Development Of MetS Research Articles

Identification of metabolic syndrome using lipid accumulation product and cardiometabolic index based on NHANES data from 2005 to 2018

BackgroundNumerous studies indicate that visceral adipose tissue (VAT) significantly contribute to metabolic syndrome (MetS) development. This study aims to assess the distinguishing value of novel obesity markers, specifically lipid accumulation products (LAP) and cardiometabolic index (CMI), in relation to MetS. Considering the gender disparity in MetS prevalence, it is essential to explore whether LAP and CMI exhibit differential distinguishing capabilities by gender.MethodThe investigation included a total of 11,687 qualified individuals who participated in the NHANES survey spanning a 14-year period from 2005 to 2018. Biochemical analysis of blood and body measurements were utilized to determine LAP and CMI values for each participant. Inclusion of gender as a variable was a key factor in the examination of all data. Restricted cube plots (RCS) were utilized to analyze the strength of the relationship between LAP, CMI, and MetS. The study delved into potential connections between LAP and CMI with MetS, all-cause and cardiovascular mortality using various statistical models such as multivariate logistic regression and Cox regression.ResultsThe findings revealed a significant nonlinear association between CMI, LAP, and MetS (P-non-linear < 0.001), irrespective of gender, with all models exhibiting a J-shaped trend. The multivariable logistic regression analysis considered both LAP and CMI as continuous variables or tertiles, revealing significant associations with MetS in male, female, and general populations (All the P < 0.001). Although males displayed a higher risk of MetS, no gender differences were observed in the area under the curve (AUC) values of LAP and CMI for distinguishing (P > 0.005) MetS. Impressively, LAP and CMI were identified as the primary predictors of MetS in both genders from AUC (P < 0.005). More specifically, the cutoff points for distinguishing MetS in females were LAP = 49.87 or CMI = 0.56, while for males, they were LAP = 52.76 or CMI = 0.70. Additionally, the Cox regression analysis revealed that LAP and CMI were correlated with all-cause mortality in both general population and females (P < 0.005), but not in males.ConclusionIn comparison to other measures of obesity, LAP and CMI demonstrated superior diagnostic accuracy for MetS in both males and females. Additionally, LAP and CMI were found to be predictive of all-cause mortality in both general population and females. These markers are cost-effective, easily accessible, and widely applicable for the early identification and screening of MetS in clinical settings.

Clinical patterns of metabolic syndrome in young, clinically stable, olanzapine-exposed patients with schizophrenia

BackgroundSchizophrenia (SCZ) is a chronic, disabling mental illness with a high disease burden and is often comorbid with metabolic syndrome (MetS). The aim of this study was to determine the prevalence of MetS in young, clinically stable, olanzapine-exposed patients with SCZ and to explore predictive factors affecting the development and severity of MetS.MethodsA total of 274 patients with SCZ who met the inclusion criteria were enrolled in this study, and their demographic data and general clinical information were collected. Concurrently, patients were assessed for psychopathology, illness severity, and antipsychotic drug–related adverse effects.ResultsThe prevalence of MetS in the target population was 35.77%, and the MetS subtype of abdominal obesity + high triglycerides + low level of high-density lipoprotein cholesterol accounted for the majority of patients in the MetS subgroup. Binary logistic regression showed that body mass index (BMI), uric acid (UA), thyroid-stimulating hormone, and QT-c interval could significantly and positively predict the development of MetS. Multiple linear regression showed that olanzapine concentration, BMI, and UA could significantly and positively predict higher MetS scores.ConclusionThis study reports the clinical patterns of MetS in young, clinically stable, olanzapine-exposed patients with SCZ and identifies the correlations influencing the development and severity of MetS. These findings could potentially be applied toward the prevention of and intervention in MetS.

Exploring the Role of Rho Kinase Enzyme in the Management of Metabolic Syndrome

Rho kinase [ROCK] enzymes are increasingly recognized for their central role in the pathogenesis of metabolic syndrome [MetS], a cluster of conditions that includes insulin resistance, hypertension, obesity, and dyslipidemia. ROCKs are serine/threonine kinases involved in the regulation of various cellular functions, including smooth muscle contraction, actin cytoskeleton organization, and gene expression. These enzymes are critically implicated in the cardiovascular and metabolic abnormalities that characterize MetS. Elevated ROCK activity has been observed in individuals with MetS, contributing to several pathogenic processes such as endothelial dysfunction, vascular inflammation, oxidative stress, and increased vascular smooth muscle contraction. These mechanisms are key drivers of hypertension and atherosclerosis, which are common complications associated with MetS. Moreover, ROCKs influence adipocyte differentiation and lipid metabolism, linking them directly to obesity and insulin resistance, two core components of the syndrome. The inhibition of ROCKs has emerged as a promising therapeutic strategy for managing MetS. Pharmacological ROCK inhibitors have shown the potential to improve insulin sensitivity, lower blood pressure, and reduce vascular inflammation and remodelling. In addition, by targeting the multiple pathways involved in the development and progression of MetS, ROCK inhibitors offer a comprehensive approach to treatment that addresses the syndrome's multifactorial nature. This therapeutic strategy not only mitigates the metabolic and cardiovascular components of the syndrome but also lowers the risk of associated complications, such as cardiovascular disease and stroke. This review concluded that interrupted Rho kinase activity contributes to the development of MetS in all its manifestations. Overall, these side effects diminish the Rho-kinase method's promise as a novel and significant treatment component.

Incidence, risk factors for metabolic syndrome and health systems capacity for its management amongst people living with HIV, Accra-Ghana: A study protocol.

Metabolic syndrome (MetS) refers to the clustering of three or more metabolic disorders including high blood pressure, glucose impairment, abdominal obesity, high triglycerides, and low high-density lipoproteins. MetS is increasingly being considered an epidemic among People Living With HIV (PLWH) with reports of association between HIV infection and/or antiretroviral therapy (ART) usage and development of MetS. MetS predisposes PLWH to the development of cardiovascular, kidney diseases and diabetes, decreases the quality of life, and burdens the health system. This study aims to establish the incidence, time to development and risk factors for development of MetS and it's components, and to assess the capacity of the health system to manage MetS and it's components among ART naive PLWH in Accra, Ghana. We will conduct a mixed methods study with quantitative and qualitative data collection. Our prospective cohort study would enroll adults of 18 years and above with none or less than three MetS components at baseline and follow them up at six months and one year. Demographic, lifestyle data, anthropometric, and laboratory data will be collected using an adapted WHO Steps Survey questionnaire. The WHO Service Availability and Readiness Questionnaire (SARA) will be adapted to collect information on capacity across the six WHO building blocks. Key informant interviews will be conducted with HIV coordinators at the national, regional, and facility levels. In-depth interviews will be conducted with PLWH from the cohort who develop MetS or MetS components during their follow-up. Data will be analysed using proportions, Kaplan Mier time to event analysis, fitting of Cox proportional hazard regression models for risk factors, and generation of themes from qualitative data. This study will generate data on the incidence, time to development, risk factors for MetS and MetS components development, and health systems capacity for MetS management among PLWH. Findings would inform revisions to the guidelines and policies for HIV care in Ghana, Africa, and beyond, ultimately improving MetS prevention and management among the vulnerable population of PLWH.

The Trend of Changes in Adiponectin, Resistin, and Adiponectin-Resistin Index Values in Type 2 Diabetic Patients with the Development of Metabolic Syndrome.

Background and Objectives: This study aimed to investigate the novel adiponectin-resistin (AR) index as a predictor of the development of metabolic syndrome (MetS) in individuals with type 2 diabetes mellitus (T2DM). MetS is common in T2DM and increases cardiovascular risk. Adiponectin and resistin, adipokines with opposing effects on insulin sensitivity and inflammation, make the AR index a potential marker for metabolic risk. Materials and Methods: This prospective observational study included 80 T2DM participants (ages 30-60) from Sarajevo, Bosnia and Herzegovina, over 24 months. The participants were divided into two groups: T2DM with MetS (n = 48) and T2DM without MetS (n = 32). Anthropometric data, biochemical analyses, and serum levels of adiponectin and resistin were measured at baseline and every six months. The AR index was calculated using the formula AR = 1 + log10(R) - 1 + log10(A), where R and A represent resistin and adiponectin concentrations. Logistic regression identified predictors of MetS. Results: T2DM patients who developed MetS showed a significant decline in adiponectin levels (40.19 to 32.49 ng/mL, p = 0.02) and a rise in resistin levels (284.50 to 315.21 pg/mL, p = 0.001). The AR index increased from 2.85 to 2.98 (p = 0.001). The AR index and resistin were independent predictors of MetS after 18 months, with the AR index showing a stronger predictive value (p = 0.007; EXP(B) = 1.265). Conclusions: The AR index is a practical marker for predicting MetS development in T2DM participants, improving metabolic risk stratification. Incorporating it into clinical assessments may enhance early detection and treatment strategies.

Mechanisms of Bioactive Lipids to Modulate Master Regulators of Lipid Homeostasis and Inflammation in Metabolic Syndrome.

Metabolic Syndrome (MetS) refers to the co-occurrence of a constellation of metabolic diseases in the same individual, such as abdominal/visceral obesity, insulin resistance or diabetes, alterations in the lipid profile (dyslipidemias), and/or hypertension, which promotes the development of other cardiometabolic and hepatic diseases. Dyslipidemia and metabolic dysfunction- associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease (NAFLD), are common MetS pathologies closely related to lipid metabolism. Alterations in the metabolism of proteins, carbohydrates, and lipids, caused by an excessive intake of nutrients and abnormal accumulation of body fat, which promotes chronic low-grade inflammation, are pivotal aspects of MetS development. To avoid damage caused by lipid overaccumulation, the transcription factors responsible for regulating lipid homeostasis and inflammation (named in this work master regulators) must modify their regular activity; however, the high adiposity established for long periods causes the appearance of insulin resistance (the MetS triggering factor most widely accepted in the literature). Fortunately, scientific evidence suggests that the abnormal activity of these regulators can be conveniently modulated by distinct species of bioactive lipids, among which unsaturated fatty acids stand out, offering new alternatives for treating MetS. Therefore, this work aims to provide a general overview of scientific evidence that supports the mechanisms of action and the effective modulation by bioactive lipids of some master lipid-metabolism-and-inflammation regulators in diverse aspects of MetS.

Impact of COVID-19 pandemic on the prevalence of metabolic syndrome in healthcare workers: a cohort study at a designated COVID-19 hospital in Taiwan.

This cohort study aimed to determine the effect of the COVID-19 pandemic on the prevalence of Metabolic syndrome (MetS) among healthcare workers at a dedicated COVID-19 hospital in Taiwan. This study recruited 397 healthcare workers who completed health checkups before and during the COVID-19 pandemic. The differences of MetS and its components prevalence before and during the COVID-19 pandemic were compared using the paired samples t-tests for normally distributed variables, and Wilcoxon signed-rank tests for non-normally distributed variables. The prevalence of MetS among healthcare workers significantly increased from 20.9% to 28.7% during the pandemic (p < .001). Central obesity and hypertension were the primary contributors to the development of MetS. COVID-19 pandemic was associated with an increasing prevalence of MetS in healthcare workers, necessitating health-promoting measures to mitigate this risk.

Unveiling Lipidomic Alterations in Metabolic Syndrome: A Study of Plasma, Liver, and Adipose Tissues in a Dietary-Induced Rat Model

Metabolic syndrome (MetS) is a complex condition characterized by fat accumulation, dyslipidemia, impaired glucose control and hypertension. In this study, rats were fed a high-fat high-fructose (HFF) diet in order to develop MetS. After ten weeks, the dietary-induced MetS was confirmed by higher body fat percentage, lower HDL-cholesterol and increased blood pressure in the HFF-fed rats compared to the normal-fed control animals. However, the effect of MetS development on the lipidomic signature of the dietary-challenged rats remains to be investigated. To reveal the contribution of specific lipids to the development of MetS, the lipid profiling of rat tissues particularly susceptible to MetS was performed using untargeted UHPLC-QTOF-MS/MS lipidomic analysis. A total of 37 lipid species (mainly phospholipids, triglycerides, sphingolipids, cholesterol esters, and diglycerides) in plasma, 43 lipid species in liver, and 11 lipid species in adipose tissue were identified as dysregulated between the control and MetS groups. Changes in the lipid signature of selected tissues additionally revealed systemic changes in the dietary-induced rat model of MetS.

Causal relationship between metabolic syndrome and hidradenitis suppurativa: A two-sample bidirectional Mendelian randomization study.

Observational studies have suggested an association between metabolic syndrome (MetS) and hidradenitis suppurativa (HS), but whether this relationship is causal remains unclear. Elucidating the causal direction could provide insights into disease mechanisms and potential interventions. We performed bidirectional two-sample Mendelian randomization (MR) using summary statistics from genome-wide association studies (GWAS) of MetS and HS. For validation, we replicated the MetS analysis using data from an independent GWAS. We applied multiple MR methods, primarily inverse variance-weighted (IVW) regression, and conducted sensitivity analyses to assess heterogeneity and pleiotropy. The MR analysis demonstrated MetS causally increased HS risk (IVW odds ratio [OR], 1.428 [95% CI, 1.193-1.710]; p < 0.001), with consistent evidence from sensitivity analyses. However, HS did not appear to causally influence MetS risk (IVW OR, 1.008 [95% CI, 0.988-1.028]; p = 0.438). This study provides evidence that MetS causally increases the risk of developing HS. However, we found no evidence for a causal relationship in the reverse direction from HS to MetS. Further research is warranted to elucidate the mechanisms underlying the identified causal association between MetS and subsequent HS development.

Prevalence Of Metabolic Syndrome in Peri and Postmenopausal Women Aged 40- 65 Years in a Tertiary Care Centre

Metabolic syndrome (MetS) is a constellation of interrelated risk factors of metabolic origin— metabolic risk factors—that appear to directly promote the development of atherosclerotic cardio-vascular disease (ASCVD). Menopausal transition with its incidental hormonal changes is considered to contribute to the development of MetS. This was a hospital based cross sectional descriptive study conducted in the Obstetrics and Gynaecology department of Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, from the 1st of September 2023 till the 29th of February 2024 after clearance from the IRC (Ref. No: 56-080/081). Convenience sampling was used among women who fulfilled the inclusion criteria. The aim of the study was to determine the prevalence of MetS among the peri and postmenopausal women and to determine which component of the diagnostic criteria of MetS was more strongly associated with MetS in our population. Women were evaluated to have MetS using both the International Diabetes Federation (IDF) and the National Cholesterol Education Program- Adult Treatment Panel III (NCEP-ATPIII criteria). The prevalence of MetS by the IDF criteria was 54% among the perimenopausal women and 61% among the postmenopausal women. Similarly, the prevalence of MetS according to NCEP-ATPIII was 53.5% among the perimenopausal and 65% among the postmenopausal women. All the MetS diagnostic markers showed a strong correlation with MetS (p&lt;0.001). The prevalence of MetS is high in our population by both the IDF and NCEP-ATP III criteria, being higher in the postmenopausal population, though not statistically significant.

Markers of Metabolic Abnormalities in Vitiligo Patients.

While vitiligo is primarily caused by melanocyte deficiency or dysfunction, recent studies have revealed a notable prevalence of metabolic syndrome (MetS) among patients with vitiligo. This suggests shared pathogenic features between the two conditions. Individuals with vitiligo often exhibit variations in triglyceride levels, cholesterol, and blood pressure, which are also affected in MetS. Given the similarities in their underlying mechanisms, genetic factors, pro-inflammatory signalling pathways, and increased oxidative stress, this study aims to highlight the common traits between vitiligo and metabolic systemic disorders. Serum analyses confirmed increased low-density lipoprotein (LDL) levels in patients with vitiligo, compared to physiological values. In addition, we reported significant decreases in folate and vitamin D (Vit D) levels. Oxidative stress is one of the underlying causes of the development of metabolic syndromes and is related to the advancement of skin diseases. This study found high levels of inflammatory cytokines, such as interleukin-6 (IL-6) and chemokine 10 (CXCL10), which are markers of inflammation and disease progression. The accumulation of insulin growth factor binding proteins 5 (IGFBP5) and advanced glycation end products (AGEs) entailed in atherosclerosis and diabetes onset, respectively, were also disclosed in vitiligo. In addition, the blood-associated activity of the antioxidant enzymes catalase (Cat) and superoxide dismutase (SOD) was impaired. Moreover, the plasma fatty acid (FAs) profile analysis showed an alteration in composition and specific estimated activities of FAs biosynthetic enzymes resembling MetS development, resulting in an imbalance towards pro-inflammatory n6-series FAs. These results revealed a systemic metabolic alteration in vitiligo patients that could be considered a new target for developing a more effective therapeutic approach.

The Potential Effect of Periodontal Disease on the Development of Metabolic Syndrome: A 10-Year Observational Study in a Thai Adult Cohort.

As data are sparse on the long-term association between periodontal diseases and development of metabolic syndrome (MetS), we investigated their relationship in a Thai cohort over a 10-year observational period. Medical records and data on periodontal assessments of 2161 employees of the Electricity Generating Authority of Thailand collected at two time points, 2003 and 2013, were used. Experienced periodontists used standard national and international criteria to define periodontitis and MetS. The impact of baseline periodontitis on subsequent MetS incidence and its components was evaluated using regression analyses. The severity and extent of periodontitis significantly predicted MetS incidence over a decade, with a higher incidence of MetS in individuals with poorer periodontal health. A single percentage increase in the periodontitis extent raised the risk of MetS incidence by 0.4% and the risk of developing individual components of MetS by 0.2%. Independent of periodontal health, age of an individual emerged as a factor impacting MetS development. This study highlights the potential effect of the severity and extent of periodontitis on the increased incidence and progression of MetS. Hyperglycaemia and hypertension were the two MetS components most significantly affected by the existence of periodontitis.

Sugar-sweetened beverages, low/no-calorie beverages, fruit juices intake and risks of metabolic syndrome in adults: The SWEET project

Background and aimsMetabolic syndrome (MetS) is an important determinant of cardiometabolic disease development, with excessive sugar intake as one of the key modifiable risk factors. However, evidence on the association between sugar-sweetened beverages (SSB), their replacement by low/no caloric beverages (LNCB), and MetS development is still limited. Methods and resultsData from participants’ of Lifelines (n = 58 220), NQPlus (n = 1094) and Feel4Diabetes (n = 342) were prospectively analysed. Dose-response associations were investigated using restricted cubic spline analyses (Lifelines). Cox proportional hazard regression analysis with robust variance was used to quantify associations between intakes of SSB, fruit juices (FJ) and LNCB and MetS incidence; data were pooled using random-effects models. Associations were adjusted for demographic, lifestyle and other dietary factors. In Lifelines, NQPlus, and Feel4Diabetes, 3853 (7 %), 47 (4 %), and 39 (11 %) participants developed MetS, respectively. Pooled analyses showed that each additional serving of SSB was associated with a 6 % higher risk of MetS (95%CI 1.02–1.10). A J-shaped association was observed for FJ and MetS, with a significant inverse association at moderate intake levels (IPR 0.89, 95 % CI 0.82–0.96). LNCB intake was not associated with MetS (IPR 1.59, 95%CI 0.74–2.43), but findings across studies were inconsistent (I2 94 %, p-value <0.01). Replacing SSB with FJ or LNCB did not show any associations with MetS incidence. ConclusionSSB intake was adversely associated with MetS incidence. A J-shaped association was observed between FJ and MetS. For LNCB, results were inconsistent across studies and therefore findings must be interpreted cautiously.

Association of the VEGF 2578C>A Polymorphism With Metabolic Syndrome and Erectile Dysfunction.

Accumulating evidence suggests a link between vascular endothelial growth factor (VEGF), erectile dysfunction (ED), and metabolic syndrome (Mets), possibly because VEGF can alter the physiological pathways involved in the regulation of endothelial cell proliferation. This study aimed to investigate the genetic susceptibility of VEGF 2578C>A polymorphism to the development of ED and Mets. Collected data included five-item International Index of Erectile Function (IIEF-5), components of Mets, and VEGF 2578C>A polymorphism. A total of 596 subjects from Kaohsiung with a mean age of 55.5 years were enrolled, data collection was done at our hospital. Individuals carrying the VEGF 2578 A allele (CA+AA genotypes) demonstrated a higher prevalence of ED compared to those with the CC genotype, with an adjusted odds ratio (OR) of 1.582 (95% confidence interval [95% CI] = 1.123-2.227, p value = 0.009) in multivariate binary regression analysis. Similarly, individuals carrying the VEGF 2578 A allele showed a higher prevalence of Mets compared to those with the CC genotype, with an adjusted OR of 2.461 (95% CI = 1.491-4.064, p value < 0.001). Furthermore, A allele carriers had significantly lower IIEF-5 scores and a higher number of Mets components compared to those with the C allele (P value < 0.001, respectively). In conclusion, VEGF 2578 A allele carriers are at a greater risk of both Mets and ED, suggesting that the VEGF 2578C>A polymorphism may serve as a common genetic susceptibility factor in the development of both disorders. Further research is warranted to evaluate the mechanisms underlying this association.

Sex difference in the association between creatinine-to-cystatin C ratio and metabolic syndrome among Chinese adults.

Metabolic syndrome (MetS), characterized by central obesity, insulin resistance, dyslipidemia, and hypertension, affects 20-25% of the global population. The creatinine-to-cystatin C ratio (CCR) is an indicator of skeletal muscle mass. While CCR may play a role in MetS development, sex differences in these associations are not fully understood. Therefore, this study aimed to investigate how CCR levels are associated with MetS in a Chinese adult population, focusing on possible sex disparities. We conducted a retrospective cross-sectional analysis of 9,376 adults from Xiamen Chang Gung Hospital between 2014 to 2016. We examined the relationship between CCR and MetS, adjusting for cardiometabolic risk factors. The prevalence of MetS was 24.7% in males and 18.0% in females. Interestingly, we observed significant sex differences in the association between CCR quartiles and MetS. Females in the lowest CCR quartile had a significantly higher risk of MetS (odds ratio=1.84). Receiver operating characteristic curve analysis revealed acceptable diagnostic power of CCR for MetS in females (area under the curve=0.65) but not in males. Our findings suggest that CCR is an independent risk factor for MetS in females, highlighting the importance of sex-specific assessments when evaluating MetS risk.

LEP rs7799039 and LEPR rs1137101 gene variants are not associated with clinical features in patients with metabolic syndrome in the Turkish population.

Genetic predisposition plays a role in the etiology of metabolic syndrome (MetS), an important health problem worldwide. Leptin (LEP), produced by adipose tissue, plays a crucial role in the development of MetS. In this study, we evaluated the effects of LEP and LEP receptor (LEPR) variants on clinical findings and risk of developing MetS in the Turkish population. A total of 320 patients were included in the study, of whom 150 were patients with MetS and 170 were healthy controls. DNA was extracted from blood samples. LEP rs7799039 and LEPR rs1137101 variants were genotyped using the polymerase chain reaction-based restriction fragment length polymorphism method. The genotype distributions of these variants and clinical and laboratory findings were compared. The LEP rs7799039 GA and AA genotypes and A allele frequencies were higher in participants with MetS than in the control group. For LEP rs7799039, the genotype AA-GA was higher in males, and the GG genotype was higher in females. On analyzing the clinical outcomes associated with these variants, it was observed that individuals possessing LEP rs7799039 GA and AA genotypes displayed elevated levels of triglycerides. In addition, those with the AG-GG genotype of LEPR rs1137101 had lower mean hemoglobin levels. Our results showed that the LEP rs7799039 and LEPR rs1137101 variants may be associated with both the risk of MetS development and clinical findings. Among the various contributors to MetS, a genetic predisposition is commonly recognized as the primary cause.

The combined effect of cardiorespiratory and muscular fitness on the incidence of metabolic syndrome before midlife.

Cardiorespiratory fitness (CRF) could reduce the risk of metabolic syndrome (MetS) while the association between muscular endurance capacity (MEC) and incident MetS has rarely been investigated in young adults. A total of 2890 military men and women, aged 18-39years, free of baseline MetS in Taiwan, were followed for incident MetS from baseline (2014) until the end of 2020. All subjects received annual health examinations for assessment of MetS. Physical fitness was assessed by CRF (estimated maximal oxygen uptake, VO2 max [mL/kg/min], in a 3000-m run) and MEC (numbers of 2-min push-ups). MetS was defined according to the International Diabetes Federation (IDF) criteria. Multiple Cox regression analysis was conducted with adjustments for baseline age, sex, substance use status and physical activity to determine the associations of CRF and MEC with incidences of new-onset MetS and related features, for example, central obesity, hypertension, dyslipidaemia and prediabetes or diabetes. To examine the combined effects of CRF and MEC status on incidence of MetS, high and low levels of CRF and MEC were separately defined by over and under the sex-specific median in each exercise test. During a median follow-up of 5.8years, there were 673 (23.3%) new-onset MetS. Higher CRF was associated with a lower incidence of MetS (hazard ratio [HR] and 95% confidence interval: 0.905 [0.877-0.933]), and its components separately, except hypertension. No association was observed between MEC and incident MetS, and its components separately, except hypertension. When evaluating the combined effects of MEC and CRF status on the incidence of MetS, it was observed that compared with the low CRF/low MEC, the high CRF/high MEC (HR: 0.553 [0.439-0.697]) and the high CRF/low MEC (HR: 0.730 [0.580-0.918]) had a lower incidence of new-onset MetS (P value for the intergroup difference=0.04). There was no significant result for the low CRF/high MEC. This study highlights that although the protective effects of MEC to reduce the incidence of MetS and most of its related features were mainly driven by CRF in young adults, there was an addictive effect of greater MEC on CRF to prevent the development of new-onset MetS before midlife.

Metabolic Associated Fatty Liver Disease in Children and Adolescents: Mechanisms of a Silent Epidemic and Therapeutic Options.

Non-alcoholic fatty liver disease (NAFLD) is now identified as a hepatic sign of metabolic syndrome and is the most frequent cause of chronic liver disease in all ages. It is assumed that a genetic predisposition associated with epigenetic factors participates in the evolution of this condition. Visceral obesity and insulin resistance (IR) have always been considered the most important causative factors of Metabolic Syndrome (MetS) and NAFLD, but currently, the interaction between genetic heritage and environmental factors is increasingly considered fundamental in the genesis of metabolic disorders associated with NAFLD. In fact, in patients with NAFLD, insulin resistance, arterial hypertension, abdominal obesity, dyslipidemia and reduced intestinal permeability have often been found, as well as a higher prevalence of coronary artery disease, obstructive sleep apnea, polycystic ovary syndrome and osteopenia, which define a MetS framework. Early diagnosis is needed to prevent disease progression through primarily lifestyle interventions. Unfortunately, at present, there are no molecules recommended for pediatric patients. However, several new drugs are in clinical trials. For this reason, targeted studies on the interaction between genetics and environmental factors involved in the development of NAFLD and MetS and on the pathogenetic mechanisms that determine the evolution in non-alcoholic steatohepatitis (NASH), should be implemented. Therefore, it is desirable that future studies may be useful in identifying patients at risk of developing NAFLD and MetS early.

Zinc finger 259 gene polymorphisms in Egyptian patients with metabolic syndrome and its association with dyslipidemia.

Zinc finger protein 1 (ZPR1), encoded by the ZNF259 gene, plays crucial roles in transcriptional regulation and cell cycle progression. Despite its known functions, its specific involvement in Metabolic Syndrome (MetS) remains debated. Genome-wide association studies have identified several genes, including ZNF259, implicated in lipid metabolism and associated with MetS. Single nucleotide polymorphisms (SNPs) in ZNF259 have been linked to altered lipid metabolism during the development of MetS. This study aims to investigate the association between MetS in Egyptian patients and three specific ZNF259 SNPs: rs964184, rs2075294, and rs2075290. The objective is to explore how these SNPs correlate with MetS development, other health outcomes, and their interaction with dyslipidemia biomarkers. 200 Egyptian participants were enrolled, and divided into two groups: 100 patients diagnosed with dyslipidemia and 100 healthy controls. The study involved comprehensive assessments, including lipid profile analysis, anthropometric measurements, and genotyping of rs964184, rs2075290, and rs2075294 in the ZNF259 gene using Real-Time Polymerase Chain Reaction (PCR). The findings indicate that rs964184 SNP correlates significantly with elevated plasma triacylglycerol (TG) levels, while rs2075290 and rs2075294 are associated with higher total serum cholesterol (TC) and TG levels. Among these SNPs, rs2075294 showed the highest predictive value (area under the curve of 0.748), followed by rs2075290 (0.738), and rs964184 (0.583), suggesting rs2075294 as the most influential SNP in MetS prediction. This study underscores the predictive role of ZNF259 SNPs in MetS risk among Egyptians. Future research should further explore the implications of ZNF259 in MetS pathogenesis and its potential as a biomarker for personalized health interventions.

Effect of Lacticaseibacillus casei LC2W Supplementation on Glucose Metabolism and Gut Microbiota in Subjects at High Risk of Metabolic Syndrome: A Randomized, Double-blinded, Placebo-controlled Clinical Trial.

Metabolic syndrome (MetS) is a global epidemic complex and will cause serious metabolic comorbidities without treatment. A prevention strategy for MetS development has been proposed to modulate gut microbiota by probiotic administrationto improve intestinal dysbiosis and benefit the host. Lacticaseibacillus casei LC2W has exhibited positive effects in preventing colitis and anti-hypertension in vivo. However, the effect of L. casei LC2W on subjects at high risk of MetS is unknown. Here, a randomized, double-blinded, placebo-controlled study was conducted on 60 subjects with high risk of MetS, and the hypoglycemic and hypolipidemic activity and possible pathways of L. casei LC2W were inferred from the correlation analysis with gut microbiome composition, function, and clinical phenotypic indicators. The results showed that oral administration of L. casei LC2W could exert significant benefits on weight control, glucose and lipid metabolism, inflammatory and oxidative stress parameters, and SCFA production, as well as modulate the composition of gut microbiota. The relative abundance of Lacticaseibacillus, Bifidobacterium, Dorea, and Blautia was enriched, and their interaction with other gut microbes was strengthened by oral administration of L. casei LC2W, which was beneficial in ameliorating gut inflammation, promoting glucose and lipids degradation pathways, thus alleviated MetS. The present study confirmed the prevention effects of L. casei LC2W towards MetS from aspects of clinical outcomes and microflora modulation, providing an alternative strategy for people at high risk of MetS.Trial registration: The study was proactively registered in ClinicalTrial.gov with the registration number of ChiCTR2000031833 on April 09, 2020.