Greater Prevalence Of Metabolic Syndrome Research Articles

Niveles séricos de 25-Hidroxivitamina D y su relación con síndrome metabólico en una población de hombres jóvenes no diabéticos.

Introducción: Los niveles no suficientes de vitamina D (VD) se han asociado a varias patologías no osteomusculares, sin embargo, es motivo de controversia si estos se asocian a mayor prevalencia de síndrome metabólico (SM).
 Objetivo: Determinar y comparar la frecuencia de insuficiencia y deficiencia de 25-Hidroxivitamina D (25(OH)D) entre hombres jóvenes obesos no diabéticos y controles con peso normal, y su correlación con el estado de síndrome metabólico.
 Materiales y métodos: Estudio de corte transversal, que incluyó 62 individuos con peso normal y 47 en obesidad, se determinaron los niveles séricos de 25(OH)D. y se midieron parámetros antropométricos y bioquímicos para establecer criterios de SM.
 Resultados: De los 47 sujetos con obesidad, 25 tenían SM, mientas que ninguno de los sujetos de peso normal cumplía con dichos criterios, No se encontraron diferencias estadísticamente significativas en cuanto a la presencia de síndrome en correlación con los niveles de vitamina D (p=0,94).. La media de los niveles séricos de 25(OH)D para la población total fue de 30,64 ng/mL; en sujetos normopeso 30,8 ng/mL y entre los obesos fue de 30,1 ng/mL con SM y 30,6 ng/mL. Por otro lado no hubo una correlación significativa entre los parámetros individuales de síndrome metabólico y los niveles séricos de VD tanto de manera global como en el análisis por subgrupos.
 Conclusión: No hubo una correlación significativa entre los niveles séricos de 25(OH)D con el estado de SM, tampoco se identificó ningún tipo de correlación significativa entre estos y los parámetros antropométricos y bioquímicos estudiados.

Gender-related differences in serum uric acid in treated hypertensive patients from central and east European countries: findings from the Blood Pressure control rate and CArdiovascular Risk profilE study.

Hyperuricemia has been associated with high blood pressure (BP) values, diabetes mellitus, metabolic syndrome and chronic kidney disease (CKD). In the present study, we assessed the gender-related relationships between serum uric acid (SUA) and cardionephrometabolic variables in central and east European hypertensive patients. A total of 3206 treated hypertensive patients with available SUA levels from the BP-CARE study was analyzed. Correlations among SUA, BP values, BP control, diabetes mellitus, metabolic syndrome and CKD were performed according to gender. Twenty-five percent of the whole population showed hyperuricemia (28% in women and 23% in men). These patients were older and showed a greater burden of cardiovascular risk factors (high BP, BMI, glucose, total cholesterol and triglyceridemia). They also showed a greater prevalence of metabolic syndrome, diabetes mellitus, rate of uncontrolled BP, more than high cardiovascular risk and CKD. Prevalence of metabolic syndrome and uncontrolled BP was similar in normouricemic and hyperuricemic women, the latter displaying a higher prevalence of diabetes mellitus, high cardiovascular risk and CKD. Hyperuricemic men were characterized by a greater prevalence of metabolic syndrome, diabetes mellitus, high cardiovascular risk, rate of uncontrolled BP and CKD but not polytherapy. Logistic regression analysis showed that none of the evaluated variables, except CKD, displayed SUA as significant covariate. Our findings provide evidence that a high prevalence of hyperuricemia occurs in hypertensive patients from central and east Europe. The data also show that gender-related differences in the association between SUA and cardionephrometabolic variables exist. This is also the case for the relationships between SUA and CKD.

Continuous Positive Airway Pressure Reduces Night-Time Blood Pressure and Heart Rate in Patients With Obstructive Sleep Apnea and Resistant Hypertension: The RHOOSAS Randomized Controlled Trial.

Most patients with resistant hypertension (RH) have obstructive sleep apnea (OSA). We aimed to determine the impact of OSA and continuous positive airway pressure (CPAP) treatment on the leptin profile and blood pressure (BP) in patients with RH. After an initial case-control study (RH with and without OSA), we performed a randomized, single blind study in OSA + RH patients receiving either sham CPAP (3 months) followed by active CPAP (6 months) or 6 months of active CPAP. The primary outcome was the comparison of leptin levels between groups of RH patients with or without OSA. Secondary outcomes were the comparison of metabolic parameters, biomarkers of sympathetic activity, and BP indices between the two groups of RH patients with or without OSA. The same outcomes were then evaluated and compared before and after sham and effective CPAP intervention. Sixty-two patients (60 ± 10 years; 77% men) with RH (24-h daytime systolic BP (SBP)/diastolic BP: 145 ± 13/85 ± 10 mmHg, 3.7 antihypertensive drugs) were included. The 37 RH patients exhibiting OSA (60%) were predominantly men (87 vs 64% for non-OSA patients), with a greater prevalence of metabolic syndrome and higher creatininemia. Their leptin concentrations were significantly lower than in non-OSA patients [9 (6; 15) vs 17 (6; 29) ng/mL] but increased after 6 months of CPAP. Three months of effective CPAP significantly decreased night-time SBP by 6.4 mmHg and heart rate (HR) by 6.0 bpm, compared to sham CPAP. The association between OSA and RH corresponds to a specific, predominately male phenotype with a higher burden of metabolic syndrome and higher creatininemia but there was no significant difference between OSA and non-OSA patients regarding BP indices, and the number of antihypertensive drugs used. Active CPAP could be efficient at decreasing night-time BP and HR, but there was no difference between CPAP and sham CPAP groups for all metabolic and SNS markers (NCT00746902 RHOOSAS).

Comprehensive Endocrine-Metabolic Evaluation of Patients With Alström Syndrome Compared With BMI-Matched Controls.

Alström syndrome (AS), a monogenic form of obesity, is caused by recessive mutations in the centrosome- and basal body-associated gene ALMS1. AS is characterized by retinal dystrophy, sensory hearing loss, cardiomyopathy, childhood obesity, and metabolic derangements. We sought to characterize the endocrine and metabolic features of AS while accounting for obesity as a confounder by comparing patients with AS to body mass index (BMI)-matched controls. We evaluated 38 patients with AS (age 2 to 38 years) who were matched with 76 controls (age 2 to 48 years) by age, sex, race, and BMI. Fasting biochemistries, mixed meal test (MMT), indirect calorimetry, dual-energy X-ray absorptiometry, and MRI/magnetic resonance spectroscopy were performed. Frequent abnormalities in AS included 76% obesity, 37% type 2 diabetes mellitus (T2DM), 29% hypothyroidism (one-third central, two-thirds primary), 3% central adrenal insufficiency, 57% adult hypogonadism (one-third central, two-thirds primary), and 25% female hyperandrogenism. Patients with AS and controls had similar BMI z scores, body fat, waist circumference, abdominal visceral fat, muscle fat, resting energy expenditure (adjusted for lean mass), free fatty acids, glucagon, prolactin, ACTH, and cortisol. Compared with controls, patients with AS were shorter and had lower IGF-1 concentrations (Ps ≤ 0.001). Patients with AS had significantly greater fasting and MMT insulin resistance indices, higher MMT glucose, insulin, and C-peptide values, higher HbA1c, and higher prevalence of T2DM (Ps < 0.001). Patients with AS had significantly higher triglycerides, lower high-density lipoprotein cholesterol, and a 10-fold greater prevalence of metabolic syndrome (Ps < 0.001). Patients with AS demonstrated significantly greater liver triglyceride accumulation and higher transaminases (P < 0.001). Severe insulin resistance and T2DM are the hallmarks of AS. However, patients with AS may present with multiple other endocrinopathies affecting growth and development.

Abstract P246: Dietary Minerals and Metabolic Syndrome: Results From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Introduction: Minerals play an integral role in lipid and carbohydrate metabolism and defense against oxidative damage, and thus mineral-poor diets may be an important risk factor for cardiometabolic disease. Little is known about the relationship between dietary mineral intake and metabolic health in Hispanics/Latinos - the largest ethnic minority in the U.S. Hypothesis: Individuals consuming less than recommended amounts of certain minerals may have a greater burden of metabolic syndrome, independent of individual-level risk factors. Methods: We studied 15,051 Hispanic/Latino individuals, aged 18-74 years, from the Hispanic Community Health Study/Study of Latinos, a population-based epidemiologic study of adults enrolled from 4 U.S. communities in 2008-2011. Daily intakes of selected minerals (copper, manganese, selenium, and zinc) from up to two dietary recalls were averaged, and combined with self-reported supplemental intakes. Copper, selenium, and zinc intake levels were dichotomized at the estimated average requirement (EAR); for manganese, the adequate intake (AI) was used as a cutoff point as an EAR has not been established. Metabolic syndrome and its component abnormalities were defined per the harmonized American Heart Association/National Heart, Lung, and Blood Institute criteria as at least 3 of the following 5 criteria: high blood pressure, high triglycerides, low HDL cholesterol, high fasting glucose, or abdominal obesity. Associations of mineral intakes with prevalent metabolic syndrome and its individual components were evaluated using logistic regression models accounting for the complex sampling design of the study. Results: Intakes of copper, manganese, selenium, and zinc were below the EAR/AI in 15%, 29%, 4%, and 13% of individuals, respectively. Copper intake below the EAR was positively associated with metabolic syndrome (OR: 1.23, 95% CI: 1.05-1.44) after adjustment for energy intake, age, gender, and Hispanic/Latino background, and was primarily driven by an association with high blood pressure (1.24, CI: 1.04-1.47). Manganese intake below the AI was also associated with metabolic syndrome (1.16, CI: 1.01-1.32), with the strongest associations observed for high fasting glucose levels (1.20, CI: 1.04-1.38) and abdominal obesity (1.19, CI: 1.05-1.36). Conclusion: Consuming less than the recommended amounts of copper and manganese was associated with a greater prevalence of metabolic syndrome. Future prospective studies are needed to confirm the importance of achieving copper and manganese adequacy and synergistic aspects of foods containing these minerals for optimal cardiometabolic health.

Hypogonadism Makes Dyslipidemia in Klinefelter's Syndrome.

Klinefelter's syndrome (KS) is a genetic syndrome that presents with hypogonadism and is associated with metabolic syndrome. Patients demonstrating hypogonadism show a greater prevalence of metabolic syndrome due to changes in body composition. We aimed to determine the association between KS and dyslipidemia. The KS group comprised 55 patients who visited the infertility clinic for an infertility evaluation and were confirmed as having a diagnosis of KS. The control group comprised 120 patients who visited the clinic for health screening. Patient characteristics were compared between the two groups with respect to height, weight, body mass index (BMI), testosterone, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride (TG) levels. Height and weight were significantly greater in patients belonging to the KS group, but no statistically significant difference was found with respect to the BMI. Testosterone levels in patients belonging to the KS group were significantly lower compared to the control group (2.4 ± 2.6 vs. 5.2 ± 1.8 ng/mL, P < 0.001). Compared to the control group, TG levels in patients belonging to the KS group were increased (134.9 ± 127.8 vs. 187.9 ± 192.1 mg/dL, P = 0.004) and HDL cholesterol was significantly decreased (51.2 ± 22.0 vs. 44.0 ± 9.5 mg/dL, P = 0.009). LDL cholesterol and total cholesterol were not significantly different between the two groups (P = 0.076 and P = 0.256, respectively). Significant differences were noted between patients belonging to the KS group and normal control group with respect to elevated TG and decreased HDL cholesterol levels.

Psoriasis, non-alcoholic fatty liver disease, and cardiovascular disease: Three different diseases on a unique background.

Psoriasis is a chronic inflammatory immune-mediated skin disease, frequently associated with systemic comorbidities. According to recent data, patients with psoriasis show a greater prevalence of metabolic syndrome, which confers a higher cardiovascular risk. The link between these pathological conditions appears to be a chronic low-grade inflammatory status. The aim of this review is to focus on the multiple epidemiological and physio-pathogenetic aspects linking non-alcoholic fatty liver disease, psoriasis, and cardiovascular disease.

Abstract 013: Early Life Stress Increases Susceptibility to Develop Obesity and Metabolic Syndrome in a Sex-specific Manner

Recent epidemiological studies demonstrate that women have a greater prevalence of metabolic syndrome with associated increases in fasting glucose not seen in men. Lifestyle factors including diet and physical activity contribute to the risk of developing metabolic disease; however, it has been reported that exposure to early life stress (ELS) has enduring emotional, immune, and metabolic disturbances resulting in increased risk for obesity and type II diabetes. To investigate the effects of ELS as an independent risk factor for metabolic disease, we expose C57Bl/6 mice to maternal separation (MSep), an established behavioral stress model during postnatal life. At weaning, mice were placed on a low-fat diet (LFD, n=6-10) or high-fat diet (HFD, 60% fat calories, n=10) for 16 weeks. Body weight (BW) gain was not different between MSep and control (C) mice when fed a LFD; however, only female MSep mice display higher fat mass compared to C (6.7 ± 0.5 vs. 5.2±0.5 g, p&lt;0.05). Magnetic resonance spectroscopy revealed elevated levels of visceral fat in female MSep mice compared to C, suggesting that MSep increases central adiposity. HFD increased BW in male MSep mice vs C (54.2± 0.7 vs 51.3 ± 0.5, p&lt;0.05); however, BW was dramatically exaggerated in female MSep mice vs. C (48.2± 1.3 vs 34.4 ±2.3 g, p&lt;0.05). Accordingly, fat mass was increased in female MSep mice vs. C (18.2 ± 1.4 vs. 7.6 ± 0 g, p&lt;0.05). Only female MSep exhibited significant impaired glucose tolerance (AUC: 18445±507 vs 22070± 696 AU, p&lt;0.05), hepatomegaly, hypercholesterolemia (156±20 vs. 82 ± 2 mg/dl, p&lt;0.05), hyperleptinemia and hyperinsulinemia (p&lt;0.05) compared to C. Because impaired metabolic function has been linked to inflammation, we characterized splenocytes in female HFD-fed mice. We found a lower population of T-cells but no difference in B-cells in MSep mice vs. C. Functional studies of T cell differentiation demonstrated a reduced capability of naïve T cells to differentiate into anti-inflammatory T regulatory cells in MSep mice vs. C (54± 4 vs. 66± 1 % FoxP3+/CD25+ cells, p&lt;0.05, n=3). The ability to polarize into the pro-inflammatory Th17 phenotype remained intact. These data suggest that the mechanisms by which MSep primes the metabolic responses are sex-specific. NIH R00 HL111354

Impact of Cadmium Exposure on the Association between Lipopolysaccharide and Metabolic Syndrome.

Cadmium (Cd) is an environmental contaminant that has a direct impact on the gut microbiome. Perturbations in the gut microbiome have been linked to metabolic disorders associated with inflammation generated by lipopolysaccharide (LPS). We investigated the impact of Cd on the association between LPS and metabolic syndrome. The study population consisted of 200 apparently healthy subjects (30–64 years of age; 96 men, 104 women). Serum LPS and blood Cd concentrations were measured by ELISA and graphite furnace-atomic absorption spectrophotometry (GF-AAS), respectively. The highest LPS quartile was associated with a greater prevalence of metabolic syndrome in men. There was a significant association between LPS activity and metabolic syndrome in men with blood Cd concentrations higher than the 50th percentile (OR = 3.05, 95% CI = 1.39–6.70); however, this relationship was not significant in men with blood Cd concentrations lower than the 50th percentile. The results of this study provide evidence for a strong association between high LPS activity and the prevalence of metabolic syndrome in men with relatively high blood Cd concentrations. Therefore, exposure to Cd may potentiate the association between LPS and metabolic syndrome in men.

Metabolic characteristics of youth with loss of control eating

PurposePreliminary data in adults suggest that binge eating is associated with greater prevalence of metabolic syndrome (MetS) components. However, there are limited data in youth, and little is known of the role of binge episode size in these relationships. MethodsWe examined the relationship between loss of control eating and metabolic characteristics in a convenience sample of 329 treatment-seeking and non-treatment-seeking adolescent boys and girls. The sample was enriched by design with adolescents who were overweight or obese and with individuals who reported episodes of loss of control over their eating (either objectively large binge episodes, OBEs or subjectively large binge episodes, SBEs, in the past month), as assessed by clinical interview. MetS components (blood pressure, lipids, glucose, and waist circumference) were the primary variables of interest. Results46% of the cohort reported loss of control eating; among those, 53% reported SBEs only and 47% reported OBEs. Youth with loss of control eating had higher systolic blood pressure (p=.001) and higher low-density lipoprotein cholesterol (LDL-c) (p=.002) compared to those without loss of control eating, in analyses adjusted for intervention-seeking status, fat mass and sociodemographic characteristics. Youth reporting OBEs had higher LDL-c (p=.013) compared to those reporting only SBEs. ConclusionsAdolescents reporting loss of control episodes had greater dysfunction in some components of the MetS compared to youth without loss of control; episode size may contribute to metabolic dysfunction.

Prevalence of Diabetes Mellitus and Metabolic Syndrome in Prostate Cancer Patients given Androgen Deprivation Therapy

Normal 0 false false false EN-US X-NONE AR-SA Objective. To compare the prevalence of diabetes mellitus (DM) and metabolic syndrome (MetS) in prostate cancer patients with or without androgen deprivation therapy (ADT). Methodology. This is a cross-sectional analytic study of p rostate cancer patients from the Integrated Surgical Information System database of the Philippine General Hospital from 2004-2010. Patients who received either continuous monthly GnRH agonist injection for at least 6 months or underwent bilateral orchiectomy at least 6 months prior (ADT group) were compared to those who did not (non-ADT group). Patients with DM and MetS were identified using the American Diabetes Association Standards of Medical Care in Diabetes 2010 and IDF Definition of Metabolic Syndrome. Results. The prevalence of DM in the ADT group is 42% and 19% in the non-ADT group (p = 0.0460). The probability of having DM is 2.17x higher among prostate cancer patients who received ADT compared to those who did not. The prevalence of metabolic syndrome in the ADT and non-ADT group is 37% and 28%, respectively (p=0.4620). Conclusions. Prostate cancer patients have become an important emerging population of medically at risk older men. Our study showed that the prevalence of DM is significantly higher among the ADT group, with a trend towards greater prevalence of metabolic syndrome in the same group. These men may benefit from closer monitoring for the development of these metabolic complications. /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:Times New Roman,serif; mso-ansi-language:EN-PH; mso-fareast-language:EN-PH;} Normal 0 false false false EN-US X-NONE AR-SA Objective [JAFES1] . To compare the prevalence of diabetes mellitus (DM) and metabolic syndrome (MetS) in prostate cancer patients with or without androgen deprivation therapy (ADT). Methodology [JAFES2] . This is a cross-sectional analytic study of p rostate cancer patients from the Integrated Surgical Information System database of the Philippine General Hospital from 2004-2010. Patients who received either continuous monthly GnRH agonist injection for at least 6 months or underwent bilateral orchiectomy at least 6 months prior (ADT group) were compared to those who did not (non-ADT group). Patients with DM and MetS were identified using the American Diabetes Association Standards of Medical Care in Diabetes 2010 and IDF Definition of Metabolic Syndrome. Results [JAFES3] . The prevalence of DM in the ADT group is 42% and 19% in the non-ADT group (p = 0.0460). The probability of having DM is 2.17x higher among prostate cancer patients who received ADT compared to those who did not. The prevalence of metabolic syndrome in the ADT and non-ADT group is 37% and 28%, respectively (p=0.4620). Conclusions [JAFES4] . Prostate cancer patients have become an important emerging population of medically at risk older men. Our study showed that the prevalence of DM is significantly higher among the ADT group, with a trend towards greater prevalence of metabolic syndrome in the same group. These men may benefit from closer monitoring for the development of these metabolic complications. [JAFES1] styles [JAFES2] styles [JAFES3] styles [JAFES4] styles /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:Times New Roman,serif; mso-ansi-language:EN-PH; mso-fareast-language:EN-PH;}

Relationship between metabolic syndrome and diagnoses of periodontal diseases among participants in a large Taiwanese cohort

Epidemiological studies suggested that individuals suffering from periodontitis present with greater prevalence of metabolic syndrome (MetS) and diabetes. We used a large health check-up data set in Taiwan to investigate this association. Data from 33,740 individuals, who undertook comprehensive health check-up at a university hospital in Taipei, Taiwan, were analysed. The dental examinations were undertaken by experienced dentists, and the diagnosis of MetS was made according to the criteria defined by the Third Adult Treatment Panel of the National Cholesterol Education Program. After adjusting for potential confounders, females and males in the periodontitis group had higher levels of blood pressure, blood glucose, triglyceride and body mass index, but lower high-density lipoprotein compared to controls. Females in the gingivitis and periodontitis group showed greater odds ratios [1.42 (95% CI: 1.30-1.56) and 1.52 (1.41-1.63) respectively] of being diagnosed with MetS, whereas males in the gingivitis and periodontitis group presented with odds ratios of being diagnosed with MetS of 1.06 (0.94-1.18) and 1.04 (0.96-1.12) respectively. A small but statistically significant association between MetS and the diagnosis of periodontal diseases was found in Taiwanese women and a weaker association in Taiwanese men.

The impact of hyperandrogenism in female obesity and cardiometabolic diseases associated with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common condition characterized by reproductive and hyperandrogenic features and is often associated with obesity and metabolic dysfunction. Overall, women with PCOS have a substantially greater prevalence of metabolic syndrome than women from the general population. Furthermore, PCOS per se (independent of its frequent association with obesity) often confers cardiometabolic risk (including insulin resistance), and its concurrence with obesity often represents a metabolic "double-whammy" from the adverse effects of PCOS and obesity. The introduction of the Rotterdam diagnostic criteria for PCOS in 2003 has broadened the scope of this condition. The Rotterdam diagnostic criteria have also introduced two new phenotypic subgroups (including normoandrogenemic women with PCOS) that have provided novel insights into a potential role for hyperandrogenism in the development of adverse cardiometabolic risk in women with PCOS. Based on evidence from cross-sectional and interventional studies, hyperandrogenism, obesity, and cardiometabolic risk in women appear to be linked through complex and multidirectional pathways. Furthermore, data from obese women without a formal diagnosis of PCOS also suggest that these interrelationships often exist in female obesity per se (in milder forms than occurs in PCOS). Data from female-to-male transsexuals are particularly informative because these show direct effects of hyperandrogenism (induced through exogenous use of androgenic therapies) on fat distribution and cardiometabolic risk in women. A challenge for the future will be to disentangle and improve our understanding of this complex pathogenic web, thereby facilitating novel and targeted therapies for the hyperandrogenic and adverse cardiometabolic manifestations of PCOS.

ASSOCIATIONS OF CARDIORESPIRATORY FITNESS AND FATNESS WITH METABOLIC SYNDROME IN RURAL WOMEN WITH PREHYPERTENSION

Background. This study investigated the associations of fitness and fatness with metabolic syndrome in rural women, part of a recognized US health disparities group. Methods. Fitness, percentage body fat, BMI, and metabolic syndrome criteria were assessed at baseline in 289 rural women with prehypertension, ages 40–69, enrolled in a healthy eating and activity community-based clinical trial for reducing blood pressure. Results. Ninety (31%) women had metabolic syndrome, of which 70% were obese by BMI (≥30 kg/m2), 100% by percentage body fat (≥30%), and 100% by revised BMI standards (≥25 kg/m2) cited in current literature. Hierarchical logistic regression models, adjusted for age, income, and education, revealed that higher percentage body fat (P < 0.001) was associated with greater prevalence of metabolic syndrome. Alone, higher fitness lowered the odds of metabolic syndrome by 7% (P < 0.001), but it did not lower the odds significantly beyond the effects of body fat. When dichotomized into “fit” and “unfit” groups, women categorized as “fat” had lower odds of metabolic syndrome if they were “fit” by 75% and 59%, for percentage body fat and revised BMI, respectively. Conclusion. Among rural women with prehypertension, obesity and fitness were associated with metabolic syndrome. Obesity defined as ≥25 kg/m2 produced results more consistent with percentage body fat as compared to the ≥30 kg/m2 definition.

Metabolic consequences of hepatic steatosis in overweight and obese adolescents.

OBJECTIVETo test the hypothesis that hepatic steatosis is associated with risk factors for type 2 diabetes in overweight and obese youth, mediated by cardiorespiratory fitness.RESEARCH DESIGN AND METHODSThis was a cross-sectional study comparing insulin sensitivity between 30 overweight and obese adolescents with hepatic steatosis, 68 overweight and obese adolescents without hepatic steatosis, and 11 healthy weight adolescents without hepatic steatosis. Cardiorespiratory fitness was determined by a graded maximal exercise test on a cycle ergometer. Secondary outcomes included presence of metabolic syndrome and glucose response to a 75-g oral glucose challenge.RESULTSThe presence of hepatic steatosis was associated with 55% lower insulin sensitivity (P = 0.02) and a twofold greater prevalence of metabolic syndrome (P = 0.001). Differences in insulin sensitivity (3.5 vs. 4.5 mU ⋅ kg−1 ⋅ min−1, P = 0.03), prevalence of metabolic syndrome (48 vs. 20%, P = 0.03), and glucose area under the curve (816 vs. 710, P = 0.04) remained between groups after matching for age, sex, and visceral fat. The association between hepatic steatosis and insulin sensitivity (β = −0.24, t = −2.29, P < 0.025), metabolic syndrome (β = −0.54, t = −5.8, P < 0.001), and glucose area under the curve (β = 0.33, t = 3.3, P < 0.001) was independent of visceral and whole-body adiposity. Cardiorespiratory fitness was not associated with hepatic steatosis, insulin sensitivity, or presence of metabolic syndrome.CONCLUSIONSHepatic steatosis is associated with type 2 diabetes risk factors independent of cardiorespiratory fitness, whole-body adiposity, and visceral fat mass.

Associations of cardiorespiratory fitness and fatness with metabolic syndrome in rural women with prehypertension.

Background. This study investigated the associations of fitness and fatness with metabolic syndrome in rural women, part of a recognized US health disparities group. Methods. Fitness, percentage body fat, BMI, and metabolic syndrome criteria were assessed at baseline in 289 rural women with prehypertension, ages 40–69, enrolled in a healthy eating and activity community-based clinical trial for reducing blood pressure. Results. Ninety (31%) women had metabolic syndrome, of which 70% were obese by BMI (≥30 kg/m2), 100% by percentage body fat (≥30%), and 100% by revised BMI standards (≥25 kg/m2) cited in current literature. Hierarchical logistic regression models, adjusted for age, income, and education, revealed that higher percentage body fat (P < 0.001) was associated with greater prevalence of metabolic syndrome. Alone, higher fitness lowered the odds of metabolic syndrome by 7% (P < 0.001), but it did not lower the odds significantly beyond the effects of body fat. When dichotomized into “fit” and “unfit” groups, women categorized as “fat” had lower odds of metabolic syndrome if they were “fit” by 75% and 59%, for percentage body fat and revised BMI, respectively. Conclusion. Among rural women with prehypertension, obesity and fitness were associated with metabolic syndrome. Obesity defined as ≥25 kg/m2 produced results more consistent with percentage body fat as compared to the ≥30 kg/m2 definition.

Metabolic abnormalities in an early psychosis service: a retrospective, naturalistic cross-sectional study

There is an increasing recognition of the impact of weight gain on the development of metabolic abnormalities in young people receiving atypical antipsychotic drugs for first-episode psychosis. This study examined the prevalence of such abnormalities in a specialist early-intervention community mental health team. A retrospective case record audit of 85 patients 16-27 years old attending the Early Psychosis Service between October 2006 and June 2008, who had at least one metabolic measure defined as: weight, body mass index (BMI), waist circumference, blood pressure, and fasting blood glucose and lipids. Metabolic syndrome identified by the International Diabetes Federation (IDF) criteria. Fifty-five percent of males and 42% of females were overweight or obese at a median treatment duration of 8 months. Duration of antipsychotic therapy was associated with higher BMI (r = 0.28, P < 0.01). More than 40% of the total sample had high waist circumference. Of the 64 subjects with complete metabolic data, eight (12.5%) met full IDF criteria for metabolic syndrome, and another 21 (32.8%) had either increased waist with one metabolic abnormality or normal waist and two metabolic abnormalities. Over a third of young patients being treated for their first episode of psychosis either had metabolic syndrome or showed metabolic abnormalities. Treatment duration related to higher BMI and greater prevalence of metabolic syndrome. Detection of metabolic complications after treatment instigation in patients with first-episode psychosis will permit early intervention with lifestyle or drug interventions in those at risk of significant physical health morbidity.

The frequency of metabolic syndrome in women with rheumatoid arthritis and in controls

To compare the frequency of the metabolic syndrome and its components in a sample of patients with rheumatoid arthritis (RA) and controls. This case control study was performed on 188 women over 18 years old: 92 RA patients and 96 healthy controls, from 2006 to 2008. Blood pressure, height, weight and waist circumference were measured. Blood was collected for the measurement of fasting glucose, lipid profile and insulin. The frequency of the metabolic syndrome was determined in case and control groups, using both WHO and National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. According to the NCEP criteria, the frequency of metabolic syndrome in RA patients and controls were 27.2% and 35.4%, respectively (P = 0.22). Based on WHO criteria, 19.6% of RA patients and 21.9% of the control group were subject to metabolic syndrome (P = 0.70). The proportion with hypertension was greater in RA patients than the control group. The duration of RA was significantly higher in patients with metabolic syndrome compared to those without metabolic syndrome using both the WHO and NCEP criteria. There was no evidence of a greater prevalence of metabolic syndrome in RA patients compared with controls in this study. The duration of RA was associated with metabolic syndrome, implicating the role of inflammation in metabolic syndrome development.

Progression of Segment-Specific Carotid Artery Intima-Media Thickness in Young Adults (from the Bogalusa Heart Study)

Carotid intima-media thickness (CIMT) progression is predictive of future cardiovascular events in middle-age and older adults. However, information is scant on segment-specific CIMT progression by race (black vs white) and gender and its predictors during short-term follow-up in asymptomatic young adults. B-mode ultrasound images of the far walls of both carotid arteries were obtained in 842 subjects aged 24 to 43 years and enrolled in the Bogalusa Heart Study (70% whites and 42% men). The CIMT and cardiometabolic risk variables were measured at baseline and after an average of 2.4 years. The mean CIMT progression rates/year adjusted for age, race, and gender were greatest at the bulb, followed by the internal and common carotid segments (p <0.0001). In a multivariate logistic model, age, mean arterial pressure, and high-density lipoprotein cholesterol were significantly associated with common CIMT progression. Smoking, age, insulin resistance index, and mean arterial pressure were significantly associated with bulb CIMT progression; and the waist/height ratio, smoking, age, and mean arterial pressure were significantly associated with internal CIMT progression, independent of the baseline CIMT and traditional cardiometabolic risk variables, including adiponectin, C-reactive protein, and intercellular adhesion molecules. In addition, the status of progression was associated with a greater prevalence of metabolic syndrome (common and internal CIMT, p <0.05; bulb CIMT, p <0.0001) and diabetes (bulb CIMT only, p <0.001). In conclusion, in younger adults, the magnitude of progression of CIMT within a short period varied in a segment-specific manner, regardless of race or gender, and was predictable using modifiable traditional risk factors. This could have implications for preventive and interventional cardiology.

Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index.

ObjectiveTo examine the relationship between body mass index and metabolic syndrome for Asian Americans and non-Hispanic Whites, given that evidence shows racial/ethnic heterogeneity exists in how body mass index predicts metabolic syndrome.Research Design and MethodsElectronic health records of 43 507 primary care patients aged 35 years and older with self-identified race/ethnicity of interest (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or non-Hispanic White) were analyzed in a mixed-payer, outpatient-focused healthcare organization in the San Francisco Bay Area.ResultsMetabolic syndrome prevalence is significantly higher in Asians compared to non-Hispanic Whites for every body mass index category. For women at the mean age of 55 and body mass index of 25 kg/m2, the predicted prevalence of metabolic syndrome is 12% for non-Hispanic White women compared to 30% for Asians; similarly for men, the predicted prevalence of metabolic syndrome is 22% for non-Hispanic Whites compared to 43% of Asians. Compared to non-Hispanic White women and men with a body mass index of 25 kg/m2, comparable prevalence of metabolic syndrome was seen at body mass index of 19.6 kg/m2 for Asian women and 19.9 kg/m2 for Asian men. A similar pattern was seen in disaggregated Asian subgroups.ConclusionsDespite lower body mass index values and lower prevalence of overweight/obesity than non-Hispanic Whites, Asian Americans have higher rates of metabolic syndrome over the range of body mass index. Our results indicate that body mass index ranges for defining overweight/obesity in Asian populations should be lower than for non-Hispanic Whites.