 (0.05), weight 5.0 (5.0) kg, BMI 1.8 (1.8) kg/m2. Cognitive restraint eating increased and uncontrolled eating, emotional eating and obesity-related psychosocial problems decreased significantly during therapy. Patients´ experiences of the therapy exceeded their expectations. Group leaders´ experiences were positive. Conclusions: It was feasible to implement CBT-TEB in primary care with health educators and district nurses as group leaders after short training. The therapy was well accepted by patients and staff. The short-term effectiveness of CBT-TEB was satisfying and seems to surpass most or all published CBT-based programmes for reduction of weight and abdominal obesity in patients attending primary care.

Metabolic syndrome in the inhabitants of Mountain Shoria: prevalence, variants of manifestations and ethnic peculiarities

Background. Metabolic syndrome is one of the most dangerous risk factors of cardiovascular and endocrine diseases development and mortality due to them, especially among young people.&#x0D; Aims: Our purpose was to study the prevalence of the metabolic syndrome, combinations of its components in indigenous and non-indigenous inhabitants of Mountain Shoria.&#x0D; Materials and methods. During the period since 2012 to 2015 we have examined the inhabitants of the villages of Mountain Shoria: Ust-Kabyrza, Orton, Sheregesh by a continuous method on the basis of a name list. All the participants were examined by a cardiologist, an endocrinologist and a general practitioner, also a waist circumference and arterial blood pressure were measured. Specific diagnostic methods included an estimation of blood glucose level, triglycerides (TG) and high density lipoprotein cholesterol (HDL-C) in blood serum.&#x0D; Results. All the subjects (460 persons) were divided into age (1839 years, 4059 years, 60 years and older), ethnic (the Shors and the non-Shors) and gender (men and women) groups. Generally, the metabolic syndrome was diagnosed in 40.2% of inhabitants of Mountain Shoria. Metabolic syndrome (MS) was presented in 12.4% of indigenous men and in 47.8% of non-indigenous examined men (р=0.00001). MSwasrevealedin 36.8%, of Shor-women and in 60.7% of non-Shor women (р=0.00002). The most common variant of 3-component MS was abdominal obesity + arterial hypertension + hyperglycemia and the rarest was abdominal obesity + TG + hyperglycemia. The most common variant of 4-component MS was a combination of abdominal obesity + hyperglycemia + arterial hypertension + HDL-C, the rarest was abdominal obesity + arterial hypertension + TG + HDL-C. Different variants of 3-component and 4-component MS occurred with similar frequency in all age groups of the Shors and non-Shors.&#x0D; Conclusions. Generally MSoccurred more frequently in non-indigenous inhabitants than in indigenous inhabitants. Only in women of young age group this pathology was revealed with the similar frequency among both ethnic groups. Among all the inhabitants of Mountain Shoria the most frequent clinical variant of 3-component MS was a combination of abdominal obesity + arterial hypertension + hyperglycemia and of 4-component variant a combination of abdominal obesity + hyperglycemia + arterial hypertension + HDL-C.

Prevalence of metabolic syndrome and its risk factors in Canadian children and adolescents: Canadian Health Measures Survey Cycle 1 (2007-2009) and Cycle 2 (2009-2011).

We investigated the prevalence of metabolic syndrome (MetS) and its risk factors, and the influence of socioeconomic status, in Canadian children and adolescents. Canadian Health Measures Survey cycle 1 (2007-2009) and cycle 2 (2009-2011) respondents aged 10 to 18 years who provided fasting blood samples were included (n = 1228). The International Diabetes Federation (IDF) consensus definition for children and adolescents (10-15 years) and worldwide adult definition (≥ 16 years) were used to diagnose MetS. Prevalence of MetS and its risk factors were calculated and differences by socioeconomic status were examined using χ2 tests. The prevalence of MetS was 2.1%. One-third (37.7%) of participants had at least one risk factor, with the most prevalent being abdominal obesity (21.6%), low HDL-C (19.1%) and elevated triglyceride levels (7.9%). This combination of abdominal obesity, low HDL-C and elevated triglyceride levels accounted for 61.5% of MetS cases. Participants from households with the highest income adequacy and educational attainment levels had the lowest prevalence of one or more MetS risk factors, abdominal obesity and low HDL-C. The prevalence of MetS (2.1%) was lower than previously reported in Canada (3.5%) and the USA (4.2%¬-9.2%), potentially due to the strict application of the IDF criteria for studying MetS. One-third of Canadian children and adolescents have at least one risk factor for MetS. Given that the risk for MetS increases with age, these prevalence estimates, coupled with a national obesity prevalence of almost 10% among youth, point to a growing risk of MetS and other chronic diseases for Canadian youth.

The combination of abdominal obesity and high-sensitivity C-reactive protein predicts new-onset hypertension in the general Japanese population: the Tanno-Sobetsu study.

The aim of this study was to examine whether the combination of abdominal obesity and high serum levels of high-sensitivity C-reactive protein (hsCRP) improves the prediction of new-onset hypertension in the general Japanese population. Participants in the Tanno-Sobetsu study, a prospective cohort study, were enrolled. Of 1516 subjects aged 30 years or older in 2002, those with hypertension or abnormal hsCRP levels were excluded, and the remaining 705 subjects were included in the present analyses. Abdominal obesity (AO) and high hsCRP levels were defined by the Japanese criteria of waist circumference and median hsCRP values, respectively. Subjects were followed up on for a maximum of 4.5 years, and the hazard ratio (HR) for new-onset hypertension was calculated using the Cox proportional hazard model. The HR for new-onset hypertension after adjustment for age, sex, fasting plasma glucose, alcohol intake, smoking, treatment for dyslipidemia and high normal blood pressure at baseline was significantly higher in the group with AO and high hsCRP (HR=1.44, 95% CI: 1.00-2.07) compared with the reference group, a group with no AO and low hsCRP; AO alone or high hsCRP alone was not associated with a significant increase in the HR. Similar trends for the increase in the HR by AO and high hsCRP were observed in separate analyses of men and women, although the differences did not reach statistical significance. Co-presence of AO and a high level of hsCRP is associated with a high risk for new-onset hypertension in the general population.