Components Of Metabolic Syndrome Research Articles

Hypertension and psychosis.

Hypertension, a prevalent component of metabolic syndrome (MetS), is a well-known risk factor for cardiovascular diseases (CVD). Psychosis is a feature in the schizophrenia spectrum. Meta-analysis suggests that the prevalence of hypertension in schizophrenia and related disorders is 39%. This may be explained by a unidirectional association between hypertension and psychosis, in that psychosis can be a causative factor of hypertension via antipsychotic medication, inflammation and irregular autonomic nervous system activity through multiple mechanisms. Obesity is a side effect of antipsychotic medication and is a risk factor for hypertension. Obesity leads to raised blood pressure, atherosclerosis, increased triglyceride concentration and decreased high-density lipoprotein concentration. Inflammation accompanies hypertension and obesity. In recent years, the role of inflammation in the onset of psychosis has been increasingly recognised. It underlies the immune dysregulation observed in both schizophrenia and bipolar disorder. Interleukin-6, a marker and driver of inflammation, is related to obesity and plays a role in the pathogenesis of MetS and hypertension. The lack of preventive care of hypertension and other MetS risk factors for patients on antipsychotic medication is reflected in the high incidence of CVD in this population. It is important to detect and treat MetS and hypertension in patients with psychosis in order to reduce cardiovascular morbidity and mortality in this population.

Polymorphisms -374 T/A and -429 T/C of the Receptor for Advanced Glycation End-Products (RAGE) and Serum Levels of RAGE (sRAGE) Are Not Associated with Metabolic Syndrome.

RAGE is a multi-ligand transmembrane glycoprotein that promotes biological signals associated with inflammatory responses and degenerative diseases. sRAGE is a soluble variant, proposed as an inhibitor of RAGE activity. -374 T/A and -429 T/C polymorphisms of the advanced glycation end products receptor AGER gene are associated with the development of some diseases, such as type of cancer, cardiovascular disease, and micro and macrovascular disease in diabetes among others but their role in metabolic syndrome (MS) is still unknown. We studied 80 healthy men without MS, and 80 men with MS according to the harmonized criteria. -374 T/A and -429 T/C polymorphisms were genotyped by RT-PCR, and sRAGE was measured by ELISA. Allelic and genotypic frequencies did not differ between Non-MS and MS groups (-374 T/A p = 0.48, p = 0.57 and -429 T/C p = 0.36, p = 0.59). Significant differences were found in fasting glucose levels and diastolic blood pressure among the genotypes of the -374 T/A polymorphism in the Non-MS group (p < 0.01 and p = 0.008). Glucose levels were different between -429 T/C genotypes in the MS group (p = 0.02). sRAGE levels were similar in both groups, but in the Non-MS group showed a significant difference between individuals with only 1 or 2 components of the metabolic syndrome (p = 0.047). However, no associations of any SNP with MS were found (recessive model p = 0.48, dominant model p = 0.82 for -374 T/A; recessive model p = 0.48, dominant model p = 0.42 for -429 T/C). -374 T/A and -429 T/C polymorphisms are not associated with MS in Mexican population and have no influence on serum sRAGE levels.

Impact of Christian Orthodox Church Fasting on Metabolic Syndrome Components in Adults Aged 18-49 Years.

Studies regarding health effects of religious fasting have been increased during the last decade. Our aim was to investigate the effects of Christian Orthodox Church (COC) fasting on metabolic syndrome in young adults. Participants were 224 men and women, of whom 111 had been following the COC fasting regime and 113 were non-fasters, all aged 18 to 49 years (mean age 29.23 ± 8.78 years). Anthropometric measurements, including the Bioelectrical Impedance Analysis, were performed on individuals, and they also completed food intake questionnaires, and provided blood samples for biochemical analysis. Metabolic syndrome was defined according to criteria of the National Cholesterol Education Program-Adult Treatment Panel III and all variables were checked. Fasters did not statistically differ in anthropometric measurements when comparing to non-fasters. Differences were found in terms of biochemical variables, and more specific in HDL cholesterol, LDL cholesterol and total blood cholesterol, and in systemic and diastolic blood pressure, although non statistically significant. Statistically significant differences were only noticed in heart pulses and insulin levels, with fasters having lower heart pulses (69.44 ± 9.84 versus 72.63 ± 10.74) and greater mean values of insulin levels (4.16 ± 4.66 versus 3.12 ± 2.35). When analysis was carried to identify which variables were met for metabolic syndrome, it was found that fasters had statistically significant lower values of blood pressure when compared to non-fasters. In more details mean systolic blood pressure was 121.67 ± 12.21 versus 123.41 ± 11.73 for fasters and non-fasters respectively, and mean diastolic blood pressure was 75.77 ± 8.82 versus 78.27 ± 10.07 for fasters and non-fasters. Furthermore, the mean energy intake was higher in non-fasters (1698.25 ± 515.99 kcals) when compared to fasters (1590.24 ± 404.19 kcals) but not statistically significant different. Young adults aged 18 to 49 years who fast according to the COC fasting regimes do not have different metabolic syndrome prevalence when comparing to non-fasters, but there was a statistically significant difference in the prevalence of elevated blood pressure with fasters having lower values.

Kidney Biopsy in a Patient with Cardiorenal Metabolic Syndrome—How to Interpret Histopathology

The components of Cardiorenal Metabolic Syndrome (CRMS) include central obesity, insulin resistance, hypertension, metabolic dyslipidemia, proteinuria, and/or reduced glomerular filtration rate. Kidney biopsy is rarely performed in patients with CRMS; histopathology findings include glomerulopathy, podocytopathy, mesangial expansion and proliferation, glomerular basement thickening, global and segmental sclerosis, interstitial fibrosis and tubular atrophy, and arterial sclerosis and hyalinosis. We report a case of CRMS with slow progression during 10 years of follow-up on chronic kidney disease (CKD). The middle-aged patient had central obesity, hypertension, dyslipidemia, cardiovascular disease, type 2 diabetes mellitus, proteinuria, and CKD stage G3b-G4. Kidney biopsy, performed 3 years after the first presentation, led to the diagnosis of chronic thrombotic microangiopathy (TMA) and complement-associated glomerulopathy. This was not compatible with the medical history and the course of the disease, and previous kidney biopsy review showed metabolic nephropathy with glomerulomegaly, global and segmental glomerulosclerosis, tubular atrophy and interstitial fibrosis, arteriosclerosis, and lipid embolus in the lumen of one artery, and found neither TMA features nor C3 deposition. The reported case demonstrates the importance of an accurate and thoughtful reading and interpretation of kidney biopsy, and stresses that disregarding medical history may potentially mislead and alter the understanding of the true cause of CKD.

2. Hypertension, a Major Risk Factor Doubles Arthritis Odds in Indonesian Elderly Population

Background: Arthritis is a highly debilitating disease prevalent in the elderly population. Despite its comparable inflammatory pathophysiology, few studies especially in the Indonesian population have explored the links between arthritis and the ever-increasing metabolic syndrome. Objective: This study aims to analyze the relationship between four metabolic syndrome components (obesity, hypertension, dyslipidemia, and diabetes mellitus) and arthritis in the Indonesian elderly population. Methods: Data are gathered from the fifth wave of Indonesian Family Life Survey fielded in 2014–2015. After sampling weight adjustments, 3493 respondents aged 60+ years fulfilled the inclusion and exclusion criteria. Independent variables of interest are analyzed using Pearson chi-square (CI = 95%, p &lt; 0.05) and logistic regression (CI = 95%, p &lt; 0.05). Result: The prevalence of arthritis in the sample population is 12.8%. The number of elderly with central obesity, hypertension, dyslipidemia, and diabetes mellitus is 44.1%, 28.4%, 8.2%, and 7.8% respectively. Multivariate analysis shows that baseline sample characteristics of female gender and low economic status, as well as three metabolic syndrome components obesity, hypertension, and dyslipidemia shows a significant association toward arthritis (p &lt; 0.05). Hypertension poses the highest risk on arthritis out of all the variables analyzed in this study (OR 2.131; 95% CI 1.723 - 2.636). Conclusion: A significant association is found between 3 out of the 4 metabolic syndrome components, namely obesity, hypertension, and dyslipidemia on arthritis. Thus, early and comprehensive treatment of these modifiable metabolic risk factors, especially hypertension, may help to lower arthritis rates in the elderly population in Indonesia.

ASSOCIATION OF NECK CIRCUMFERENCE WITH LIPID PROFILE IN POSTMENOPAUSAL WOMEN ATTENDING TERTIARY CARE HOSPITAL.

Introduction: Metabolic syndrome is believed to increase the risk of cardiovascular disease and postmenopausal women are more prone to develop cardiometabolic risk, most probably due to change in body fat distribution due to deciency of estrogen. Evidence regarding the clinical signicance of neck circumference in cardio-metabolic syndrome is limited. Also there is inconsistency in the results of studies regarding the relationship between neck circumference and lipid prole. Therefore, present study was conducted with an objective to examine association between neck circumference and lipid prole to nd the independent contribution of neck circumference to cardiometabolic risk. Materials and Methods: This was a hospital based cross-sectional, observational study. A total of 129 postmenopausal women, age &gt; 45 years were selected consecutively after applying the inclusion and exclusion criteria. Anthropometric and biochemical parameters taken in our study were height, weight, BMI, neck circumference, waist circumference, fasting blood glucose, lipid prole. Neck circumference &gt;=34cm was considered as abnormal. Metabolic syndrome was dened based on (AHA/NHLBI+IDF) 2009 criteria. Me Result: an neck circumference was found to be 32.52 ± 2.67cm. 40% of total subjects had neck circumference &gt;=34cms. NC was found to be signicantly associated with components of metabolic syndrome (p&lt;0.001). NC was also found to be signicantly associated with cardiometabolic risk factors like low density lipoprotein cholesterol (LDL), triglycerides (TG), total cholesterol (TC) (all p- value &lt; 0.001). NC showed signicant but negative correlation with high density lipoprotein cholesterol (HDL) (p&lt;0.001). NC showed signicant correlation with lipid prol Conclusion: e (TC, TG, LDL, HDL). NC can serve as clinical marker to easily identify individuals, with a higher risk of developing cardiometabolic disorders, such as in postmenopausal women.

MP79-16 ANALYSIS OF THE EFFECT OF TESTOSTERONE REPLACEMENT ON BODY COMPOSITION, PHYSICAL FITNESS AND THE CORRELATION WITH HYPOGONADAL SYMPTOMS IN THE TESTOSTERONE DEFICIENCY

You have accessJournal of UrologyCME1 Apr 2023MP79-16 ANALYSIS OF THE EFFECT OF TESTOSTERONE REPLACEMENT ON BODY COMPOSITION, PHYSICAL FITNESS AND THE CORRELATION WITH HYPOGONADAL SYMPTOMS IN THE TESTOSTERONE DEFICIENCY Tae Yong Park, Dong Su Kim, Jeong Kyun Yeo, and Min Gu Park Tae Yong ParkTae Yong Park More articles by this author , Dong Su KimDong Su Kim More articles by this author , Jeong Kyun YeoJeong Kyun Yeo More articles by this author , and Min Gu ParkMin Gu Park More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003356.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: This study aimed to investigate how testosterone replacement therapy (TRT) change body composition and physical fitness, and which those changes correlate with serum testosterone level and hypogonadal symptoms. METHODS: Seventy patients with testosterone deficiency (TD) were divided into group I (n: 23) and group II (n :47). Only group II was given testosterone enanthate intramuscularly for 6 months. Both groups were investigated following items at the beginning and end of the study: Baseline demographics and serologic test; questionnaires of aging male symptom (AMS) scale and international prostate symptom score (IPSS); BMI, waist circumference, body composition; and physical fitness. Body composition was assessed by bioelectrical impedance analysis. Seven types of basic exercise tests were used to measure physical fitness. RESULTS: No significant difference was observed in baseline measurements between the two groups before treatment. After 6 months, group I showed no significant change in all measurements. Group II showed significant improvement in IPSS and AMS scales. Hematocrit, and prostate specific antigen slightly increased, while total cholesterol significantly decreased after treatment. As to body composition parameters, TRT significantly decreased body fat mass, visceral fat mass and waist circumference. Skeletal muscle mass was significantly increased by TRT although upper body muscle appeared to be more responsive. Most parameters of physical fitness resulted in improvement except for flexibility and endurance. The decrease of waist circumference was significantly correlated with serum testosterone level changes. AMS scale improvement was correlated with the changes of IPSS, cardiorespiratory fitness and agility. CONCLUSIONS: TRT improved hypogonadal and lower urinary tract symptoms. TRT also resulted in overall improvement in metabolic syndrome components, body composition and physical fitness. Testosterone increment and hypogonadal symptom improvement are correlated with waist circumference, cardiorespiratory fitness, and agility, respectively. Combined adjunctive exercise program that improve those parameters, might maximize the effect of TRT. Source of Funding: No conflict of interests © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1147 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tae Yong Park More articles by this author Dong Su Kim More articles by this author Jeong Kyun Yeo More articles by this author Min Gu Park More articles by this author Expand All Advertisement PDF downloadLoading ...

PD26-07 TESTOSTERONE IS ASSOCIATED WITH ABDOMINAL BODY COMPOSITION DERIVED FROM COMPUTED TOMOGRAPHY: A LARGE CROSS SECTIONAL STUDY

You have accessJournal of UrologyCME1 Apr 2023PD26-07 TESTOSTERONE IS ASSOCIATED WITH ABDOMINAL BODY COMPOSITION DERIVED FROM COMPUTED TOMOGRAPHY: A LARGE CROSS SECTIONAL STUDY Ji Hyung Yoon, Chongsuk Chae, Taekmin Kwon, Sungchan Park, Kyung Hyun Moon, Sang Hyeon Cheon, and Seong Cheol Kim Ji Hyung YoonJi Hyung Yoon More articles by this author , Chongsuk ChaeChongsuk Chae More articles by this author , Taekmin KwonTaekmin Kwon More articles by this author , Sungchan ParkSungchan Park More articles by this author , Kyung Hyun MoonKyung Hyun Moon More articles by this author , Sang Hyeon CheonSang Hyeon Cheon More articles by this author , and Seong Cheol KimSeong Cheol Kim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003304.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A close relationship exists among testosterone, metabolic syndrome, and abdominal body composition. However, few studies have evaluated the relationship between testosterone and abdominal body composition after adjusting for metabolic syndrome. We evaluated the association between serum testosterone and abdominal body composition based on abdominopelvic computed tomography measurements after adjusting for individual metabolic syndrome components in a large cohort who voluntarily underwent health examinations. METHODS: We performed a cross-sectional study using subjects who underwent a general health examination with abdominopelvic computed tomography and testosterone measurements at our hospital between March 2014 and June 2019. Body composition was evaluated with abdominopelvic computed tomography. To confirm an association between testosterone and abdominal body composition, we conducted linear regression analysis. The effect of abdominal body composition was adjusted for important clinical factors such as age, albumin, and metabolic components in the multivariable regression analysis. RESULTS: Overall, 1,453 subjects were included in the primary analysis. The mean age of the study participants was 55.2±8.4 years, and the mean serum testosterone level was 4.36±1.73 ng/ml. In the univariable linear regression analyses, the loge-transformed testosterone had a negative correlation with hemoglobin A1c (unstandardized β=-0.060, p<0.001) and C-reactive protein ≥2.0 mg/dL (unstandardized β=-0.381, p<0.001). All metabolic syndrome components had a negative correlation with the loge-transformed testosterone. Regarding abdominal body composition, subcutaneous fat area index (unstandardized β=-0.048, p<0.001), visceral fat area index (unstandardized β=-0.026, p<0.001), total abdominal muscle area index (unstandardized β=0.110, p<0.001), and normal attenuation muscle area index (unstandardized β=0.076, p<0.001) had an association with the loge-transformed testosterone. After adjustment for age, individual metabolic syndrome components, albumin, hemoglobin A1c, and C-reactive protein ≥2 mg/dL, we found that subcutaneous fat area index (unstandardized β=-0.042, p<0.001), total abdominal muscle area index (unstandardized β=0.115, p<0.001), normal attenuation muscle area index (unstandardized β=0.070, p<0.001), and loge-transformed lower attenuation muscle area index (unstandardized β=0.140, p=0.002) had an association with loge-transformed testosterone level. CONCLUSIONS: After adjusting for individual metabolic syndrome components, testosterone was significantly associated with subcutaneous fat, but not visceral fat. In addition, testosterone was positively correlated with abdominal muscle regardless of qualitative features such as fat-rich and fat-free. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e737 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ji Hyung Yoon More articles by this author Chongsuk Chae More articles by this author Taekmin Kwon More articles by this author Sungchan Park More articles by this author Kyung Hyun Moon More articles by this author Sang Hyeon Cheon More articles by this author Seong Cheol Kim More articles by this author Expand All Advertisement PDF downloadLoading ...

Association of subclinical hypothyroidism with metabolic syndrome components in a group of apparently healthy Syrians: a retrospective cross-sectional study.

A retrospective, cross-sectional study was performed at Al-Assad University Hospital. Participants were healthy individuals aged 18 years and older. Data about their biochemical tests, weight, height, BMI, and blood pressure were collected and analyzed. Participants were categorized according to their thyroid tests into euthyroid, subclinical hypothyroid, subclinical hyperthyroid, and according to their BMI into normal, overweight, and obese, and according to the International Diabetes Foundation into normal and having MetS. A total of 1111 participants were involved in this study. Subclinical hypothyroidism and subclinical hyperthyroidism were found in 4.4 and 1.2% of participants, respectively. The incidence of subclinical hypothyroidism was significantly increased in females and in the presence of positive antithyroid peroxidase. Subclinical hypothyroidism was significantly associated with MetS, a higher waist circumference, central obesity, and triglycerides; however, there was no correlation with high-density lipoprotein. The prevalence of thyroid disorders among Syrians was consistent with the results of other studies. These disorders were significantly more common in females compared to males. Add to that, subclinical hypothyroidism was significantly associated with MetS. Since MetS is a known factor for morbidity and mortality, this may raise the attention needed to perform future prospective trials to evaluate the possible benefits of subclinical hypothyroidism treatment with a low dose of thyroxin.

Renal affection among type 2 diabetic patients and their families

Background and Aim It was believed that both environmental and genetic factors are involved in the pathogenesis of tyrje 2 diabetes mellitus (T2DM). We aimed to figure out the renal affection in patients with T2DM and their family relatives. Patients and methods The current study included 80 patients with T2DM without history of kidney diseases and 80 family members of the diabetic patients neither known to be diabetic nor had kidney diseases compared with 80 apparently healthy persons as a normal control group without a family history of diabetes. Results The prevalence of microvascular complications in diabetic patients and their relatives was as follows: nephropathy (27.5 and 5%, respectively), neuropathy (30 and 8.75%, respectively), and retinopathy (18.83 and 6.2%, respectively). Overall, 22.5% of the relatives had metabolic srtndrome. Microvascular complications of diabetes were associated with longer disease duration, elevated blood pressure, and poor glycemic control, whereas microvascular complications in relatives were associated with one or more of t.he metabolic components of metabolic syndrome. Conclusion screening of diabetic patients for microvascular complications is mandatory as early as possible.The detection of the metabolic components in T2 diabetic relatives can predict the prediabetic state and also can predict the possible occurrence of microvascular complications before happening, and early management can delay them.

Heart failure in patients with metabolic syndrome X.

Metabolic syndrome X has been known to be a risk factor for the development of cardiovascular dysfunction. Insulin resistance, diabetes mellitus and serum lipid abnormalities, which are all seen in metabolic syndrome X, have been found to negatively impact heart function, leading to heart failure in particular. Heart failure is a condition resulting when the heart is unable to perform its function of providing sufficient blood flow to meet the body's requirements. The treatment of heart failure in metabolic syndrome X varies based on the various components of metabolic syndrome X, which include obesity, hyperglycemia, hypertension and dyslipidemia. Obesity is regarded as one of the derangements seen in patients with metabolic syndrome X. It is a significant risk factor in the development of cardiovascular disease, which may eventually lead to heart failure. However, the obesity paradox suggests that obesity provides a higher chance of survival in patients with metabolic syndrome and heart failure. This review article focuses on the pathophysiology of heart failure in patients who already have metabolic syndrome X, as well as the therapeutic management complexity of the two conditions taking into consideration the protective role provided by obesity.

Metabolic disturbances in children with narcolepsy: a retrospective study.

To determine the prevalence of metabolic syndrome (MS) in children with narcolepsy and to evaluate their clinical and sleep characteristics according to the different components of MS. This retrospective study consisted of 58 de novo children with narcolepsy (median age: 12.7 years, 48.3% of boys). The recently published MS criteria in a French population of children were used. Clinical and sleep characteristics were compared between groups with different components of MS. MS was present in 17.2% of children with narcolepsy, among whom 79.3% presented with high homeostasis model assessment for insulin resistance (HOMA-IR), 25.9% with high body mass index, 24.1% with low high-density lipoprotein cholesterol (HDL-C), and 12.1% with high triglycerides. Patients with at least two MS components had more night eating behaviors and tended to have lower percentage of slow-wave sleep and more fragmented sleep. On multiple sleep latency test, they had shorter mean sleep latencies to rapid eye movement (REM), non-REM sleep and tended to have more sleep onset REM periods (SOREMPs) than those with less than two MS components. Insulin resistance was found to be the core metabolic disturbance in obese as well as in nonobese children with narcolepsy. Children with narcolepsy with at least two MS components presented a more severe daytime sleepiness and a higher prevalence of night-eating behaviors than those with less than two MS components. Such children might benefit from early evaluation and management in order to prevent future complications.

Metabolically healthy and unhealthy obesity and the development of lung dysfunction

We investigated the association of metabolically healthy (MH) and unhealthy (MU) obesity with incident lung dysfunction. This cohort study included 253,698 Korean lung disease-free adults (mean age, 37.4 years) at baseline. Spirometry-defined lung dysfunction was classified as a restrictive pattern (RP) or obstructive pattern (OP). We defined obesity as BMI ≥ 25 kg/m2 and MH as the absence of any metabolic syndrome components with a homeostasis model assessment of insulin resistance < 2.5: otherwise, participants were considered MU. During a median follow-up of 4.9 years, 10,775 RP cases and 7140 OP cases develped. Both MH and MU obesity showed a positive association with incident RP, with a stronger association in the MU than in the MH group (Pinteraction = 0.001). Multivariable-adjusted hazard ratios (95% CI) for incident RP comparing obesity to the normal-weight category was 1.15 (1.05–1.25) among the MH group and 1.38 (1.30–1.47) among MU group. Conversely, obesity was inversely associated with OP because of a greater decline in forced vital capacity than forced expiratory volume in 1 s. Both MH and MU obesity were positively associated with RP. However, the associations between obesity, metabolic health, and lung functions might vary depending on the type of lung disease.

The combination of the enhanced liver fibrosis and FIB-4 scores to determine significant fibrosis in patients with nonalcoholic fatty liver disease.

The presence of fibrosis in NAFLD is the most significant risk factor for adverse outcomes. We determined the cutoff scores of two non-invasive te sts (NITs) to rule in and rule out significant fibrosis among NAFLD patients. Clinical data and liver biopsies were used for NAFLD patients included in this analysis (2001-2020). The enhanced liver fibrosis (ELF) and FIB-4 NITs were calculated. Liver biopsies were read by a single hematopathologist and scored by the NASH CRN criteria. Significant fibrosis was defined as stage F2-F4. There were 463 NAFLD patients included: 48 ± 13 years old, 31% male, 35% type 2 diabetes; 39% had significant fibrosis; mean ELF score was 9.0 ± 1.2, mean FIB-4 score was 1.22 ± 1.05. Patients with significant fibrosis were older, more commonly male, had lower BMI but more components of metabolic syndrome, higher ELF and FIB-4 (p < 0.0001). The performance of the two NITs in identifying significant fibrosis was: AUC (95% CI)=0.78 (0.74-0.82) for ELF, 0.79 (0.75-0.83) for FIB-4. The combination of ELF score ≥9.8 and FIB-4 ≥ 1.96 returned a positive predictive value of 95% which can reliably rule in significant fibrosis (sensitivity 22%, specificity >99%), while an ELF score ≤7.7 or FIB-4 ≤ 0.30 had a negative predictive value of 95% ruling out significant fibrosis (sensitivity 98%, specificity 22%). The combination of ELF and FIB-4 may provide practitioners with easily obtained information to risk stratify patients with NAFLD who could be referred to specialists or for enrollment in clinical trials.

Altered Risk of Incident Gout According to Changes in Metabolic Syndrome Status: A Nationwide, Population-Based Cohort Study of 1.29 Million Young Men.

Few data are available on whether changes in metabolic syndrome affect incident gout. This study was undertaken to assess associations between metabolic syndrome status and incident gout, as well as changes in the clinical characteristics of metabolic syndrome and incident gout, in a cohort of young men. This nationwide, population-based cohort study included 20-39-year-old men who participated in serial health check-ups. The outcome, incident gout, was defined according to the claims database diagnostic code for gout. Associations among changes in metabolic syndrome status and incident gout were analyzed using Cox proportional hazards models. Among 1,293,166 individuals, 18,473 were diagnosed as having gout (incidence rate 3.36 per 1,000 person-years). Subjects who had chronic metabolic syndrome (defined as metabolic syndrome at all 3 health check-ups) had a nearly 4-fold higher risk of incident gout compared to subjects who did not have metabolic syndrome at any of the 3 health check-ups (adjusted hazard ratio [HRadj ] 3.82 [95% confidence interval (95% CI) 3.67-3.98]). Development of metabolic syndrome more than doubled the risk of incident gout (HRadj 2.31 [95% CI 2.20-2.43]). Conversely, recovery from metabolic syndrome reduced the risk of incident gout by nearly half (HRadj 0.52 [95% CI 0.49-0.56]). Among metabolic syndrome components, changes in elevated triglycerides (development of elevated triglycerides, HRadj 1.74 [95% CI 1.66-1.81]; recovery from elevated triglycerides, HRadj 0.56 [95% CI 0.54-0.59]) and abdominal obesity (development of abdominal obesity, HRadj 1.94 [95% CI 1.85-2.03]; recovery from abdominal obesity, HRadj 0.69 [95% CI 0.64-0.74]) showed the greatest association with altered risk of incident gout. Associations between changes in the status and clinical characteristics of metabolic syndrome and incident gout were more pronounced in subjects ages 20-29 years compared to those ages 30-39 years, and in subjects who were underweight or who had a normal weight. Changes in the status and clinical characteristics of metabolic syndrome were associated with altered risk of incident gout. These results suggest that metabolic syndrome is a modifiable risk factor for gout.

Associations between individual depressive symptoms and immunometabolic characteristics in major depression

Inflammation and metabolic dysregulations are likely to underlie atypical, energy-related depressive symptoms such as appetite and sleep alterations. Indeed, increased appetite was previously identified as a core symptom of an immunometabolic subtype of depression. The aim of this study was 1) to replicate the associations between individual depressive symptoms and immunometabolic markers, 2) to extend previous findings with additional markers, and 3) to evaluate the relative contribution of these markers to depressive symptoms. We analyzed data from 266 persons with major depressive disorder (MDD) in the last 12 months from the German Health Interview and Examination Survey for Adults and its mental health module. Diagnosis of MDD and individual depressive symptoms were determined by the Composite International Diagnostic Interview. Associations were analyzed using multivariable regression models, adjusting for depression severity, sociodemographic/behavioral variables, and medication use. Increased appetite was associated with higher body mass index (BMI), waist circumference (WC), insulin, and lower high-density lipoprotein. In contrast, decreased appetite was associated with lower BMI, WC, and fewer metabolic syndrome (MetS) components. Insomnia was associated with higher BMI, WC, number of MetS components, triglycerides, insulin, and lower albumin, while hypersomnia was associated with higher insulin. Suicidal ideation was associated with higher number of MetS components, glucose, and insulin. None of the symptoms were associated with C-reactive protein after adjustment. Appetite alterations and insomnia were most important symptoms associated with metabolic markers. Longitudinal studies should investigate whether the candidate symptoms identified here are predicted by or predict the development of metabolic pathology in MDD.

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

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

Association of acanthosis nigricans with metabolic syndrome – An analytic cross-sectional study

BackgroundGlobally, few studies have been undertaken to assess the association of acanthosis nigricans (AN) with metabolic syndrome (MS). Most of the available studies have either focused on a particular age group, gender, ethnicity or on a single component of MS. ObjectivesTo determine the association between AN and MS as a whole and with all individual components of MS in adult patients of either gender. Material and methodsThis was a cross-sectional study with a comparative group. Eighty-one subjects were recruited in each group. Fasting plasma glucose (FPG) and lipid profile were done. MS was defined by using the international diabetic federation (IDF) criteria. Association of body mass index (BMI), waist circumference, blood pressure, FPG, high-density lipoprotein (HDL) and triglycerides (TG) with AN was assessed by Pearson’s chi-square test followed by univariate and multivariate analysis. ResultsThe prevalence of MS was found to be significantly higher in the group with AN. On univariate analysis, a significant association of AN was found with BMI, waist circumference, high systolic and diastolic blood pressure, HDL, and TG. Multivariate analysis revealed a significant association between waist circumference, high systolic and diastolic blood pressure, and high TG levels with AN. The risk of MS was found to be eight times higher in cases of AN. Study limitationsThe small sample size and single-center data are the limitations of the present study. ConclusionAN is strongly associated with MS as a whole and with its individual components including increased waist circumference, hypertension, and dyslipidemia.

A review of research on the intersection between breast cancer and cardiovascular research in the Women's Health Initiative (WHI).

Both obesity and metabolic syndrome are linked to increased incidence of type 2 diabetes, cardiovascular disease (CVD), and cancers of the breast (post-menopausal), and other obesity-related cancers. Over the past 50 years, the worldwide prevalence of obesity and metabolic syndrome has increased, with a concomitant higher incidence of associated co-morbidities and mortality. The precise mechanism linking metabolic syndrome to increased cancer incidence is incompletely understood, however, individual components of metabolic syndrome have been linked to increased breast cancer incidence and worse survival. There is a bidirectional relationship between the risk of CVD and cancer due to a high burden of shared risk factors and higher rates of CVD among cancer survivors, which may be impacted by the pro-inflammatory microenvironment associated with metabolic syndrome and cancer-directed therapies. The Women's Health Initiative (WHI) is an excellent resource to study a dual relationship between cancer and CVD (cardio-oncology) with extensive information on risk factors and long-term outcomes. The purpose of this review is to provide an overview of research on cardio-oncology conducted utilizing WHI data with focus on studies evaluating both breast cancer and CVD including shared risk factors and outcomes after cancer. The review also includes results on other obesity related cancers which were included in the analyses of breast cancer, articles looking at cancer after heart disease (reverse cardio-oncology) and the role of Clonal Hematopoiesis of Indeterminate Potential (CHIP) as a shared risk factor between CVD and cancer. A summary of pertinent WHI literature helps to delineate the direction of future research evaluating the relationship between CVD and other cancer sites, and provides information on the opportunity for other novel analyses within the WHI.

Effect of propolis on mood, quality of life, and metabolic profiles in subjects with metabolic syndrome: a randomized clinical trial

Metabolic syndrome (MeS) is a common multifaceted disorder. Plants contain antioxidant bioactive compounds, which are beneficial to improve the health condition of patients with MeS. Propolis is a hive natural product that is composed of various constituent. We aimed to assess the effects of Iranian propolis as a natural and safe agent on indicators of MeS, quality of life and mood status in individuals with MeS. In total, 66 interested eligible patients recruited to the present study. Participants were randomly assigned to consume a tablet at dose of 250 mg of propolis extract, twice daily for 12 weeks or placebo. Propolis supplementation could lead to a significant reduction in waist circumference (WC), increase in physical functioning, general health and the overall score of SF-36 compared with placebo group (P-value < 0.05). However, no significant differences were observed regarding other anthropometric indices and biochemical parameters between two groups (P-value > 0.05). The current study indicated that propolis can be effective in decreasing WC and improving physical health and quality of life, while had no significant effects on other components of MeS among subjects with this syndrome. Clinical trials registration Iran Registry of Clinical Trials.ir IRCT20121216011763N49, registration date 23/12/2020.