Full Syndrome Research Articles

Prevalence of Metabolic Syndrome and Its Individual Components in Patients with AMI and Consideration of Obesity Markers among These Patients

Background: Many studies have estimated the prevalence of Metabolic Syndrome (MS) and also its association with type II Diabetes and cardiovascular disease. But its prevalence and association with acute cardiovascular events like Acute Myocardial Infarction (AMI) remained largely unexplored. Objectives: (1) To determine the prevalence of the metabolic syndrome in patients with AMI; (2) To find out the association of the individual component of the metabolic syndrome with AMI. (3) To study the association of obesity markers like waist circumference (WC), Body Mass Index (BMI) and Waist Hip Ratio (WHR) with AMI. Study Design: Hospital based cross-sectional case control study. Methods: The study was conducted in a Medical College of Kolkata, West Bengal. Applying National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria and evaluated subjects for the 5 component conditions of the metabolic syndrome: insulin resistance, abdominal obesity based on waist circumference, hypertriglyceridemia, low HDL cholesterol (HDL-C), and hypertension, as well as the full syndrome, defined by the presence of at least 3 of the 5 conditions. Statistical Analysis: Student's t test and Chi-square test. Results: Among the 76 AMI patients, 47.36% male AMI cases and 46.87% of female AMI cases had MS and both are statistically significant when compared with controls. Among the 5 component conditions of MS, 4 components like insulin resistance, hypertension, hypertriglyceridemia and low HDL cholesterol were more prevalent in cases in both the sex groups compared with controls and the results were statistically significant. Only one exception obesity measured by high WC (p>0.05) which was not independently related to MS. Among the component conditions insulin resistance had the highest OR in men and low HDL had the highest OR in women. Among other obesity markers the association of BMI with MI was not statistically significant whereas central obesity measured by WHR of >0.09 were significantly related to MI in both male and female group. Conclusion: The study indicates that prevalence of MS and its individual component conditions are significantly related to AMI. Considering the marker of obesity waist circumference and BMI were not significantly related to AMI whereas WHR is significantly related to AMI. Maybe this is the time when we should look upon to derive the cut off points for obesity with consideration specifically related to Asian Indians.

2448 – Adolescent subthreshold depression and anxiety

A significant proportion of individuals with substantial functional impairment who either identify themselves as psychiatric patients or who are referred for psychiatric evaluation by their families/teachers or other clinicians may not receive a standard diagnosis based on the current classification systems due to an insufficient number or duration of symptoms. Their conditions are labeled as subthreshold mental disorders. This presentation aims to give an overview on the current knowledge on adolescent subthreshold depression and anxiety. Based on the literature the presence of subthreshold depression and anxiety is associated with more medical comorbidity, more workdays lost, greater use of services for medical and mental health problems and increased suicide risk. Adolescents with subthreshold conditions have an increased risk for developing future full syndrome disorders than individuals without these conditions. People with subthreshold conditions report significantly more social dysfunction and disability compared to those with several common general medical conditions such as hypertension or diabetes. The results of the Saving and Empowering Young Lives in Europe (SEYLE) study - as the risk for increased burden of disease and suicide risk among adolescents with subthreshold-depression/anxiety is between the risk for those non-depressed/nonanxious and full syndrome depressed/anxious - contribute to the current discussions about the advantages and disadvantages of categorical and dimensional classification systems: these findings suggest that subthreshold and full DSM-IV-TR depression/anxiety could be on the same continuum. Inputting subthreshold disorders into the diagnostic systems could provide a bridge between categorical and dimensional diagnostic models.

Does an alcolmeter in the hands of an anesthesiologist make TURP safer? - Results from a case-control study.

Background:This hospital-based, prospective, case-controlled study was carried out to monitor fluid absorption during transurethral resection of the prostrate (TURP) by marking the irrigating fluid with ethanol for signs of TURP syndrome. Addition of ethanol allows early detection and prevention of full blown TURP syndrome as also the volume of fluid absorbed can be measured.Subjects and Methods:Patients were divided into two groups of 50 each, taking males undergoing TURP belonging to ASA (American Society of Anesthesiologists) I and II. Group 1 received irrigation with 1.5% glycine alone and group 2 received irrigation with 1.5% glycine along with ethanol during TURP. The primary outcome measure was the detection of TURP syndrome using end expiratory ethanol levels and comparing with serum electrolytes and clinical manifestations. The secondary outcome measures, the hemodynamic parameters such as heart rate, systolic and diastolic pressures, and oxygen saturation were recorded during the intraoperative period after spinal anesthesia and then postoperatively till the end of the first hour in the recovery room.Statistical Analysis:Chi-square test, Student's t-test and Pearson's correlation coefficient ‘r’.Results:Mean resection time in the ethanol positive patients (36.36 min) was significantly higher than that in the ethanol negative patients (22.08 min) (P < 0.01). The estimated fluid absorbed was statistically significant in 45 minutes of resection in three patients with positive ethanol readings (P < 0.05). Resection was temporally stopped in 16 patients (32%) and permanently in 1 patient (2%), whose resection time reached 60 min. A positive correlation was found between total fall in serum sodium and maximum expiratory ethanol concentration. There was a significant difference in the heart rate between the two groups in the 40th minute (P < 0.05).Conclusion:Ethanol is a noninvasive, easy-to-use marker in irrigating fluid for assessing fluid absorption. It forewarns to take corrective measures earlier than both fall in sodium and manifestations of TURP syndrome, allowing successful completion of TURP.

(123I)FP-CIT SPECT in suspected dementia with Lewy bodies: a longitudinal case study

ObjectivesLittle is known regarding the ‘false-negative’ or ‘false-positive’ striatal dopamine transporter binding on SPECT for the diagnosis of dementia with Lewy bodies (DLB). We explored the clinical course in patients...

Who are the children and adolescent patients of a national referral service of eating disorders in Brazil?: a cross-sectional study of a clinical sample.

To investigate the sociodemographic and clinical profile of patients receiving treatment at a specialized service for children and adolescents with eating disorders (ED) in São Paulo, Brazil, and to compare data with the relevant literature. This cross-sectional study assessed male and female patients with ED up to 18 years of age. All data were collected upon admission. A total of 100 subjects were assessed. Mean age was 15.41±0.18 years, and mean age at ED onset was 13.5±0.19 years. Mean disease duration was 21.06 ±1.67 months. Of the total sample, 82% of the patients were female, 84% were Caucasian, 64% came from A and B economic tiers. Moreover, in 60% ED started at 14 years of age or less, and 74% had psychiatric comorbidities. Anorexia nervosa was the most prevalent diagnosis (43%). Hospitalized patients had lower body mass index, longer ED duration, and more severe scores on the Children's Global Assessment Scale than outpatients (p < 0.05). Our young Brazilian patients with ED present epidemiological and symptomatic characteristics very similar to those found in the scientific literature, including a high prevalence of psychiatric comorbidities. The higher frequency of full syndrome ED, the predominance of cases with an early onset, the delay in beginning specialized treatment, and the more severe state of inpatients provide grounds for concern because these factors differ from what has been reported in reference studies and indicate greater ED severity.

Differentiating disordered affect in children and adolescents with type 1 diabetes

BackgroundThere is evidence for increased risk of affective disorders (AD) in adults with type 1 diabetes however, the prevalence and characteristics of AD in young people with the condition is unclear. Comorbid AD in type 1 diabetes is associated with deleterious self-management, sub-optimal clinical indicators, reduced quality of life, poorer physical health, increased complications, increased high risk behaviours in adolescence and young adulthood, and earlier mortality. The present study investigated the prevalence and character of AD in young people with type 1 diabetes. MethodsThe self-report PH-PANAS-C was employed in a cross-sectional, case-control design to identify and differentiate full-syndrome (FS) and subthreshold (St) levels of AD in 53 participants with type 1 diabetes (case) and 54 age-balanced controls (N=107; 7–18 yrs). ResultsCase participants reported greater AD than controls. When differentiated, only anxiety was significantly more prevalent. Case participants reported less positive affect, and greater negative affect and autonomic arousal. Further, 1:3 case participants presented with St symptoms of AD. LimitationsSelf-report measures are known to produce moderated responses therefore symptoms may be more severe than reported. There has been some suggestion that responses to somatic items in the PH-PANAS-C may relate to diabetes-specific states rather than affect-related symptoms however, recent evidence has refuted this argument. ConclusionsAD, particularly anxiety, represents a significant clinical concern in young people with type 1 diabetes both as a disorder in its own right and as a major impediment to primary care and management of the diabetes. The significant dominance of anxiety-related symptoms and prevalence of subthreshold presentation warrant further investigation.

Psychological factors that may confer risk for bipolar disorder

Several psychological domains may be dysfunctional in people with bipolar disorder (BD). When dysfunction occurs prior to onset of mood symptoms, it may signify risk for onset of the full syndrome of illness. Among these domains, cognitive dysfunction has received considerable attention as a possible endophenotype for BD, with some suggestion that changes in cognitive function may antedate onset of mood symptoms in individuals at risk for BD. Domains of social cognition, including emotion comprehension, theory of mind, and empathy, along with autobiographical memory, represent understudied aspects of psychological function that may be dysfunctional in people with BD. Temperament and personality factors, such as ruminative tendencies and neuroticism, may also leave some people vulnerable to mood instability. This review summarises the evidence for dysfunction in each of these domains for people with BD and examines whether there is any evidence that this dysfunction antedates the onset of mood symptoms or confers risk for illness.

Transphenoidal surgery without steroid replacement in patients with morning serum cortisol below 9 μg/dl (250 Nmol/l)

Adrenal insufficiency is a feared complication in patients undergoing transphenoidal surgery (TSS). Using the insulin tolerance test (ITT) for the preoperative assessment of hypothalamic-pituitary-adrenal (HPA) status is less than ideal, and the morning serum cortisol (MSC) is often used as a proxy for ITT. However, neither the ITT nor the MSC level has been validated to indicate HPA sufficiency compared to a physiological gold standard such as patients' ability to withstand transphenoidal surgery. To evaluate the intraoperative and postoperative course of nine patients with non-ACTH-secreting pituitary adenomas who did not receive intraoperative cortisol replacement despite having a preoperative MSC below 9 μg/dl (250 nmol/l) and to compare this with a set of patients with a preoperative MSC greater than 14.5 μg/dl (400 nmol/l) and another set of patients with MSC below 9 μg/dl (250 nmol/l) who received intraoperative cortisol administration. Preoperative and day 1 and day 2 postoperative MSC, intraoperative anesthetic record, vital signs, fluid balance, medications, and complications were recorded. None of the patients experienced the full syndrome of adrenal insufficiency. One patient with a preoperative MSC <9 μg/dl (250 mol/l) had isolated postoperative fatigue and required cortisol replacement. No patient suffered any life-threatening complications. There were no differences among the three groups in their intraoperative or postoperative courses when compared for intraoperative hypotension, acute blood pressure drop, and administration of vasopressors. This study suggests that TSS can be performed safely in patients with preoperative MSC less than 9 μg/dl (250 nmol/l) in closely monitored settings without intraoperative cortisol administration. Further studies are warranted.

Effect of a Low-Fat Versus a Low-Gycemic-Load Diet on Inflammatory Biomarker and Adipokine Concentrations

Low-grade inflammation is linked to metabolic syndrome and obesity. We studied the effects of weight loss and dietary composition on serum concentrations of biomarkers of inflammation and adipokines. Men and women (n=181) aged 30-65 years with a body mass index (BMI) of 28-40 kg/m(2) (28-35 kg/m(2) for women) and one or more components of metabolic syndrome were randomized to follow one of two hypocaloric diets, a low-fat or low-glycemic-load diet for 3 months. Blood samples were taken pre- and postintervention. Serum concentrations of interleukin-6 (IL-6), tumor necrosis factorα (TNF-α), plasminogen activator inhibitor-1 (PAI-1), monocyte chemoattractant protein-1 (MCP-1), and adipokines (leptin, resistin, and adiponectin) were analyzed using multiplexed microsphere immunoassays. Weight loss was not different in the low-fat (4.4%±3.8%) and low-glycemic-load (4.9%±3.2%) groups. Concentrations of IL-6, TNF-α, PAI-1, and leptin were significantly reduced in both dietary groups with no between-group differences, whereas MCP-1 and adiponectin concentrations did not change. Subjects with full metabolic syndrome (three or more components; n=109) experienced greater weight loss than subjects (n=72) with one to two components and greater reduction in leptin [7.08 (95% confidence interval 5.19, 8.97) vs. 3.46 (0.91, 6.00) ng/mL; p=0.02] and a tendency to greater reduction in TNF-α (1.00 [0.60, 1.44] vs 0.40 [0.02, 0.78] pg/mL; p=0.05). Hypocaloric diets improved inflammatory biomarkers and adipokines independently of dietary composition. The response tended to be greater in subjects with three or more components of metabolic syndrome than their counterparts with one to two components.

C3 Glomerulopathy Masquerading as Acute Postinfectious Glomerulonephritis

We report the case of a 63-year-old man who presented with acute kidney injury, active urine sediment, nephrotic syndrome, and hypocomplementemia after a recent report of a sore throat. Kidney biopsy showed diffuse proliferative and exudative glomerulonephritis with C3-dominant staining by immunofluorescence. Taken together, clinical and pathologic findings were most suggestive of acute postinfectious glomerulonephritis, although the history of full nephrotic syndrome, presence of segmental membranoproliferative features, and absence of classic subepithelial hump-shaped deposits were unusual for this condition. Three months after the initial biopsy, the patient continued to have hypocomplementemia and nephrotic syndrome, prompting a repeated kidney biopsy that showed findings most consistent with C3 glomerulopathy. C3 glomerulopathy is a proliferative pattern of glomerulonephritis characterized by complement deposits that stain solely or dominantly for C3. A subset of cases of C3 glomerulopathy have features that overlap extensively with acute postinfectious glomerulonephritis. Clinicians and pathologists should be aware of the similar findings seen in these 2 conditions.

Elevated plasma succinate in PTEN, SDHB, and SDHD mutation–positive individuals

PurposeCowden syndrome results from germline mutations in the gene for phosphatase and tensin homologue deleted on chromosome 10 (PTEN) and from variants in succinate dehydrogenase B and D subunits. We hypothesized that succinate accumulation may be common among individuals with SDH variants/mutations and those with PTEN mutations. MethodsUrine and blood were collected from individuals meeting full or partial Cowden syndrome diagnostic criteria or those with paraganglioma (PGL) or a known susceptibility paraganglioma-associated gene mutation, and succinate was measured. PTEN, SDHB, SDHC, and SDHD genes were sequenced from genomic DNA. ResultsElevated plasma succinate was observed in 13/21 (62%) individuals with germline PTEN, SDHB, or SDHD mutations as compared with 5/32 (16%) controls (P < 0.001), in 10/15 (67%) individuals with pathogenic PTEN mutations but in <20% of mutation-negative individuals meeting identical criteria, and in individuals with mutations in SDHB (1/1, 100%) and SDHD (2/5, 40%). ConclusionOur data suggest that mutations in PTEN, SDHB, and SDHD reduce catalytic activity of succinate dehydrogenase, resulting in succinate accumulation, and identify a common biochemical alteration in these two patient populations (PTEN and SDHx mutation positive individuals). Plasma organic acid analysis may provide an effective and inexpensive screening method to determine when more expensive gene sequencing of PTEN and SDH genes is warranted.Genet Med 2012:14(6):616–619

APOC3 and PNPLA3 in non‐alcoholic fatty liver disease: Need to clear the air

See article in J. Gastroenterol. Hepatol. 2012; 27: 951–956.

Differences in cortico‐striatal‐cerebellar activation during working memory in syndromal and nonsyndromal children with prenatal alcohol exposure

Although children with heavy prenatal alcohol exposure may exhibit the distinctive facial dysmorphology seen in full or partial fetal alcohol syndrome (FAS/PFAS), many lack that dysmorphology. This study examined the functional organization of working memory in the brain in three groups of children-those meeting diagnostic criteria for FAS or PFAS, heavily exposed (HE) nonsyndromal children, and healthy controls. A verbal n-back task (1-back and 0-back) was administered to 47 children (17 with FAS/PFAS, 13 HE, and 17 controls) during fMRI. Intra-group one-sample t-tests were used to identify activity regions of interest central to verbal working memory including the dorsal prefrontal cortex (dPFC), inferior frontal gyrus, caudate/putamen, parietal cortex, and cerebellar Crus I/lobule VI and lobule VIIB-IX. Whereas groups did not differ in task sensitivity, fMRI analyses suggested different patterns of sub-network recruitment across groups. Controls primarily recruited left inferior frontal gyrus (Broca's area). By contrast, HE primarily recruited an extensive set of fronto-striatal regions, including left dPFC and left caudate, and the FAS/PFAS group relied primarily on two cerebellar subregions and parietal cortex. This study is, to our knowledge, the first to demonstrate differential recruitment of critical brain regions that subserve basic function in children with different fetal alcohol spectrum disorders compared to controls. The distinct activation patterns seen in the two exposed groups may be related to substantial differences in alcohol dose/occasion to which these groups were exposed in utero.

Chronic kidney disease, severe arterial and arteriolar sclerosis and kidney neoplasia: on the spectrum of kidney involvement in MELAS syndrome

BackgroundMELAS syndrome (MIM ID#540000), an acronym for Mitochondrial Encephalopathy, Lactic Acidosis and Stroke-like episodes, is a genetically heterogeneous mitochondrial disorder with protean manifestations and occasional kidney involvement. Interest in the latter is rising due to the identification of cases with predominant kidney involvement and to the hypothesis of a link between mitochondrial DNA and kidney neoplasia.Case presentationWe report the case of a 41-year-old male with full blown MELAS syndrome, with lactic acidosis and neurological impairment, affected by the "classic" 3243A > G mutation of mitochondrial DNA, with kidney cancer. After unilateral nephrectomy, he rapidly developed severe kidney functional impairment, with nephrotic proteinuria. Analysis of the kidney tissue at a distance from the two tumor lesions, sampled at the time of nephrectomy was performed in the context of normal blood pressure, recent onset of diabetes and before the appearance of proteinuria. The morphological examination revealed a widespread interstitial fibrosis with dense inflammatory infiltrate and tubular atrophy, mostly with thyroidization pattern. Vascular lesions were prominent: large vessels displayed marked intimal fibrosis and arterioles had hyaline deposits typical of hyaline arteriolosclerosis. These severe vascular lesions explained the different glomerular alterations including ischemic and obsolescent glomeruli, as is commonly observed in the so-called "benign" arteriolonephrosclerosis. Some rare glomeruli showed focal segmental glomerulosclerosis; as the patient subsequently developed nephrotic syndrome, these lesions suggest that silent ischemic changes may result in the development of focal segmental glomerulosclerosis secondary to nephron loss.ConclusionsNephron loss may trigger glomerular sclerosis, at least in some cases of MELAS-related nephropathy. Thus the incidence of kidney disease in the "survivors" of MELAS syndrome may increase as the support therapy of these patients improves.

Night eating is associated with emotional and external eating in college students

The night eating syndrome (NES) consists of evening hyperphagia and/or nocturnal eating and has been associated with depressed mood that worsens in the evening. However, it is not consistently related to elevated BMI. The present study was conducted to examine whether a relationship exists between NES and emotional, external, and restrained eating. BMI and sleep quality were also obtained. A sample of 246 students completed the Night Eating Diagnostic Questionnaire (NEDQ), Night Eating Syndrome History and Inventory (NESHI), Sleep Quality Index (SQI), and Dutch Eating Behavior Questionnaire (DEBQ), containing subscales for emotional, external, and restrained eating. They also provided demographic information, including height and weight. Participants were grouped by severity of NES features using the NEDQ and NESHI: normal, mild night eater, moderate night eater, and full night eater syndrome. MANOVA was used to compare DEBQ subscores for the groups; those in the full syndrome category had significantly higher emotional eating scores and external eating scores than those in the normal and mild categories. There was no difference in restrained eating between the normal and full syndrome groups. Those with moderate and full syndrome NES symptoms also reported significantly lower sleep quality. No significant relationship was found between NES and BMI. The results show that NES is associated with more eating in response to negative mood and in response to food cues.

Environment, Developmental Origins, and Attention-Deficit/Hyperactivity Disorder

Environment, Developmental Origins, and Attention-Deficit/Hyperactivity Disorder

Life Satisfaction and Burnout Among Heart, Lung, Liver, and Kidney Transplant Patients and Their Spouses

Objective: While a number of studies have dealt with the psychosocial consequences of transplantation for patients, we know comparatively little about the strains faced by their spouses. The present study investigates the psychosocial health of transplant patients and their spouses, as well as the link between these groups’ physical and psychosocial status, on the one hand, and their degree of burnout and level of life satisfaction on the other. Design: In a cross-sectional study, 121 patients and their spouses are surveyed by questionnaire following heart, lung, liver, or kidney transplant. Methods: The psychosocial parameters investigated in both patients and spouses are sense of coherence, quality of life, quality of the relationship, life satisfaction, and burnout. Results: Patients rate the quality of the relationship higher than their partners do, and they are more satisfied with the relationship than their spouses are (p &lt; .001). Regression analyses show that patients’ life satisfaction is associated with quality of the relationship. Evidence of a full burnout syndrome can be found in three of the patients and two of the spouses. Burnout in the case of both patients and their partners is associated with limitations in one’s own sense of coherence and in one’s mental and physical health (multiple R2 = 0.79 for patients and 0.76 for spouses). Conclusion: Because of the importance of the couple’s relationship, psychosocial counseling should pay more attention to relationship satisfaction. Psychotherapeutic techniques should be used to improve the sense of coherence in both patient and spouse.

Who is really at risk? Identifying risk factors for subthreshold and full syndrome eating disorders in a high-risk sample

Who is really at risk? Identifying risk factors for subthreshold and full syndrome eating disorders in a high-risk sample

Metabolic syndrome in Mediterranean women with polycystic ovary syndrome: when and how to predict its onset

Polycystic ovary syndrome (PCOS) is associated with the metabolic syndrome (MetS). The metabolic disorders are not universal and may vary with race, age and phenotype. Our purpose was to determine the clinical and biochemical characteristics of Mediterranean PCOS women with MetS, compare them with non-MetS PCOS patients, and assess the ability of clinical data and biochemical tests to predict these abnormalities within our population. A total of 218 subjects, 196 PCOS women and 22 controls, undergo a physical examination and laboratory evaluation for a diagnosis of MetS. MetS was categorized according to NCEP ATP III guidelines. PCOS patients were analyzed separately and compared in three subgroups: three or more MetS criteria, two criteria, one or no criteria. The overall prevalence of MetS was 21.4%. Women with MetS had higher glucose (G) levels than PCOS women with two criteria (5.7 ± 1.5 vs 5 ± 0.4, p < 0.05). Both groups were comparable for all the other parameters. Waist circumference (WC), body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), bioavailable testosterone (uT), triglycerides (TG) and insulin (I) levels were significantly higher and sex hormone-binding globulin (SHBG) levels, high-density lipoprotein (HDL), HOMA and QUICKI indexes significantly lower in both groups, MetS and patients with two criteria, compared with women with one or no criteria and the control group. WC, HDL and TG were the best predictors of PCOS patients at risk for MetS. In conclusion, we recommend considering PCOS patients with two criteria of MetS as having the same risk as patients with the full syndrome. Waist circumference with HDL and triglycerides is an efficient combined test to identify PCOS women at risk for metabolic and cardiovascular diseases.

Enhanced Oxidative Stress and Platelet Activation Combined with Reduced Antioxidant Capacity in Obese Prepubertal and Adolescent Girls with Full or Partial Metabolic Syndrome

In adults, obesity is a main factor implicated in increased oxidative stress (OS), platelet activation (PA) and impaired antioxidant status (AS), all predisposing factors for cardiovascular disease leading to increased morbidity and mortality. Furthermore, the metabolic syndrome (MetS) is an important cardiovascular risk factor, which progressively develops and may already be present during late childhood or adolescence. However, scarce data exist on oxidative-antioxidant balance and PA in childhood and adolescence in the presence of partial (PMetS) or full MetS. The aim of the study was to evaluate OS, PA, and AS in prepubertal and adolescent obese girls with partial or full MetS. 96 girls with a clinical and metabolic evaluation for obesity and 44 healthy normal-weight sex- and age-matched girls were studied. IDF-adopted criteria were used to define full and partial MetS and the patient population was divided into 4 groups: the first comprised 31 pre-pubertal girls with PMetS (PR-PMetS), the second 37 adolescents with PMetS (AD-PMetS), the third 10 prepubertal girls with full MetS (PR-MetS), and the fourth 18 adolescents with full MetS (AD-MetS). The OS was evaluated by measuring plasma 15-F(2t)-Isoprostane levels (15-F(2t)-IsoP) and protein carbonyls, PA by thromboxane B(2) levels (TXB(2)), and AS by serum vitamin E and plasma total antioxidant capacity (TAC) levels. 15-F(2t)-IsoP, protein carbonyls, and TXB(2) levels were significantly gradually amplified, and vitamin E and TAC reduced, and significantly correlated with obesity from childhood to adolescence and from partial to full MetS. This study demonstrates the loss of the normal homeostatic balance between oxidant-antioxidant state in obese children and adolescents with manifestations of partial and full MetS.