Individual Components Of MetS Research Articles

Correlation between Metabolic Syndrome and Gastric Cancer: Results of an Evidence-Based Strategy in Oriental Populations.

Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors, including abdominal obesity, hyperglycemia, hypertension, and dyslipidemia. Gastric cancer (GC) is a common malignancy with significant mortality rates. The relationship between MetS and GC risk remains controversial. This systematic review and meta-analysis aimed to evaluate the correlation between MetS and GC. Case-control studies investigating the association between MetS and GC were obtained from various databases, including China National Knowledge Infrastructure (CNKI), SinoMed, Embase, Web of Science, The Cochrane Library, and PubMed. The search was performed from the inception of each database up until September, 2023. Two researchers independently screened the literature, extracted data, and assessed the quality of the included studies. A meta-analysis of the included literature was conducted using Stata 12.0 software. The study protocol is registered in PROSPERO (CRD42023490410). A total of eight studies involving a combined sample size of forty-four thousand eight hundred and seventy participants were included in the meta-analysis. The findings revealed that the risk of developing GC was not significantly associated with body mass index, triglycerides, hypertension, high fasting glucose, or MetS. However, it was found to be positively correlated with high-density lipoprotein cholesterol (OR = 1.69, 95%CI: 1.35-2.12). This meta-analysis suggests that MetS is not significantly associated with an increased risk of GC. The risk of GC increases with the presence of individual MetS components, such as high-density lipoprotein cholesterol. Therefore, GC prevention strategies should include lifestyle modifications and targeted interventions to manage MetS and its components. CRD42023490410 (PROSPERO).

Abstract PO4-19-12: Trial in progress: An Observational Study to Examine Changes in Metabolic Syndrome Components in Patients With Breast Cancer Receiving (Neo)Adjuvant Aromatase Inhibitors

Abstract Background: (Neo) adjuvant systemic therapy has been shown to adversely impact metabolic health manifested as weight gain, dyslipidemia, and insulin resistance, which ultimately lead to the development of metabolic syndrome (MetS). MetS increases the risk of development for type 2 diabetes mellitus and cardiovascular disease and is associated with an increased risk of breast cancer recurrence, death due to breast cancer, and all-cause mortality. We have previously reported that 76% of metabolically healthy women receiving (neo) adjuvant chemotherapy will develop MetS at a median of 15 weeks. The impact of aromatase inhibitors (AIs) on metabolic health has not been systematically assessed in a longitudinal study. We hypothesize that AIs in the (neo) adjuvant setting will alter metabolic parameters and have embarked on a clinical trial to study this. Methods: This is a prospective observational study that will include: postmenopausal patients with newly diagnosed, early-stage hormone receptor (HR)-positive breast cancer with planned (neo)adjuvant treatment with an AI. Participants will be excluded if they have received or have planned treatment with (neo)adjuvant chemotherapy or are currently receiving antidiabetic medications or cholesterol-lowering agents. All patients will undergo a baseline assessment that includes: BMI, physical exam inclusive of blood pressure, waist circumference, assessment of body fat, lipid profile, insulin, metabolic biomarkers, and completion of the Functional Assessment of Cancer Therapy – Endocrine Symptoms (FACT-ES). Following institution of an AI, reassessment of the aforementioned tests will be repeated after 4 months and 12 months of therapy. The primary endpoint is the change in insulin resistance (as measured by HOMA-IR, homeostatic model assessment for insulin resistance) at 4 months. Secondary endpoints include the change in HOMA-IR at 12 months and the change in individual MetS components, metabolic biomarkers, anthropometric measurements, as well as FACT-ES scores from baseline to 4- and 12-months of AI treatment. The mean paired differences will be calculated for HOMA-IR measurements as well as for the secondary endpoints, and the 1-sided paired t-test will be used to test for statistical significance. One-way analysis of covariance will be used to compare means while adjusting for age, race/ethnicity, and BMI. Using a 1-sided paired t-test for the mean difference in HOMA-IR measurements from baseline to 4 months, we will have 80% power to detect an effect size of 0.405 with 40 patients (α = 0.05). Enrollment began in April 2023 and is ongoing. Contact alevee@coh.org for more information. Given the increased recognition of the importance of metabolic health in breast cancer outcomes, this data will inform future trials that focus on maintaining metabolic health in breast cancer survivors. Citation Format: Alexis LeVee, Nora Ruel, Victoria Seewaldt, Joanne Mortimer. Trial in progress: An Observational Study to Examine Changes in Metabolic Syndrome Components in Patients With Breast Cancer Receiving (Neo)Adjuvant Aromatase Inhibitors [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-19-12.

57 Utilizing a Digital Phenotype for Metabolic Syndrome to Elucidate Risk Profiles for Neurocognitive Disease: An Electronic Medical Record Study

OBJECTIVES/GOALS: Metabolic syndrome (MetS), defined as a cluster of cardiometabolic disease risk factors, is seldom coded using the ICD-10 system in electronic medical records (EMR). The goal of this study was to use EMR to construct MetS with a digital phenotype to amplify the pool of patients available to assess risk for neurocognitive disease in this population. METHODS/STUDY POPULATION: A digital phenotype using the EMR platform TriNetX (n=38 million patients between age 50 and 80) was created by clustering codes for the individual components of MetS (insulin resistance, hypertension, dyslipidemia, and central adiposity). The research network database on TriNetX was utilized to elucidate risk ratios for neurocognitive decline, Alzheimer’s disease and related dementias (ADRDs), and cerebrovascular disease between a preclinical sample of older adults with and without MetS. Propensity score matching was used to match cohorts on demographic variables, medication use, and relevant comorbidities. Risk ratios (RR) and confidence intervals (95% CI) were presented for all outcomes. RESULTS/ANTICIPATED RESULTS: The digital phenotype for MetS expanded the sample from 29,830 to 274,703, a 10-fold increase. Sensitivity to the standard MetS ICD-10 code was 95.1%, showing strong agreement between coding schema. Older adults with MetS had higher risk of cognitive decline (RR: 1.30, 95% CI: 1.15–1.48, p <0.001), ADRDs (RR: 1.48, 95% CI: 1.25–1.75, p <0.001), and cerebrovascular issues (RR: 1.62, 95% CI: 1.55–1.70, p <0.001) when controlling for demographics, medication, and comorbidities. MetS individuals with cerebrovascular dysfunction had even greater risks for neurocognitive decline (RR: 1.70, 95% CI: 1.38–2.08, p < 0.001) and ADRDs (RR: 2.09, 95% CI: 1.56–2.80, p < 0.001) than those with only MetS. DISCUSSION/SIGNIFICANCE: Implementing a digital MetS phenotype in EMR effectively increased sample size and power for analyses. Older adults with MetS have higher risk for neurocognitive decline, especially among those with cerebrovascular dysfunction, highlighting a critical intervention window prior to overt cardiometabolic disease.

Metabolic syndrome, its components, and gastrointestinal cancer risk: a meta-analysis of 31 prospective cohorts and Mendelian randomization study.

Cohort studies have linked metabolic syndrome (MetS) to gastrointestinal (GI) cancer risk. We aimed to evaluate the associations between MetS, its components, and combinations of MetS components with eight GI cancers risk. We conducted a systematic search of prospective cohort studies and performed a meta-analysis. Subgroup analyses regarding diagnostic criteria, sex, cancer sites, histological subtypes, ethnic groups, and studies adjusted for alcohol consumption were carried out. Mendelian randomization (MR) was employed to evaluate the causality between 17 MetS-related traits and eight GI cancers among Europeans and Asians separately. Meta-analyses of 31 prospective studies indicated that MetS was significantly associated with an increased risk of colorectal cancer (CRC) (RR [95% CI]=1.13 [1.12-1.15]), esophageal cancer (EC) (RR [95% CI]=1.17 [1.03-1.32]), gallbladder cancer (GBC) (RR [95% CI]=1.37[1.10-1.71]), liver cancer (LC) (RR [95% CI]=1.46 [1.29-1.64]), and pancreatic cancer (PaC) (RR [95% CI]=1.25 [1.20-1.30]), but not gastric cancer (GC) (RR [95% CI]=1.11 [0.96-1.28]). Regarding the associations between MetS components and GI cancers risk, the following associations showed statistical significance: obesity-CRC/LC/EC/, hypertriglyceridemia-LC/PaC, reduced high-density lipoprotein (HDL)-CRC/LC/GC/PaC, hyperglycemia-CRC/LC/PaC, and hypertension-CRC/LC/EC/PaC. Sex-specific associations were observed between individual MetS components on GI cancers risk. Among the top three common combinations in both sexes, obesity+HTN+hyperglycemia had the strongest association with CRC risk (RR [95% CI]=1.54 [1.49-1.61] for males and 1.27 [1.21-1.33] for females). MR analyses revealed causality in 16 exposure-outcome pairs: waist-to-hip ratio/BMI/HbA1c-CRC; BMI/childhood obesity/waist circumference/T2DM/glucose-EC; BMI/waist circumference/cholesterol-LC; cholesterol/childhood obesity/waist circumference/HbA1c-PaC; and HbA1c-GBC. These results were robust against sensitivity analyses. Since MetS is reversible, lifestyle changes or medical interventions targeting MetS patients might be potential prevention strategies for GI cancers.

Associations between metabolic syndrome and markers of brain pathologies: the role of sex‐differences

AbstractBackgroundIn old age, cardiovascular and metabolic disorders rarely occur in isolation, but rather cluster together, in the so‐called metabolic syndrome (MetS). Although individual MetS components (obesity, hypertension, diabetes, and dyslipidemia) have been linked to dementia, their combined effect on cognition remains poorly explored. We recently showed that MetS was associated with clinically relevant cognitive decrements in otherwise cognitively healthy septuagenarians. However, the mechanistic underpinnings are unknown. This study investigates the association between MetS and markers of neurodegenerative and cerebrovascular pathologies, considering sex‐differences.MethodWithin the Gothenburg H70‐Birth cohort 1944, we included 741 cognitively intact septuagenarians with available brain MRI (n = 286 with cerebrospinal fluid [CSF] samples). MetS was identified according to standard criteria as the presence of at least three conditions: central obesity, raised blood pressure, raised blood glucose, reduced HDL‐cholesterol, or elevated triglycerides. MRI markers of brain pathology included overall (mean cortical thickness) and Alzheimer’s disease (AD; average cortical thickness in signature areas) neurodegeneration as well as cerebrovascular pathology including small vessel disease (SVD) and DTI’s microstructural white‐matter changes. CSF biomarkers included t‐tau, neurofilament light, and neurogranin (overall neurodegeneration), Aβ42 and p‐tau (AD), and CSF/serum albumin ration (blood‐brain barrier integrity). Analyses included linear, quantile, and logistic regression models as well as interaction and stratification by sex.ResultOverall, 410 participants (53%) had MetS; 196 were women. In multi‐adjusted regressions (by sex, education, heart disease, and APOE‐ɛ4 allele), MetS was associated with increased likelihood of neurodegeneration (OR = 2.0, 95%CI 1.4–2.9) and AD (OR = 1.8, 95%CI 1.4–2.6), high SVD burden (presence of ≥3 SVD compared to none: OR = 2.1, 95%CI 1.1‐4.3), and greater microstructural white‐matter changes. In the CSF sample, MetS was associated with higher CSF/serum albumin ratio. In analyses stratified by sex, men with MetS (reference: no‐MetS) had increased odds of higher SVD burden, particularly of enlarged perivascular spaces (ePVS; OR = 2.9, 95%CI 1.7–5.0). Such differences were not observed between women with and without MetS. No associations were observed between MetS and amyloid and tau biomarkers.ConclusionMetS in late‐life increased the likelihood of neurodegenerative and cerebrovascular pathologies. SVD, especially ePVS, appears more prominent in men with MetS than women.

LEP (G2548A-G19A) and ADIPOQ (T45G-G276T) gene polymorphisms are associated with markers for metabolic syndrome

Background and aimsThere is a link between genetics with metabolic balance and adiposity homeostasis on metabolic syndrome (MetS). Polymorphism in adipokine genes such as leptin and adiponectin may play an important role in its development. This study aimed to determine the association of the individual and general components of MetS with genetic alterations in LEP (rs7799039 and rs2167270) and ADIPOQ (rs1501299 and rs2241766) genes in the Mexican population.Methods and resultsThe polymorphisms of the LEP gene rs7799039 and rs2167270, together with rs1501299 and rs2241766 polymorphisms of the ADIPOQ gene were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) on 328 individuals (n = 131 MetS). The rs7799039 under the recessive inheritance model was found to be associated with increased risk of MetS (OR = 2.16, 95% CI = 1.06–4.37), dyslipidemia (OR = 7.97, 95% CI = 2.17–29.36), low HDL (OR = 7.01, 95% CI = 1.65–29.71) and hypertension (OR = 13.02, 95% CI = 1.76–96.44); the heterozygote demonstrate a protective effect on MetS (OR = 0.48, 95% CI = 0.28–0.88) and diabetes (OR = 0.09, 95% CI = 0.02–0.53) under the over the dominant model. Haplotype analysis showed linkage disequilibrium between the SNPs of ADIPOQ rs1501299/rs2241766, and their association as risk factors for low HDL and hypertension.ConclusionThe association of rs7799039 with the presence of MetS, suggests a risk factor for the development of dyslipidemia, as well as its heterozygous as a protective factor for DM. There is a linkage disequilibrium between the SNPs of ADIPOQ.

Metabolic Syndrome and the Risk of Ductal Carcinoma In Situ of the Breast in the UK Biobank.

Metabolic syndrome (MetS), defined by the presence of three of more metabolic dysregulations such as hyperlipidemia, hyperinsulinemia, central obesity, and hypertension, has been associated with increased risk of cardiovascular disease, diabetes, and various cancers, including invasive breast cancer (IBC). Whether MetS is a risk factor for ductal carcinoma in situ of the breast (DCIS), a nonobligate precursor of IBC, remains unknown. A total of 198,748 women ages 40 to 69 years, DCIS- and IBC-free at enrolment in UK Biobank, were included in the current study. Multivariable-adjusted Cox proportional hazards models were used to estimate the association between MetS and DCIS. A total of 1,251 DCIS cases were ascertained during an average follow-up of 11.4 years. There was no association between MetS and the risk of DCIS overall, or by menopausal status. Analysis of individual components of MetS showed an association between central obesity (waist circumference ≥88 cm) and increased DCIS risk in postmenopausal women. In this prospective study, we found no association between MetS and DCIS risk. The study findings do not support an association between MetS and this breast cancer precursor.

Abstract 18621: Platelet Aggregation is Heightened in Those With Metabolic Syndrome and Less Effectively Mediated by Aspirin Therapy

Background: Patients with metabolic syndrome (MetS) are at a higher risk of developing cardiovascular disease (CVD); however, interventions to mitigate this risk are not fully known. Platelets play a significant role in atherothrombosis, and aspirin is an important, yet controversial therapy used for the primary prevention of CVD. In this study, we examined platelet phenotype in MetS and degree of inhibition from ex vivo aspirin administration. Methods: In a study examining the mechanisms of atherothrombosis in pro-inflammatory conditions, patients without clinical CVD were enrolled and underwent phenotyping. Patients with MetS (n = 34, age 53.3 ± 13 years, 59% male) were compared to patients with no MetS (n = 63, age 41.1 ± 16 years, 52% male). Platelet aggregation of freshly isolated platelets was measured via light transmission aggregometry (LTA) in resting and stimulated conditions, in response to agonists adenosine diphosphate (ADP), high and low dose of arachidonic acid (AA), and after ex vivo aspirin (ASA) administration. Results: MetS patients were older and similar in sex and race (Figure 1A). As expected, patients with MetS had higher individual components of MetS, yet similar LDL-C (Figure 1A). Platelet aggregation to low dose ADP (p=0.09) and AA (p=0.04) was significantly increased in MetS (Figure 1B). Platelet aggregation in response to AA and coincubation with ASA was significantly lower in the no MetS cohort (Figure 1C). The efficacy of aspirin therapy was significantly lower in MetS (Figure 1D). In response to high dose AA after ASA treatment, platelet aggregation increased as number of MetS parameters also increased (Figure 1E). However, no individual metabolic syndrome parameter appeared to be driving these findings (Figure 1E). Conclusion: Among MetS patients, platelet aggregation is heightened and less inhibited by aspirin than those with no MetS. Additional research is warranted to explore possible anti-platelet strategies in patients with MetS.

Association of Endocrine Disrupting Chemicals With the Metabolic Syndrome Among Women in the Multiethnic Cohort Study.

Metabolic syndrome (MetS) is associated with a high risk of cardiovascular disease, a leading cause of death among women. MetS is a diagnosis of at least 3 of the following: high blood pressure, high fasting glucose, high triglycerides, high waist circumference, and low high-density lipoprotein cholesterol. Epidemiological studies suggest that endocrine disrupting chemical (EDC) exposure is positively associated with individual components of MetS, but evidence of an association between EDCs and MetS remains inconsistent. In a cross-sectional analysis within the Multiethnic Cohort Study, we evaluated the association between 4 classes of urinary EDCs (bisphenol A [BPA], triclosan, parabens, and phthalates) and MetS among 1728 women. Multivariable logistic regression was used to estimate odds ratios and 95% CI for the association between tertiles of each EDC and MetS adjusting for age, body mass index (BMI), racial and ethnic group, and breast cancer status. Stratified analyses by race and ethnicity and BMI were conducted. MetS was identified in 519 (30.0%) women. We did not detect statistically significant associations of MetS with BPA, triclosan, or phthalate metabolite excretion. MetS was inversely associated with total parabens (Ptrend = .002). Although there were suggestive inverse associations between EDCs and MetS among Latino and African American women, and women with BMI < 30 kg/m2, there was no statistically significant heterogeneity in associations by race and ethnicity or BMI. These findings suggest an inverse association between parabens and MetS in larger multiethnic studies. Prospective analyses to investigate suggested differences in associations by race, ethnicity, and BMI are warranted.

Heterogeneity in familial clustering of metabolic syndrome components in the multiethnic GENNID study.

Metabolic syndrome (MetS) is defined by clustering of cardiometabolic components, which may be present in different combinations. The authors evaluated clustering in individuals and extended families within and across ancestry groups. The prevalence of different combinations of MetS components (high fasting glucose, low high-density lipoprotein cholesterol, high triglycerides, high blood pressure, and abdominal obesity) was estimated in 1651 individuals (340 families) self-reporting as European American (EA), Hispanic/Mexican American (MA), African American (AA), and Japanese American (JA). Odds ratios were estimated using logistic regression with generalized estimating equations comparing individual MetS components, number, and combinations of components for each ancestry group versus EA. Clustering of all five components (Combination #16) was more prevalent in EA (29.9%) and MA (25.2%) individuals than in AA (18.7%) and JA (15.5%) individuals. Compared with EA individuals, AA individuals were 64% and 66% less likely to have high triglycerides and low high-density lipoprotein cholesterol, whereas JA individuals were 85% and 56% less likely to have abdominal obesity and high blood pressure, respectively. Compared with EA individuals, the odds of having two, four, or five components were at least 77% lower in JA individuals, whereas the odds of having three, four, or five components were at least 3.79 times greater in MA individuals. Understanding heterogeneity in MetS clustering may identify factors important in reducing health disparities.

Non-HDL cholesterol and long-term follow-up outcomes in patients with metabolic syndrome

BackgroundNon-high-density lipoprotein-cholesterol (non-HDL-C) has been identified as a potential biomarker for metabolic syndrome (MetS). However, its predictive capability for MetS varies among different ethnic groups, necessitating further investigation. This study aimed to assess the role of non-HDL-C in the early diagnosis of MetS in the Iranian population through a longitudinal study with a 10-year follow-up period.MethodsOur study enrolled 4684 individuals from the MASHAD (Mashhad Stroke and Heart Atherosclerotic Disorder) cohort who were followed for 10 years to examine the association between non-HDL-C and the incidence of MetS. Additionally, the contribution of individual MetS components to the overall burden was evaluated.ResultsA total of 1599 subjects developed MetS, while 3085 did not. Non-HDL-C levels ≥ 130 were associated with a 42% higher risk of developing MetS (relative risk (RR), 1.42; 95% confidence interval (CI), 1.25–1.62). Regarding MetS components, elevated waist circumference (WC) showed the strongest association with MetS incidence (RR, 2.32; 95% CI, 1.45–2.9), whereas triglyceride (TG) levels ≥ 150 mg/dL demonstrated the weakest association (RR, 1.23; 95% CI, 1.04–1.46). Additionally, higher HDL-C levels were reported to be 20% protective against the risk of MetS (RR, 0.8; 95% CI, 0.73–0.86). Moreover, fasting blood glucose (FBG) levels ≥ 100 mg/dL were not significantly linked to MetS burden, while systolic blood pressure (BP) levels ≥ 130 mmHg or diastolic BP levels ≥ 85 mmHg increased the risk of MetS incidence (RR, 1.25; 95% CI: 1.11–1.41).ConclusionsElevated non-HDL-C and increased WC serve as significant predictors of MetS in Iranians. Strategies targeting non-HDL-C levels and weight loss should be emphasized to mitigate the risk of MetS development.

Independent association between age- and sex-specific metabolic syndrome severity score and cardiovascular disease and mortality

Traditional metabolic syndrome (MetS) criteria have several limitations, which hinder its use in clinical practice. To overcome the limitations, we investigated the association between age- and sex-specific continuous MetS severity score (cMetS-S) and cardiovascular disease (CVD) and mortality beyond MetS components in the framework of the Tehran Lipid and Glucose Study. Participants aged 20–60 years at baseline were included in the study. We excluded participants with CVD, cancer, use of corticosteroids, estimated glomerular filtration rate < 30 ml/min/1.73 m2, and those who were pregnant. We evaluated the association between cMetS-S with CVD and mortality over 18 years of follow-up among 8500 participants with continuous and quantile approaches using the Cox proportional hazard regression model. In addition, the model performance of cMetS-S for predicting CVD events was compared to the conventional MetS criteria. Participants with higher cMetS-S had a significantly increased risk for CVD, coronary (CHD) and non-coronary heart disease (non-CHD), and all-cause, cardiovascular, and sudden cardiac death. Independent of the confounders and MetS components, the cMetS-S had the HRs of 1.67 (95% CI 1.47–1.89), 1.60 (95% CI 1.37–1.86), and 1.88 (95% CI 1.50, 2.35) for CVD, CHD, and non-CHD events upon 1-SD increment, respectively. The risk of mortality was increased for 1-SD of cMetS-S (all-cause mortality, HR 1.24; 95% CI 1.09–1.41; CVD mortality, HR 1.72; 95% CI 1.20–2.45; sudden cardiac death, HR 1.60; 95% CI 1.03–2.49). The model fitness of cMetS-S was superior to the conventional MetS criteria in predicting CVD and mortality. The cMetS-S provided an additional risk for CVD and mortality beyond the individual MetS components. Standardized cMetS-S could be a potential universal measure to define MetS severity while considering the weighted contribution of MetS components and their variations by age, sex, and ethnicity.

Metabolic syndrome and erectile dysfunction: a systematic review and meta-analysis study.

The clinical significance of metabolic syndrome (MetS) versus its single components in erectile dysfunction (ED) is conflicting. Thus, the purpose is to analyze the available evidence on the relationship between MetS-along with its components-and ED. All prospective and retrospective observational studies reporting information on ED and MetS were included. In addition, we here reanalyzed preclinical and clinical data obtained from a previously published animal model of MetS and from a consecutive series of more than 2697 men (mean age: 52.7 ± 12), respectively. Data derived from this meta-analysis showed that MetS was associated with an up to fourfold increased risk of ED when either unadjusted or adjusted data were considered. Meta-regression analysis, performed using unadjusted statistics, showed that the MetS-related risk of ED was closely associated with all the MetS components. These associations were confirmed when unadjusted analyses from clinical models were considered. However, fully adjusted data showed that MetS-associated ED was more often due to morbidities included (or not) in the algorithm than to the MetS diagnostic category itself. MetS is also associated with low testosterone, but its contribution to MetS-associated ED-as derived from preclinical and clinical models-although independent, is marginal. The results of our analysis suggest that MetS is a useless diagnostic category for studying ED. However, treating the individual MetS components is important, because they play a pivotal role in determining ED.

A network analysis investigating the associations between posttraumatic stress symptoms, markers of inflammation and metabolic syndrome

Chronic systemic inflammation has been implicated in trauma exposure, independent of a psychiatric diagnosis, and in posttraumatic stress disorder (PTSD) and its highly comorbid conditions, such as metabolic syndrome (MetS). The present study used network analysis to examine the interacting associations between pro-inflammatory cytokines, posttraumatic stress (PTS) symptoms and symptom clusters, and individual components of MetS, in a cohort of 312 participants (n = 139 PTSD cases, n = 173 trauma-exposed controls). Pro-inflammatory cytokines were measured in serum samples using immunoturbidimetric and multiplex assays. Three network models were assessed, and the decision on which model to use was guided by network stability estimates and denseness. Weak negative associations were observed between interleukin one beta (IL-1β) and detachment (D6) and irritability (E1); tumour necrosis factor alpha (TNFα) and hypervigilance (E3); and C-reactive protein (CRP) and emotional cue reactivity (B4), which could be due to high cortisol levels present in a female-majority cohort. Network models also identified positive associations between CRP and waist circumference, blood pressure, and high-density lipoprotein cholesterol (HDL-C). The strongest association was observed between CRP and waist circumference, providing evidence that central obesity is an important inflammatory component of MetS. Some networks displayed high instability, which could be due to the small pool of participants with viable cytokine data. Overall, this study provides evidence for associations between inflammation, PTS symptoms and components of MetS. Future longitudinal studies measuring pro-inflammatory cytokines in the immediate aftermath of trauma are required to gain better insight into the role of inflammation in trauma-exposure and PTSD.

Plasma Carotenoids and Polyphenols and Their Association with MetS: The Need for Nutritional Interventions.

Metabolic syndrome (MetS) is characterized by increased pro-oxidative stress and a chronic inflammation state and their consequent alterations. Several studies have highlighted the protective effect of carotenoids and polyphenols in MetS patients. This study aimed to evaluate the plasma level of selected carotenoids and polyphenols and to determine their relationship with MetS severity, MetS components, and inflammatory markers in Polish adults with metabolic disorders. It was designed as a cross-sectional study. The final study group comprised 275 adults, including 158 women and 117 men. Data were collected on the frequency of consumption of selected food groups. Anthropometric measurements and blood samples were taken to determine the concentration of carotenoids, polyphenols, and indicators (parameters) of metabolic disorders. Plasma concentrations of selected carotenoids and polyphenols were low in adults with MetS. The highest concentrations of carotenoids and polyphenols in the blood were observed for lutein and phenolic acids (including gallic and p-coumaric acids). Nevertheless, a correlation was found between the individual bioactive compounds and MetS components. In terms of the lipid profile, our study showed that the plasma of the selected carotenoids and polyphenols positively correlated with HDL cholesterol (zeaxanthin; total carotenoids), LDL cholesterol (chlorogenic acid), triglycerides (lycopene), and the total cholesterol (kaempferol). We found that the level of CRP as a marker of inflammation negatively correlated with the concentration of zeaxanthin. In our study group, no relationship was found between the dietary antioxidant intensity and the variables studied, which may be attributed to the low frequency of consumption of the sources of bioactive compounds, such as carotenoids and polyphenols, but also to the metabolic disorders. Further research is needed to determine whether these associations are causally related to the metabolic syndrome or are a result of the pathologies of the syndrome or improper diet with a low intake of vegetables and fruit.

Dissecting Relations between Depression Severity, Antidepressant Use, and Metabolic Syndrome Components in the NHANES 2005-2020.

We aimed to dissect the complex relations between depressive symptoms, antidepressant use, and constituent metabolic syndrome (MetS) components in a representative U.S. population sample. A total of 15,315 eligible participants were included from 2005 to March 2020. MetS components were defined as hypertension, elevated triglycerides, reduced high-density lipoprotein cholesterol, central obesity, and elevated blood glucose. Depressive symptoms were classified as mild, moderate, or severe. Logistic regression was used to evaluate the relationship between depression severity, antidepressant use, individual MetS components and their degree of clustering. Severe depression was associated with the number of MetS components in a graded fashion. ORs for severe depression ranged from 2.08 [95%CI, 1.29-3.37] to 3.35 [95%CI, 1.57-7.14] for one to five clustered components. Moderate depression was associated with hypertension, central obesity, raised triglyceride, and elevated blood glucose (OR = 1.37 [95%CI, 1.09-1.72], 1.82 [95%CI, 1.21-2.74], 1.63 [95%CI, 1.25-2.14], and 1.37 [95%CI, 1.05-1.79], respectively). Antidepressant use was associated with hypertension (OR = 1.40, 95%CI [1.14-1.72]), raised triglyceride (OR = 1.43, 95%CI [1.17-1.74]), and the presence of five MetS components (OR = 1.74, 95%CI [1.13-2.68]) after adjusting for depressive symptoms. The depression severity and antidepressant use were associated with individual MetS components and their graded clustering. Metabolic abnormalities in patients with depression need to be recognized and treated.

Abstract #1405166: The Association of Thyroid Stimulating Hormone Among the Reference Range and its Change with the Incidence of Metabolic Syndrome in a 5-year Prospective Cohort Study

Although a number of studies have explored the association between thyroid stimulating hormone (TSH) among the normal range and the prevalence of metabolic syndrome (MetS), the conclusions are conflicting. We aimed to investigate the association of TSH among the reference range and its change (ΔTSH) with the incidence of MetS. In this prospective population-based cohort study, 1501 participants with baseline TSH among the reference range were divided into three groups by tertile cut-off values and 1386 participants with the normal TSH levels both in 2014 and 2019 were divided into three groups by ΔTSH in tertiles. Binary logistic regression models were used to estimate the associations of TSH and ΔTSH with MetS and its components. The reported association was measured using the odds ratios (ORs) and 95% confidence intervals (CIs). Compared with the lowest baseline TSH group, the highest group of TSH was associated with a higher incidence of MetS (OR 1.659; 95% CI 1.089, 2.525) in women after adjusting for important confounders. Among the individual components of MetS, the highest group of TSH was associated with central obesity (OR 1.746; 95% CI 1.135,2.685) in women. There was a lack of association between ΔTSH and MetS in both sexes. However, a significant relationship was found for the highest group of ΔTSH and central obesity (OR 1.887; 95% CI 1.144, 3.114) in men. Moreover, the middle (OR 2.526; 95% CI 1.374, 4.645) and high groups (OR 2.057; 95% CI 1.104, 3.833) of ΔTSH were associated with hypertriglyceride in women. Our results suggest that an increase in TSH levels even among the normal range is related to a higher risk of MetS and certain components. It is important to monitor basic TSH as well as the dynamic changes of TSH.

Metabolic syndrome and risk of incident heart failure in non-diabetic patients with established cardiovascular disease

BackgroundIn patients with established cardiovascular disease (CVD), the relation between metabolic syndrome (MetS) and incident heart failure (HF) in the absence of diabetes mellitus (DM) is largely unknown. This study assessed this relation in non-diabetic patients with established CVD. MethodsPatients from the prospective UCC-SMART cohort with established CVD, but without DM or HF at baseline were included (n = 4653). MetS was defined according to the Adult Treatment Panel III criteria. Insulin resistance was quantified using the homeostasis model of insulin resistance (HOMA-IR). The outcome was a first hospitalization for HF. Relations were assessed using Cox proportional hazards models adjusted for established risk factors: age, sex, prior myocardial infarction (MI), smoking, cholesterol, and kidney function. ResultsDuring a median follow-up of 8.0 years, 290 cases of incident HF were observed (0.81/100 person years). MetS was significantly related to an increased risk of incident HF independent of established risk factors (hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.04–1.68, HR per criterion 1.17; 95% CI 1.06–1.29), as was HOMA-IR (HR per standard deviation [SD] 1.15; 95% CI 1.03–1.29). Of the individual MetS components, only higher waist circumference independently increased the risk of HF (HR per SD 1.34; 95% CI 1.17–1.53). Relations were independent of the occurrence of interim DM and MI, and were not significantly different for HF with reduced vs preserved ejection fraction. ConclusionIn CVD patients without a current diagnosis of DM, MetS and insulin resistance increase the risk of incident HF independent of established risk factors.

The Effect of Metabolic Syndrome and Its Individual Components on Renal Function: A Meta-Analysis

Observational studies have reported inconsistent findings in the relationship between metabolic syndrome (MetS), its components, and loss of renal function, mainly including eGFR decline, new-onset CKD, and ESRD. This meta-analysis was performed to investigate their potential associations. PubMed and EMBASE were systematically searched from their inception to 21 July 2022. Observational cohort studies in English assessing the risk of renal dysfunction in individuals with MetS were identified. Risk estimates and their 95% confidence intervals (CIs) were extracted and pooled using the random-effects approach. A total of 32 studies with 413,621 participants were included in the meta-analysis. MetS contributed to higher risks of renal dysfunction (RR = 1.50, 95% CI = 1.39-1.61) and, specifically, rapid decline in eGFR (RR 1.31, 95% CI 1.13-1.51), new-onset CKD (RR 1.47, 95% CI 1.37-1.58), as well as ESRD (RR 1.55, 95% CI 1.08-2.22). Moreover, all individual components of MetS were significantly associated with renal dysfunction, while elevated BP conveyed the highest risk (RR = 1.37, 95% CI = 1.29-1.46), impaired fasting glucose with the lowest and diabetic-dependent risk (RR = 1.20, 95% CI = 1.09-1.33). Individuals with MetS and its components are at higher risk of renal dysfunction.

Handgrip Strength Is Associated with Metabolic Syndrome and Insulin Resistance in Children and Adolescents: Analysis of Korea National Health and Nutrition Examination Survey 2014-2018.

Reduced handgrip strength (HGS) is associated with adverse cardiometabolic health outcomes. We examined HGS, metabolic syndrome (MetS), and insulin resistance (IR) in children and adolescents. The following population-based data from 2,797 participants (aged 10-18 years) of the Korea National Health and Nutrition Examination Survey 2014-2018 were analyzed: complete anthropometric measures, HGS, MetS, and IR (subgroup with fasting insulin, n=555). HGS was analyzed as the combined HGS (CHGS) and the normalized CHGS (nCHGS=CHGS divided by body weight). At a mean age of 14.4 years, 276 participants (9.9%) had abdominal obesity, 56 (2.0%) had MetS, and 118 (20.9%) had IR. Individual components of MetS and IR were inversely associated with the nCHGS. The odds ratios (ORs) for MetS and IR decreased significantly with higher nCHGS after adjustment for sex, age, physical activity, and sedentary times. The optimal cut-off values that predicted MetS were 0.80 kg/kg (males) and 0.71 kg/kg (females), with significant associations with MetS (OR: 7.4 in males; 5.7 in females) and IR (OR: 3.3 in males; 3.2 in females) observed when nCHGS values were lower than those cut-offs. HGS is associated with MetS and IR and might be a useful indicator of cardiometabolic risk factors in children and adolescents.