Correction Of Metabolic Syndrome Research Articles

Laparoscopic gastric bypass surgery with a single anastomosis: a comparative analysis of the metabolic and bariatric effects

Objective. To compare the results of the effect of long–loop, distal and mini–gastric bypass surgery with a single anastomosis on the loss of excess body weight, indicators of protein, lipid, carbohydrate metabolism, correction of metabolic syndrome and development of deficiency states after 36 months. Materials and methods. Patients with morbid obesity were divided into 3 groups: Group 1 – 25 patients who underwent long–loop gastric bypass with a biliopancreatic loop length of 200 cm; Group 2 – 25 patients who underwent mini–gastric bypass with a biliopancreatic loop length of 200 cm using laparoscopic access; Group 3 – 25 patients who underwent distal gastric bypass with a total loop length of 250 cm. Results. 36 months after the operation, the loss of excess body weight was (69 ± 1.1)% in group 1, (70.1 ± 1.3)% in group 2 and (72 ± 0.9)% in group 3; remission of dyslipidaemia was observed in 4 (80%) of 5 patients in group 1, 11 (84.6%) of 13 patients in group 2 and 7 (100%) of 7 patients in group 3; remission of type II diabetes mellitus – in 3 (75%) out of 4, 5 (83.3%) out of 6 and 6 (100%) out of 6 patients, respectively, complete remission of arterial hypertension – in 6 (46.2%) out of 13, 7 (50%) out of 14 and 9 (60%) out of 15 patients, respectively. Conclusions. Laparoscopic long–loop gastric bypass with a single anastomosis is effective and safe, does not cause severe deficiency states, and can be used as a primary bariatric surgery.

Nutritional approaches to correction of metabolic syndrome before abdominoplasty

The aim of the study was to highlight modern approaches to the dietary correction of metabolic syndrome in patients who have decided to perform abdominoplasty. Materials and methods. The keywords driven search for scientific references was carried out in the PubMed, Google Scholar and elibrary.ru databases for the period from 2000 to 2020. 38 sources were selected from 159 received links. Results and Discussion. Current approaches to dietary therapy of obese patients who have decided to perform abdominoplasty, taking into account the comorbidity of patients, is provided. Particular attention is drawn to the subjects’ nutritional status periodical reassessment, the identification and comprehensive correction of carbohydrate and lipid metabolism disorders both at the stage of preoperative preparation and throughout subsequent life. The principles of calculating the daily caloric content and the nutrition planning are considered. A personalized interdisciplinary approach to patient management within the wide specialties spectrum (internist, endocrinologist, cardiologist, gastroenterologist, nutritionist, psychotherapist, plastic surgeon) cooperation and the application of digital technologies for remote life-long monitoring and counseling is discussed. Conclusion. A unified algorithm of actions of an interdisciplinary team of specialists, taking into account the personal characteristics and needs of patients, the possibilities of digital technologies, allows to reduce the risk of developing comorbid pathology, improve the results of abdominoplasty, the quality and life expectancy of the patient and ensure the best therapeutic and aesthetic result, as well as prevent relapses of weight gain during long-term follow-up of patients after abdominoplasty.

Drinking mineral water in the correction of metabolic syndrome in patients with cicatricial skin changes

The article analyzes the efficiency of complex physiotherapy in combination with internal intake of medium-mineralized water “Essentuki № 17” in patients with cicatricial skin changes in the presence or absence of metabolic syndrome. It was found that internal mineral water intake supplementing physiotherapy effectively corrected carbohydrate and lipid metabolism disorders by reducing the insulin resistance index, which contributed to a greater regression of clinical manifestations of cicatricial skin changes in patients with metabolic syndrome. Meanwhile, in the absence of metabolic syndrome, the course intake of mineral water did not signifi cantly affect complex physiotherapy, although the index of insulin resistance and body weight of patients significantly decreased. It is suggested that, given the presence of nonspecifi c preventive potential of the course of drinking mineral waters intake, there is some theoretical and possibly practical interest in research on pre-course mineral water intake before performing cosmetic operations to accelerate the process of skin regeneration and the formation of scarring in a less pronounced form.

Possibilities of modern drug correction of metabolic syndrome: the role of bile acids

After the discovery of the method of synthesis of ursodeoxycholic acid (UDCA) and the publication of evidence confirming its ability to reduce the lithogenic properties of bile, active clinical use of UDCA began around the world. This drug, in addition to the proven choleretic, cytoprotective, litholytic, anti-apoptotic effects, has a signaling activity that allows UDCA to influence metabolic syndrome components such as hyperglycemia, hypercholesterolemia.
 Under the influence of UDCA, FXR is activated in the liver, which leads to an increase in the activity of glycogen synthase and decrease in the level of glycaemia. Another mechanism by which UDCA affects glycaemia is mediated by the activation of the TGR5 membrane receptor under the influence of this bile acid, as well as the release of insulin from pancreatic β-cells and decrease in postprandial glycaemia. When taking UDCA, the concentration of glycosylated hemoglobin, insulin in the blood plasma decreases the effects of insulin resistance decrease. UDCA has a beneficial effect on the vascular wall, reducing the severity of atherosclerotic lesions and normalizing the average thickness of the intima-media complex. UDCA improves lipid metabolism by regulating the activity of the AKT/ mTOR-signaling pathway, reduces the synthesis of cholesterol, and decreases the fractional rate of cholesterol synthesis and the fractional rate of triglyceride synthesis. It is proved that UDCA administration is accompanied by a drop in the level of total cholesterol and cholesterol of low-density lipoproteins. Normalization of the metabolism of glucose, triglycerides, cholesterol and the insulin-signaling pathway under the influence of bile acids is the basis for the use of UDCA for the correction of metabolic syndrome, as well as its hepatological manifestations - NAFLD.

Relation between insulin resistance and severity of psoriasis in Egyptian patients

Background Psoriasis is an immune-mediated disease of multifactorial etiology. The prevalence of insulin resistance (IR) in patients with psoriasis has been extensively studied. The prevalence varies based on many factors such as aging, genetics, diet, and sedentary lifestyle. Aim To study the association between psoriasis and IR and detection of the correlation between level of IR and the psoriasis severity. Patients and methods A total of 30 patients with psoriasis and similar number of age-matched and sex-matched controls were enrolled in this study. Patients and controls were subjected to the following measurements: systolic and diastolic blood pressure, BMI, serum triglycerides, cholesterol, low-density lipoprotein, high-density lipoprotein, fasting plasma glucose, serum insulin, and IR. Assessment of psoriasis severity was done using psoriatic area severity index score. Results A statistically significant difference regarding serum insulin, IR, fasting plasma glucose, triglyceride, low-density lipoprotein, systolic blood pressure, diastolic blood pressure, and BMI was found between patients and controls. A positive correlation between psoriasis severity and level of IR was also found. Conclusion and recommendation Patients with psoriasis had strong association with IR. The level of IR correlated with severity of psoriasis. Dermatologists and internists should give more attention toward screening and early recognition of associated metabolic disorders and IR. Correction of metabolic syndrome and IR should be initiated in this group of patients.

Blood fatty acids in the development and correction of metabolic syndrome

to investigate the composition of plasma fatty acids (FA) and red blood cells and the level of eicosanoids in patients with metabolic syndrome (MS) and to assess whether metabolic disturbances may be corrected during a cycle use of an ω-3 polyunsaturated fatty acid (PUFA). Examinations were made in 46 patients, including Group 1 (a control group) of 15 persons without MS components; Group 2 of 31 patients with MS, Group 3 of 16 MS patients who had taken an ω-3 PUFA for 6 months, and Group 4 of 15 MS patients who had received the drug for 12 months. The composition of plasma FA and red blood cells was analyzed on a gas-liquid chromatograph. An enzyme immunoassay was used to measure the serum levels of tumor necrosis factor-α (TNF-α) and eicosanoids (thromboxane B2, 6-keto-prostaglandin F1α, leukotriene B4). A biologically active additive from the king crab (Paralithodes camtschatica) hepatopancreas was used as a source of ω-3 PUFA. Having a higher proportion of linoleic and α-linolenic acids in the plasma, the patients were found to have decreased levels of ω-3 and ω-6 PUFAs (linoleic and α-linolenic, arachidonic, and eicosapentaenoic acids) and a larger proportion of Mead acid and saturated FAs (myristic and stearic acids) in the red blood cells, suggesting that that cellular blood FA transfer was impaired and FAs were absorbed by cells. Their serum samples showed the high levels of leukotriene B4, 6-keto-prostaglandin F1α, and thromboxane A2. The long-term (6- and 12-month) use of ω-3 PUFA from the king crab hepatopancreas had a positive impact in modifying the lipid FA composition of red blood cells and in eliminating deficiencies of physiologically important ω-3 and ω-6 PUFAs in the blood cells. The findings suggest that FAs and their metabolites play an important role in the pathogenesis of MS and that dietary ω-3 PUFA should be incorporated into a package of preventive and therapeutic measures for MS.

Коррекция метаболического синдрома у пациентов с тяжелой хронической обструктивной болезнью легких

Коррекция метаболического синдрома у пациентов с тяжелой хронической обструктивной болезнью легких

Mangiferin stimulates carbohydrate oxidation and protects against metabolic disorders induced by high-fat diets.

Excessive dietary fat intake causes systemic metabolic toxicity, manifested in weight gain, hyperglycemia, and insulin resistance. In addition, carbohydrate utilization as a fuel is substantially inhibited. Correction or reversal of these effects during high-fat diet (HFD) intake is of exceptional interest in light of widespread occurrence of diet-associated metabolic disorders in global human populations. Here we report that mangiferin (MGF), a natural compound (the predominant constituent of Mangifera indica extract from the plant that produces mango), protected against HFD-induced weight gain, increased aerobic mitochondrial capacity and thermogenesis, and improved glucose and insulin profiles. To obtain mechanistic insight into the basis for these effects, we determined that mice exposed to an HFD combined with MGF exhibited a substantial shift in respiratory quotient from fatty acid toward carbohydrate utilization. MGF treatment significantly increased glucose oxidation in muscle of HFD-fed mice without changing fatty acid oxidation. These results indicate that MGF redirects fuel utilization toward carbohydrates. In cultured C2C12 myotubes, MGF increased glucose and pyruvate oxidation and ATP production without affecting fatty acid oxidation, confirming in vivo and ex vivo effects. Furthermore, MGF inhibited anaerobic metabolism of pyruvate to lactate but enhanced pyruvate oxidation. A key target of MGF appears to be pyruvate dehydrogenase, determined to be activated by MGF in a variety of assays. These findings underscore the therapeutic potential of activation of carbohydrate utilization in correction of metabolic syndrome and highlight the potential of MGF to serve as a model compound that can elicit fuel-switching effects.

PS16 - 78. Iminosugars and correction of metabolic syndrome

Iminosugars are carbohydrate analogues currently used as therapeutic agents in the treatment of diabetes mellitus type 2 and Gaucher disease. The lypophilic iminosugar AMP-DMN (adamantine methyloxypentyl-deoxynojirimycin) has been proven to be the most efficient in correcting the hyperglycemia and the metabolic syndrome present in obesity and diabetes type 2 animal models, as compared to other iminosugar compounds.

Correction of metabolic syndrome and liver disease after biliopancreatic diversion in morbidly obese patients

The aim of this study was to analyze the corrections of the metabolic syndrome and the liver dysfunction of morbidly obese patients after the biliapancreatic diversion (BPD). All patients were divided into two groups: first group with average BMI 44,6±3,0 and second group with average BMI 53,0±6,7. After BPD the average % excess weight loss (EWL) in the first group was 72,8% and in the second - 53,2%. The corrections of the metabolic syndrome and the liver dysfunction were also better in the first group. The baseline BMI predicts the outcomes after BPD.

Treatment of Metabolic Syndrome Slows Progression of Diabetic Nephropathy

Metabolic syndrome contributes to the development of albuminuria and to the decrease of glomerular filtration rate (GFR) in type 2 diabetes patients. The aim of this study was to analyze the effect of MS treatment on the progression of diabetic nephropathy (DN). This was a retrospective and comparative cohort study. Baseline and follow-up data related to the presence of metabolic syndrome, microalbuminuria (mA), and GFR were obtained in individuals with type 2 diabetes. Subjects were classified in two groups: (1) With correction of metabolic syndrome and (2) without correction of metabolic syndrome at follow-up. Furthermore, they were stratified in four subgroups: (A) Without metabolic syndrome at baseline and at follow-up, (B) with metabolic syndrome and correction of metabolic syndrome, (C) without metabolic syndrome and development of metabolic syndrome, and (D) with metabolic syndrome and persistence of metabolic syndrome. Final GFR and mA were lower and higher, respectively, in group 2 versus 1 [89.8±3 2.3 vs. 98.3±32.0 mL/min, P=0.010, and 51.0 (13.5-195) vs. 7.9 (4-31) mg/day, P<0.001, respectively]. Lack of metabolic syndrome correction [hazard ratio (HR)=2.8, 95% confidence interval (CI) 1.9-4.2, P<0.001], being in subgroups C (HR=2.05, 95% CI 1.03-4.1, P=0.04) and D (HR=3.3, 95% CI 2.0-5.3, P<0.001), and the presence of two (HR=3.4, 95% CI 1.9-6.1, P<0.001), three (HR=5.0, 95% CI 2.5-9.9, P<0.001), and four (HR=4.2, 95% CI 1.5-12.1, P=0.006) metabolic syndrome components were independent factors associated with development of mA in Cox regression analysis adjusted for age, gender, baseline mA and GFR, glycosylated hemoglobin (HbA1c), hypertension, and obesity. Metabolic syndrome treatment and control are independently associated with a lesser progression of DN.

The Relationship between Metabolic Syndrome and Cognitive Function

BackgroundMetabolic syndrome has been reported to have adverse effects on cognitive function, although the results are conflicting. The purpose of this study was to examine the relationship between metabolic syndrome and cognitive function in elderly Korean participants older than 60 years.MethodsWe examined elderly participants who visited the health promotion center in Gyeonggi-do province. We categorized the participants into two groups based on the presence of metabolic syndrome (48 participants in the metabolic syndrome group and 45 in the control group). Cognitive function was assessed in all participants using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K).ResultsCompared with those without metabolic syndrome, participants with metabolic syndrome had lower mean total CERAD-K scores (64.2 ± 11.1 vs. 69.8 ± 9.2, P = 0.010). In the comparison of CERAD-K items, significantly lower scores were observed in the verbal fluency test, the construction recall test, the word list learning test, and trail making B in the group with metabolic syndrome. After controlling age, sex, education, smoking, alcohol, physical activity and the Korean version of the Short Geriatric Depression Scale of Korean, multiple regression analysis showed that metabolic syndrome was independently associated with cognitive function (P = 0.014). Alcohol intake (P = 0.002) and education years (P = 0.001) were also contributing factors to cognitive function.ConclusionThis study found a significant relationship between cognitive function and metabolic syndrome. It will be necessary to perform a prospective study to determine whether metabolic syndrome causes cognitive dysfunction or if the correction of metabolic syndrome can improve cognitive function.

Effect of Testosterone Replacement Treatment in Testosterone Deficiency Syndrome Patients with Metabolic Syndrome

PurposeThis study was conducted to investigate the effect of testosterone replacement treatment (TRT) in testosterone deficiency syndrome (TDS) patients with metabolic syndrome.Materials and MethodsWe reviewed the data of 200 men who were diagnosed with TDS and were undergoing TRT between August 2006 and August 2009. The 200 patients were divided into two groups (group 1: 71 patients with metabolic syndrome, group 2: 129 patients without metabolic syndrome) depending on metabolic syndrome, which was diagnosed according to the NCEP III criteria for Asians. Age, BMI (body mass index), waist circumference, serologic tests, AMS (the Aging Males' Symptoms scale), and IIEF (International Index of Erectile Function) were measured.ResultsIn group 1, waist circumference and fasting glucose were significantly decreased; hemoglobin and total testosterone were increased; and the somatovegetative scale score of the AMS, the total AMS score, the erectile function score of the IIEF, the overall satisfaction score of the IIEF, and the total IIEF score were significantly improved after TRT. On the other hand, in group 2, waist circumference, BMI, total cholesterol, LDL, and fasting glucose were significantly decreased; hemoglobin and total testosterone were increased; and the 2 subscale scores of the AMS (psychologic and somatovegetative), the total AMS score, all subscale scores of the IIEF, and the total IIEF score were significantly improved after TRT.ConclusionsOverall, the patients who had TDS with metabolic syndrome showed less improvement in AMS, IIEF, and serum variables. Therefore, the correction of metabolic syndrome, such as diabetes, obesity, and hypertension, should be considered during TRT.