Components Of Syndrome Research Articles

Does Smoking and Alcohol Abuse Precipitate and Aggravate the Risk of Metabolic Syndrome?

Does Smoking and Alcohol Abuse Precipitate and Aggravate the Risk of Metabolic Syndrome?

Spectrum of CT and MR findings in Sturge-Weber syndrome: A case report

Sturge-Weber syndrome is an uncommon, sporadically occurring neurocutaneous syndrome characterized by port wine stain (facial nevus flammeus), congenital glaucoma, and anomalous leptomeningeal angiomatous malformation. Port wine stain is usually the first component of the syndrome. Seizures of the side contralateral to the port wine stain occur early in infancy and worsen with age. Radiological investigations, like computed tomography and magnetic resonance imaging are most useful, playing a pivotal role in demonstrating the cerebral changes. We report the case of a 10-month-old infant presenting with port wine stain over face, trunk, and extremities, hemiparesis of the left side of the body, and new onset of seizure. This case highlights the various neurological manifestations of Sturge-Weber syndrome and how imaging helps to characterize each.

ASSOCIATION BETWEEN HEART RATE VARIABILITY AND COMPONENTS OF THE METABOLIC SYNDROME IN WOMEN WITH RHEUMATOID ARTHRITIS

Aim. To study the relationship between heart rate variability (HRV) and components of the metabolic syndrome (MS) in women with rheumatoid arthritis (RA). Material and methods. Female patients (n=291) with a firm RA diagnosis under 60 years of age were examined. Evaluation of traditional cardiovascular risk factors, MS components (International Diabetes Federation criteria), 24-hour ECG monitoring were performed along with the assessment of clinical symptoms, the degree of activity and severity of RA. Results. Weak associations of HRV with waist circumference, blood pressure level, hypertriglyceridemia, hypoalphalipoproteinemia and smoking were found in the correlation analysis. Patients with RA were divided into three groups depending on the number of existing MS components. Group 1 (0-1 component) included 113 women (39%), group 2 (2-3 components) – 109 women (37%) and group 3 (4-5 components) – included 69 women with RA (24%). Progressive decrease in the absolute values and the increase in the percentage of the low values of all the studied time and frequency HRV indices, adjusted by age and heart rate, from the 1st to the 3rd group of women with RA were determined. Significant increase in sympathovagal index from the 1st to the 3rd group was also shown. Conclusion. A combination of several components of the MS in RA plays a greater role in the development of disorders of neurovegetative autonomic control of heart activity (increased influence of the sympathetic and/or reduced influence of the parasympathetic nervous system on cardiac function) than each traditional cardiovascular risk factor taken separately. Abnormality in autonomic regulation of cardiac activity may be an important link in the pathogenesis of cardiac arrhythmias, sudden cardiac death and overall cardiovascular mortality in women with RA.

Heterotaxy syndrome: an autopsy case report and review of the literature

Heterotaxy, also referred to as atrial isomerism or situs ambiguous, is a rare group of heterogeneous developmental disorders of lateralization, characterized by disruption of the normal left-right axis orientation of visceral organs, including the heart, lungs, stomach, spleen, and liver. Lateralization disorders are divided into incomplete (i.e., heterotaxy), and complete (i.e., situs inversus totalis). Heterotaxy is defined by abnormal assembly of the thoracic and abdominal organs from the normal situs solitus, occurring during early embryonic development. Complex cardiac malformations are a major component of heterotaxy syndrome, with consequent significant morbidity and mortality. Atrial appendage isomerism, with either bilateral right atria (right atrial isomerism) or paired left atria (left atrial isomerism) are a pivotal feature, as well as either asplenia or polyspenia. These two features are the cornerstones of the morphologic classification of these disorders. This case study reports autopsy findings in a 39 week old neonate with heterotaxy syndrome, born to a 25 year old G2 P1 mother with no family history of anomalies, with a review of the literature.

Dietary Intake Association with IFG and Responses of a Lifestyle Changing Protocol in a Community-B based Adult Cohort

Objective: Investigate the association of diet on Impaired Fasting Glucose (IFG) and response of a lifestyle changing protocol (LISC) on a community sample of adults. Methods: A cross sectional study of LISC was conducted with 1004 subjects. From those, 264 adults individuals participated in a 20-week intervention based on physical exercises and dietary counseling and were divided in three groups, normoglycemic, IFG, and T2DM. Evaluations were done at baseline (M0) and after a 20-week intervention (M1). The analyses were performed by using SAS, version 9.2., and results were discussed based on the level of significance of p<0.05. Results: At baseline, the three groups differed for plasma triglycerides, and number of altered metabolic syndrome (MetS) components. T2DM differed from normoglicemic by presenting higher intake of meat, lower of sugar, and less dietary variety, along with higher plasma levels of uric acid. After 20-week intervention, normoglicemics, IFG and T2DM responded similarly to LISC. Both genders increased body fatness. Men increased fasting plasma insulin, saturated fatty acid intake, along with a decrease of vegetable oil intake while women showed a significant increase in HEI and dietary fiber intake and a trend to higher sugar and protein intake and lower vegetable oil intake. Overall T2DM decreased 68% from M0 (9.5%) to M1 (6.4%) of LISC. Conclusion: Our data showed a significant difference in food composition on altered plasma glucose, and its further normalization with lifestyle intervention was independent of significant body weight and body fat changes.

Plasma levels of glucose and insulin in patients with brain tumors.

In the last years there were many authors that suggest the existence of an association between different components of metabolic syndrome and various cancers. Two important components of metabolic syndrome are hyperglycemia and hyperinsulinemia. Both of them had already been linked with the increased risk of pancreatic, breast, endometrial or prostate cancer. However the correlation of the level of the glucose and insulin with various types and grades of brain tumors remains unclear. In this article we have analysed the values of plasma glucose and insulin in 267 patients, consecutively diagnosed with various types of brain tumors. Our results showed no correlation between the glycemia and brain tumor types or grades. High plasma levels of insulin were found in brain metastasis and astrocytomas while the other types of brain tumors (meningiomas and glioblastomas) had lower levels of the peptide. The levels of insulin were also higher in brain metastasis and grade 3 brain tumors when compared with grade 1, grade 2 and grade 4 brain tumors.

On the surgical treatment of the metabolic syndrome

We present he results of surgical treatment of 136 patients with metabolic syndrome at long-term period of evaluation (up to 15 years). All patients had jejunoileal bypass surgery in modification prof. Y.I. Sedletsky. We show the effect of surgery on overweight, hypertension, dyslipidemia, and hyperglycemia. We've traced above changes depending on the period elapsed since the time of the operation. The results prove the efficiency and stability of effects of jejunoileal bypass surgery on components of the metabolic syndrome. Evaluation of the complications rate of this method is also presented in the article.

Clinical Correlation of Metabolic Syndrome in Indian Type-2 Diabetics Patients with Their Socioeconomic Status under Different Age Group

The metabolic syndrome is a complex condition in which numerous aspects of normal metabolism are perturbed. The syndrome represents a cluster of the major risk factors for cardiovascular disease i.e. obesity, insulin resistance / hyperinsulinemia, impaired glucose tolerance / diabetes, dyslipidemia and hypertension. The syndrome is also described by a procoagulant state that is attributed, in part, to an elevation in circulating lipoprotein, fibrinogen and plasminogen activator inhibitor one levels. This in turn contributes to the metabolic abnormalities that lead to cardiovascular disease. Several hypothesis have been proposed for the etiology of the metabolic syndrome, and the potential role of insulin resistance, leptin resistance, and other disturbances as major contributing factors. Hyperinsulinemia and insulin resistance are predictors of type 2 diabetes and are key factors in the development of the metabolic syndrome. A survey was conducted to study the clinical correlation of metabolic syndrome in Indian type -2 diabetic patients with their socioeconomic status (high income group, middle income group & low income group) under different age group (upper age group, middle age group & low income group) in western Uttar Pradesh, India. Four hundred five type 2 diabetic patients aged 52 ±17 year including 215 (53.09%) males and 190 ( 46.91%) females were surveyed for this purpose. Of these hypertension & diabetics were simultaneously diagnosed in 196 (48.39%) & 152 (37.53%) patients. Family history of these patients showed the occurrence of diabetes , hypertension & concurrent hypertension with diabetes mellitus in about 59 (14.0%), 56 (13.8%) & 77 (19.1%) respectively. The frequencies of individual component of the metabolic syndrome were as follows: dyslipidemia - 68.4%, systemic hypertension - 54.3% , obesity - 42.5% microalbuminuria - 44.9% & hyperuracemia 58.3% . Ischemic heart disease (myocardial infarction) occurs in - 2.4%. Of these 405 diabetic studies, 278(68.2%) had metabolic syndrome victims occurs in the high income group & the low income group.

Impact of metabolic syndrome on fractional flow reserve

Objective Fractional fl ow reserve (FFR) assessment is widely used to determine signifi cance of intermediate coronary lesions. Previously, components of the metabolic syndrome (MS) which may aff ect FFR validity were not tested cumulatively. In this study, we investigate the possible eff ect of MS on FFR assessment.Methods and results We retrospectively evaluated 178 consecutive patients who had undergone FFR assessment. Thirty-two patients were excluded. All of the coronary lesions were in the left anterior descending artery. They were evaluated with quantitative coronary angiography (QCA). In 105 patients the MS was present and 41 patients were without the MS. According to the severity of the coronary lesions in QCA, patients were divided into three groups: 40-50%, 51-60% and 61-70% lesions. FFR measurements were compared in each group with respect to MS presence. Coronary artery lesions were accepted as haemodynamically signifi cant if FFR ≤ 0.80. Age of the population, lesion length, lesion diameter and adenosine dosage performed during FFR assessment were not diff erent between patients with MS or without MS. When the lesions were divided into three categories according to the severity of the luminal narrowing expressed in stenosis percentages as 40-50, 51-60, and more than 61%, the observed FFR values decreased with advancing lesion category (P = 0.04). However, observed FFR values did not diff er between the patients with MS and without MS in each category (P = 0.88). After exclusion of the diabetic patients, FFR values still did not diff er between the patients with MS and without MS in each category (P = 0.78).Conclusions Presence of the metabolic syndrome has no signifi cant eff ect on FFR assessment. This study provides additional data for the reliability of FFR in patients with MS.

Does metabolic syndrome or its components differ in naturally and surgically menopausal women?

Objectives This study aimed to compare metabolic syndrome and its components in naturally and surgically menopausal women.Methods This is a longitudinal study, with incident case and control groups, conducted on 446 women participants of the Tehran Lipid and Glucose Study, who experienced surgical or natural menopause over a 10-year period. In both groups, data collection was conducted using questionnaires including information on demographic, reproductive and metabolic characteristics at baseline and again after 3 years. Physical examinations and the biochemical profiles were also assessed.Results During the follow-up, metabolic syndrome was observed in 28.7% and 32.5% of the naturally menopause and surgically menopausal women, respectively. Mean fasting blood sugar and 2-h plasma glucose were significantly higher in the surgically menopause group, compared to the naturally menopause one, whereas mean systolic blood pressure was significantly higher in naturally menopausal women as compared to surgically menopause ones, after further adjustment for premenopausal status.Conclusions Although no difference in the prevalence of metabolic syndrome in naturally menopausal women and in surgically menopausal women was found, the components of metabolic syndrome were more prevalent among those with surgical menopause.

The Development and Implementation of an Electronic Health Record Tool for Monitoring Metabolic Syndrome Indices in Patients with Serious Mental Illness.

Objectives1. A quality performance improvement (QI) project to implement an electronic screening and monitoring tool to record components of the metabolic syndrome (e-MSD) during clinic visits by persons with serious mental illness (SMI). 2. To encourage psychiatrists to use this tool in their documentation.MethodsWorking with the information technology staff; five psychiatrists developed, tested, revised and embedded the e-MSD tool into the medication management document within the electronic health record. A continuing medical education program on metabolic syndrome was developed, and released to psychiatrists and mental health clinicians. Psychiatrist offices at one clinic were equipped with weighing scales, sphygmomanometers, waist circumference tapes and a QI project was initiated.ResultsAt one month, 9 to 12% of the anthropometric measures (height, weight, body mass index, waist circumference, and blood pressure) were recorded in 974 unique patient encounters, and 1 year later the numbers moved upwards - 15 to 41%. Towards the end of Year 1, a patient care associate was hired to measure the anthropometric measures, and one year later, the documented rates increased to 75-80%. Laboratory recordings (glucose and lipids) remained ≤ 8% throughout the first year, but moved upwards to 25% in Year 2.DiscussionNotwithstanding significant administrative and technical support for this QI project, changing clinician practice to screen, monitor and document metabolic indices in persons with SMI in the ambulatory setting changed significantly after the hiring of a patient care associate. Efforts to obtain laboratory measures in real-time remain a challenge. Next steps include interventions to promote weight loss and smoking cessation in SMI patients, and effective communication with their primary care doctors.

Perioperative Care of a Pediatric Patient With PHACES Syndrome

PHACE syndrome is a neurocutaneous syndrome that was originally described by Dr. Ilonia Frieden in 1996. The term PHACE is an acronym for the main components of the syndrome including: P osterior fossa malformations of the central nervous system (CNS); H emangioma typically involving the skin of the head or neck; A rterial lesions usually involving the cerebral vasculature; C ardiac abnormalities, most commonly aortic coarctation; and Eye abnormalities. When accompanied by ventral developmental defects, it is termed PHACES syndrome, with the “S” representing sternal cleft or supraumbilical raphe. Patients may present for a variety of surgical procedures including the airway, CNS or the heart. Airway compromise secondary to hemangiomas and the potential for alterations in cerebral blood flow due to abnormalities of the cerebral arterial vasculature present major challenges for the anesthetic management of these patients. The perioperative implications of PHACES syndrome are discussed and previous reports of anesthetic care are reviewed. J Med Cases • 2013;4(12):811-815 doi: http://dx.doi.org/10.4021/jmc1374w

Author reply to: serum ischaemic-modified albumin levels might not be a marker of oxidative stress in patients with hypothyroidism

To the Editor, We have read the critics of Reddy et al. [1] with a great interest. We are grateful for the inspiring comments on our manuscript reported in the April 2013 issue of the Endocrine [2]. The patients in our study were divided into three groups: hypothyroid, subclinical hypothyroid and control. No significant difference was determined among these three groups in terms of the parameters hyperlipidemia and metabolic syndrome. Hypothyroidism can give rise to hypercholesterolemia, and this has been shown to be reversible with thyroid hormone replacement [3]. The data concerning the relation between subclinical hypothyroidism and hyperlipidemia are inconsistent. There are studies reporting no significant difference in plasma lipid levels in patients with subclinical hypothyroidism compared to controls [4, 5]. While in our study low-density lipoprotein (LDL) cholesterol levels were slightly higher in patients with evident hypothyroidism compared to those with subclinical hypothyroidism and the control group, no statistically significant difference was determined. We already have highlighted that as our groups did not differ for lipid levels on contrary to Ma and colleaugues’ study [6] we think that the possible effect that may arise from different lipid levels have been excluded in our study. The relatively low patient numbers in our study may have been involved in this. While a relation is reported between total cholesterol levels and ischaemic-modified albumin (IMA), this was not evaluated in our study since it is not a component of metabolic syndrome. While metabolic syndrome was slightly higher in evidently hypothyroid patients in our study, no statistically significant difference was determined among the three groups in terms of metabolic syndrome. There was no significant difference between the metabolic patient and control groups in terms of IMA levels. The authors pointed the study by Gottlieb and colleagues in which IMA levels were found to be higher than control group among patients with metabolic syndrome; however, in that study also similar to Ma and colleagues’ study [6] body mass index (BMI), waist circumference, blood pressure (systolic and diastolic), glucose levels and lipid levels (total cholesterol, LDL and HDL) were higher among patients with metabolic syndrome [7]. Although they have performed multivariate analysis for BMI and lipids they do not ignore the potential effect of these parameters on IMA levels in the discussion section [7]. It has been reported that hypothyroidism and subclinical hypothyroidism may be associated with an atherosclerotic process and chronic ischaemia [8]. In addition, a rise in metabolic rate as a result of the biological effect of thyroid hormones and a rise in oxygen radicals with calorigenesis has been reported [9]. It has also been reported that metabolic processes decelerating in hypothyroidism and decreasing oxygen radical production may have a protective effect against ischaemia [10]. The authors emphasised that the level of albumin is correlated with IMA levels and the absence of albumin levels of our patients. They are completely right, but our study group had no other diseases, other than thyroid disease; patients with abnormal albumin levels were not included in the study. Testing the binding of albumin to cobalt is a technique that measures IMA levels indirectly, and low albumin levels have been reported to be capable of affecting IMA levels. Gaze et al. reported a negative correlation between serum albumin levels and IMA levels, but I. Anaforoglu (&) K. Ersoy E. Algun Department of Endocrinology and Metabolism, Trabzon Kanuni Education and Research Hospital, 61000 Trabzon, Turkey e-mail: ianaforoglu@hotmail.com

A Review on the Role of Hypertension in the Metabolic Syndrome

The metabolic syndrome significantly elevates the risk of cardiovascular disease and renal damage. Because of the relationships among different components of metabolic syndrome, it is difficult to understand the cause of these diseases. Blood pressure is one of the most factors of cardiovascular risk and disease. Hypertension is in many cases underrated and undiagnosed. It is suggested that there are different mechanisms to play a role in the blood pressure elevation in different subjects. Elevated blood pressure is believed a significant component of metabolic syndrome. Individuals with metabolic syndrome have been shown increased blood pressure or hypertension. It is reported that metabolic syndrome expand hypertension related cardiac and renal damage. The treatment of subjects with the metabolic syndrome is important to decrease the risk of cardiovascular and renal diseases, diabetes and hypertension and organ damage in the future. In present study, it was reviewed with a number of related articles on the role of hypertension (as one of the metabolic syndrome components) in metabolic syndrome. © 2013 Asian Network for Scientific Information.

MODERN APPROACH TO THE ASSESSMENT OF HYPERTENSION AND METABOLIC DISORDERS

According to modern ideas, hypertension is the leading component of the metabolic syndrome (MS) in the Russian Federation. The interaction of genetic and environmental factors is known to create a cascade of cardiometabolic disorders that reduce the patients’ quality of life, increase the risk of cardiovascular complications, morbidity and all-cause mortality. There is a complex of unfavourable factors acting in MS. An active search for other medical risk factors in a hypertensive patient, including subclinical organ damage, followed by adequate treatment of each of the components, should be encouraged.

Plasma IgA antibody levels to malondialdehyde acetaldehyde-adducts are associated with inflammatory mediators, obesity and type 2 diabetes

Aim. Obesity and type 2 diabetes (T2D) associate with increased oxidative stress. Malondialdehyde acetaldehyde (MAA) adducts have been suggested to be one of the antigenic epitopes in MDA-LDL responsible for the antibody recognition. Our aim was to investigate the associations between plasma IgA antibodies to MAA-LDL, inflammatory markers, adipokines, obesity, and T2D.Methods. IgA to MAA-LDL were measured in a subsample (n = 1507) of the Finnish Health 2000 survey. The associations between antibody levels, obesity, TNF-α, IL-6, high-sensitivity (hs) CRP, resistin, adiponectin, fasting plasma (fp) glucose, fp-insulin, glycosylated hemoglobin (Hb-A1C), and T2D were investigated.Results. IgA to MAA-LDL associated positively with fasting plasma insulin. IgA to MAA-LDL were higher among subjects with T2D (P < 0.001) compared to subjects with normal glucose metabolism. IgA to MAA-LDL associated with obesity, but was not independently (P = 0.002, not significant after correction for multiple tests) associated with T2D in logistic regression analysis. IgA to MAA-LDL, obesity, and TNF-α all associated with markers of glucose metabolism.Conclusions. T2D subjects had increased IgA to MAA-LDL compared to subjects with normal glucose metabolism. The data suggest that the associations between IgA to MAA-LDL and markers of glucose metabolism were independent of TNF-α but dependent on components of the metabolic syndrome.

Current research on the relationship between vitamin D deficiency and pediatric metabolic syndrome

Vitamin D(Vit D) belongs to steroids derivative and is also known as anti-rickets vitamin owing to its effect of anti-rickets.Pediatric metabolic syndrome is a group of complex, interrelated accumulation of risk factors that can lead to cardiovascular disease and type 2 diabetes.Recently, more and more reports demonstrate that Vit D deficiency is associated with the risk for pediatric metabolic syndrome, but the association is disputed among the children which is a special group since they are in the period of growth and the metabolic indicators are in the dynamic changes among all ages.Therefore, research on the relationship between Vit D and the components of pediatric metabolic syndrome will provide some theoretical basis for early intervention and treatment by raising the status of serum Vit D in order to reduce the risk for pediatric metabolic syndrome. Key words: Vitamin D deficiency; Metabolic syndrome; Obesity; Dyslipidemia; Hypertension; Glucose metabolism disorders; Child

Associations of Components of Metabolic Syndrome with Pulmonary Function and Functional Capacity

Associations of Components of Metabolic Syndrome with Pulmonary Function and Functional Capacity

TESTOSTERONE AND METABOLIC SYNDROME IN MEN

Testosterone is vital hormone for men’s health and a keyplayer in glucose homeostasis, lipid metabolism, and cardiovascular pathology. Testosterone deficiency is associated with age, many chronic health conditions and other metabolic disorders. There is strong evidence that a low testosterone level has a high prevalence in men with metabolic syndrome. Many components of metabolic syndrome are adversely affected especially in relation to cardiovascular risk in the presence of hypogonadism.Testosterone deficiency is a risk factor in itself for the subsequent development of the metabolic syndrome. The hypothesis suggests that low testosterone as a result of high aromatase activity leads to a cycle which promotes increasing adipocyte number and fat deposition which gradually leads to a lower testosterone level. The hypogonadal-obesity-adipocytokine hypothesis explains why the body cannot respond to low testosterone levels by a compensatory production of the hormone. The interventional studies have shown that testosterone administration on hypogonadal men with metabolic syndrome has beneficial effects. These benefits have not only found that hypogonadal symptoms such as sexual function improve, but key metabolic markers also improve. It must also not be forgotten that testosterone replacement therapy in hypogonadal men with metabolic syndrome can have a major impact on the patient’s quality of life and well-being. Key words: testosterone, metabolic syndrome.

Abstract 169: Stable Nitric Oxide Metabolites Levels and Their Relation to the Metabolic Syndrome Components in Essential Hypertension

Objective: To investigate levels of the stable nitric oxide metabolites (NOx) in relation to components of the metabolic syndrome (MS) in essential hypertension (EH) Methods: We examined 124 untreated patients with EH (mean age 51.4 ± 6.5 years, mean hypertension duration 8,5±7,6 years) and 25 healthy volunteers with comparable age (47.2 ± 7.8 years, p&gt;0,05). Plasma leptin levels were measured by radioimmunoassay, plasma NOx - by spectrophotometry. Results were processed with Statistica 6.0 software. Results: Visceral obesity had 64% of hypertensive patients, dyslipidemia - 80.6%, hyperglycemia - 41,6%, MS - 24%. In 32% the MS diagnosis was based on the presence of two additional criteria, in 68% - on three. NOx levels were significantly higher in hypertensives (43,18±21, μmol/l) than in controls (28.3 ± 9.6 μmol/l) ( p = 0.01). In patients with hyperglycemia NOx concentration was higher (46,5 ± 23,9 μmol/l) than in those without it (38,6±18, μmol/l)(p&lt;0,05). NOx levels correlated with blood glucose levels (r=0,32, p&lt;0,05). NOx concentration did not differ between hypertensives with or without dyslipidemia (43,2±22,2 and 42,05±21,1 μmol/l, accordingly p&gt;0,05). Nonobese hypertensives had lower NOx concentration than obese hypertensives (38,8±17,9 and 48,5±24,7 μmol/l, p&lt;0,05). NOx levels correlated with the presence (r=-0,44, p&lt;0,05) and degree of obesity (r=-0,3, p&lt;0,05). NOx levels were lower in patients with MS (31,6±11,3 and 47,05±20,7 μmol/l, p&lt;0,05). NOx levels decreased with the increase of additional MS criterias: 37,99 ± 12,6 μmol/l in the presence of 2 and 28,3 ± 9,6 μmol/l in the presence of 3 criteria (p&lt;0,05). NOx levels correlated with the amount MS components (r=-0,38, p&lt;0,05). Hypertensives with high leptin levels had lower NOx concentration (29 ± 12,2 μmol/l), compared to hypertensives with normal leptin levels (34,7±10,5 μmol/l) (p&lt;0,05). Conclusion: In essential hypertension NOx metabolism differs in relation to metabolic status. Hypertension per se and hyperglycemia increase NOx levels, whereas MS and its essential signsas visceral obesity and high plasma leptin level decrease NOx levels.