Individual Components Of Metabolic Syndrome Research Articles

A Study of Prevalence of Renal Function Abnormalities and Their Association with the Individual Components of Metabolic Syndrome.

Metabolic syndrome (MetS) is one of the most important emerging pandemics of the 21st century and is associated with renal dysfunction in a significant number of subjects, the association of which is shown to be of greater significance in the South Asian population. The prevalence of renal dysfunction in patients with MetS is the primary outcome. The secondary outcome is to assess the strength and significance of the association between the individual components of MetS and the presence of renal dysfunction. This is a hospital-based cross-sectional observational study conducted for 2 years in a tertiary care hospital in India. A total of 100 diagnosed subjects of MetS were taken as cases and underwent relevant blood tests. Data were collected and analyzed in a Statistical Package for the Social Sciences (SPSS) v29 sheet. Over a period of 18 months, 100 subjects with MetS were documented, among which 66% had albuminuria, with microalbuminuria being 24% and the rest being macroalbuminuria. Among the same subjects, 30% had an estimated glomerular filtration rate (eGFR) <60 mL/minute/1.73m2. Waist circumference (WC) [measured by the National Institutes of Health (NIH) protocol] had the strongest association with increased albuminuria (r = 0.540; p-value < 0.001) as well as reduced eGFR (r = 0.460; p-value < 0.001). All the components of MetS, for example, increased WC, hypertension, increased fasting glucose, raised triglyceride (TG), and low high-density lipoprotein (HDL), have statistically significant correlations with increased urine albumin-to-creatinine ratio (ACR) and decreased eGFR, signifying glomerular injury and renal dysfunction, respectively.

The Effects of Sustained Immunosuppression Withdrawal After Liver Transplantation on Metabolic Syndrome.

Liver transplant (LT) recipients often experience adverse effects of immunosuppressive (IS) drugs, especially on metabolic profiles. Selected LT recipients can achieve successful IS withdrawal; however, its effects on metabolic syndrome (MS) are unknown. This is a retrospective single-center study investigating the incidence and/or regression of MS in 75 selected LT recipients who were previously enrolled in prospective IS withdrawal trials between 1999 and 2017. Patients who were transplanted due to nonalcoholic steatohepatitis/metabolic-associated fatty liver disease were excluded, as well as those with a follow-up <3 y after IS weaning. Forty-four patients (58.7%) achieved sustained withdrawal or minimization of immunosuppression (WMIS) and 31 patients (41.3%) required reintroduction of immunosuppression (no-WMIS). Among LT recipients who were metabolically healthy (n = 52, 69.3%) before the start of IS weaning, there was a significantly lower rate of de novo MS in WMIS patients compared with no-WMIS patients after 5 y (8.3% and 47.8%, respectively, P = 0.034). Of 23 LT recipients (30.7%) who had MS at the time of commencing IS withdrawal, complete regression of MS was observed in 47.1% of WMIS patients and in none (0%) of the no-WMIS patients after 5 y (P = 0.054). Furthermore, individual components of MS were better controlled in IS-weaned patients, such as arterial hypertension and abnormal serum lipids. Achievement of sustained IS withdrawal reduces the incidence of de novo MS development in metabolically healthy patients and increases the likelihood of MS regression in patients with established MS. The foreseeable long-term beneficial effects of these favorable metabolic changes on morbidity and mortality of LT recipients require further investigation.

The association between dietary patterns and metabolic syndrome among Iranian adults, a cross-sectional population-based study (findings from Bandare-Kong non-communicable disease cohort study)

BackgroundMetabolic syndrome is a cluster of metabolic disorders increasing the risk of cardiovascular disease and diabetes. Dietary patterns are supposed to be important and controllable factors in developing metabolic syndrome. The purpose of this study was to investigate the association of dietary patterns with metabolic syndrome and its components.Subjects/MethodsCross-sectional data were extracted from the Bandare-Kong cohort study conducted on 4063 people aged 35 to 70. Dietary patterns were extracted using principal component analysis based on thirty-eight pre-defined food groups. Multivariable logistic regression was conducted to investigate the association between metabolic syndrome and its components with quintiles of dietary patterns in crude and adjusted models.ResultsThree major dietary patterns were identified (healthy, western, and traditional) in the final analysis of 2823 eligible individuals. After adjusting for covariates, the odds of metabolic syndrome were significantly decreased by 46% in subjects with the highest adherence to the healthy dietary pattern compared to those with the lowest adherence quintile. Results from fully adjusted models on individual metabolic syndrome components showed an inverse association between higher adherence to the healthy dietary pattern and the odds of increased blood glucose, high waist circumference, and elevated blood pressure. However, in fully adjusted models, no significant association was observed between the western and traditional dietary patterns with odds of metabolic syndrome and its components.ConclusionsAdherence to a healthy dietary pattern containing high amounts of fruits, vegetables, nuts, low-fat dairy products, and legumes, could be recommended to prevent and control metabolic syndrome.

Exposure to per- and polyfluoroalkyl substance and metabolic syndrome: A nationally representative cross-sectional study from NHANES, 2003–2018

Per- and polyfluoroalkyl substances(PFAS) are widespread organic pollutants with endocrine-disrupting effects on human health, but the association of PFAS exposure with metabolic syndrome remains conflicting. National Health and Nutrition Examination Survey(NHANES) program was utilized to evaluate the association of individual PFAS exposure and metabolic disorders and further determined the joint effect of PFAS co-exposures. 13921 participants and five PFAS exposures(PFHxS, MPAH, PFDE, PFNA, and PFUA) were included for analysis. The association between individual PFAS and metabolic syndrome varied in the specific PFAS and the specific metabolic disorder examined. PFHxS was negatively associated with obesity(Q4; OR = 0.75; P < 0.001), but positively associated with hyperlipidemia (Q3; OR = 1.2; P = 0.013). PFUA was negatively associated with obesity (Q4; OR = 0.6; P < 0.001), hyperlipidemia (Q3; OR = 0.85; P = 0.03), and non-alcoholic fatty liver disease (NAFLD, Q4; OR = 0.64; P = 0.015), but positively associated with hyperglycemia(Q3; OR = 1.27; P = 0.004). Furthermore, PFAS co-exposures were negatively associated with obesity(OR = 0.63; P < 0.001) and NAFLD(OR = 0.85; P = 0.021), and positively associated with hyperlipidemia(OR = 1.05; P = 0.022), but not significantly associated with hyperglycemia or hypertension. Overall, there was a negative association between PFAS co-exposures and metabolic severity score(β = −0.15; P < 0.001). Subgroup analysis stratified by gender and obesity consistently showed the negative association of PFAS co-exposures with metabolic severity score, and the positive association with hyperlipidemia. However, subgroup analysis showed a negative association with NAFLD in females but not in males, and a negative association with hyperglycemia in the obesity group, but not in the non-obesity group. Collectively, our study showed a negative association of PFAS co-exposures with metabolic syndrome severity score, but did not support a consistent association between PFAS co-exposures and individual components of metabolic syndrome. Additionally, there were gender-specific as well as BMI-specific differences in these associations. Further studies are needed to rule out the reverse causality and clarify the relationship of PFAS co-exposures with the specific metabolic disorder.

Reduction of prevalence of patients meeting the criteria for metabolic syndrome with tirzepatide: a post hoc analysis from the SURPASS Clinical Trial Program

BackgroundMetabolic syndrome is characterized as the co-occurrence of interrelated cardiovascular risk factors, including insulin resistance, hyperinsulinemia, abdominal obesity, dyslipidemia and hypertension. Once weekly tirzepatide is approved in the US and EU for the treatment of type 2 diabetes (T2D) and obesity. In the SURPASS clinical trial program for T2D, tirzepatide demonstrated greater improvements in glycemic control, body weight reduction and other cardiometabolic risk factors versus placebo, subcutaneous semaglutide 1 mg, insulin degludec, and insulin glargine. This post hoc analysis assessed the effect of tirzepatide use on the prevalence of patients meeting the criteria for metabolic syndrome across SURPASS 1–5.MethodsMetabolic syndrome was defined as having ≥ 3 of 5 criteria according to the US National Cholesterol Education Program: Adult Treatment Panel III. Analyses were based on on-treatment data at the primary endpoint from patients adherent to treatment (taking ≥ 75% study drug). A logistic regression model with metabolic syndrome status as the response variable, metabolic syndrome status at the baseline visit as an adjustment, and randomized treatment as fixed explanatory effect was used. The effect of tirzepatide use on the prevalence of patients meeting the criteria for metabolic syndrome by categorical weight loss, background medication and gender were assessed.ResultsIn SURPASS, the prevalence of patients meeting the criteria for metabolic syndrome at baseline was 67–88% across treatment groups with reductions at the primary endpoint to 38–64% with tirzepatide versus 64–82% with comparators. Reductions in the prevalence of patients meeting the criteria for metabolic syndrome was significantly greater with all tirzepatide doses versus placebo, semaglutide 1 mg, insulin glargine, and insulin degludec (p < 0.001). Individual components of metabolic syndrome were also reduced to a greater extent with tirzepatide vs comparators. Greater reductions in body weight were associated with greater reductions in the prevalence of patients meeting the criteria for metabolic syndrome and its individual components. Background SGLT2i or sulfonylurea use or gender did not impact the change in prevalence of patients meeting the criteria for metabolic syndrome.ConclusionsIn this post hoc analysis, tirzepatide at all doses studied was associated with a greater reduction in the prevalence of patients meeting the criteria for metabolic syndrome compared to placebo, semaglutide 1 mg, insulin degludec, and insulin glargine. Although more evidence is needed, these data would support greater potential improvement in cardiovascular risk factor profile with tirzepatide treatment in people across the continuum of T2D.

(090) The Relationship Between C-Reactive Protein and Total Testosterone in Aging Men: Findings from the Baltimore Longitudinal Study of Aging

Abstract Introduction Elevated C-Reactive Protein (CRP) and testosterone deficiency are associated with advanced age and chronic inflammatory diseases, such as cancer, diabetes, and cardiovascular disease. Testosterone decreases inflammation through several mechanisms, and testosterone replacement therapy (TRT) has been shown to lower CRP levels in aging, hypogonadal men. While cross-sectional studies have shown an inverse relationship between CRP and total testosterone (TT) levels, mixed findings have been reported when individual components of metabolic syndrome are considered. We hypothesized that men with testosterone deficiency will have high levels of CRP. Objective We evaluated the relationship between CRP and TT levels in men from 2004-2018 using the Baltimore Longitudinal Study of Aging and specifically attempted to determine if low androgen status is associated with a high inflammatory profile independent of comorbidities. Methods Male participants with serum TT level measured during two separate visits &amp;gt;3 years apart were included in our cohort. CRP, High-Density Lipoprotein (HDL) and Triglyceride levels were collected via blood specimens. Comorbidity data were documented at each visit. Panel regression was used to analyze the relationship of a series of independent variables collected in pooled cross-sectional observations over time with a dependent variable for modeling. Results A total of 347 patients were included in this study (mean age = 69 ± 15, average follow up time = 6.7 ± 3.2 years). Participants had a median CRP level of 1.0 mg/dL and a median TT level of 446 ng/dL. On univariable analysis TT and HDL levels were associated with a decline in CRP, while BMI, congestive heart failure (CHF), Diabetes, and Triglycerides were associated with increased CRP. Age was not associated with CRP. On multivariable analysis, we found that increasing TT level was associated with a decline in CRP levels, independent of comorbidities (p = 0.018; Table 1). BMI was associated with a significant increase in CRP (p = 0.001, Table 1). Age, CHF, Diabetes, HDL, and Triglycerides were not significant predictors of CRP on multivariable analysis. Conclusions Lower levels of serum total testosterone are associated with an increased CRP in older men. Given the importance of CRP in pathogenesis of chronic disease, we highlight the potential benefits of restoring testosterone levels in older, hypogonadal men via TRT. Disclosure No.

Metabolic syndrome and breast cancer risk

BackgroundLimited data are available on metabolic syndrome and its relation to breast cancer risk in Egypt. We aimed to study metabolic syndrome and its individual components as risk of breast cancer.MethodsThis case–control study recruited 112 breast cancer cases and 112 age-matched controls from Assiut University. In addition to demographic, clinical, and anthropoemetric characteristics, blood samples were collected from both study groups to evaluate metabolic syndrome and its individual components.ResultsMean age of breast cancer cases and control groups was 46.10 ± 4.34 and 45.66 ± 4.68 years, respectively. According to Joint Interim Statement (JIS) criteria for clinical diagnosis of metabolic syndrome, the overall prevalence of metabolic syndrome in all participants was 42.9%, and prevalence in breast cancer cases and control group was 57.14% and 28.6%, respectively, OR 33.33, 95% CI (1.91–5.81). BMI was more likely to be higher in breast cancer patients with a linear trend, p < 0.001. For individual components of metabolic syndrome, breast cancer cases were more likely to have high fasting blood glucose level, systolic and/or diastolic blood pressure, high triglycerides level, and low HDL-C as compared to the control group.ConclusionMetabolic syndrome and its components were found to be associated with the risk of breast cancer. We believe that prevention or reversal of metabolic syndrome by raising community awareness for lifestyle changes could be an effective way in minimizing the toll of the disease.

New perspectives on the use of melatonin in menopausal metabolic syndrome

Introduction Metabolic syndrome is a complex of disorders including abdominal obesity, impaired glucose tolerance, dyslipidemia, and arterial hypertension. Antioxidant and anti-inflammatory properties of the pineal hormone melatonin are of great importance for preserving body homeostasis, and potentially melatonin can be a a safe and effective agent in the complex treatment of menopausal women with metabolic syndrome.The aim of the study is to determine the prospects of using the epiphysis hormone melatonin in the complex treatment of menopausal metabolic syndrome based on the analysis of scientific publications.Material and methods The review includes data from studies on the effect of melatonin (MT) on the components of metabolic syndrome in periand postmenopausal women. Sources were searched for the period 2016–2023 in the international databases Medline, Scopus, Web of Science and the Russian scientific electronic library eLibrary by search words and phrases: melatonin, menopause, perimenopause, metabolic syndrome, obesity, insulin resistance, dyslipidemia, arterial hypertension.Results and Discussion The analysis of the literature data showed a number of advantages of the effect of exogenous MT preparations on individual components of metabolic syndrome, but some results were contradictory. Scientific evidence of MT influence on anthropometric indices, markers of glucose homeostasis, hemodynamic parameters and signs of body's inflammatory response, as well as multidirectional effects on lipid profile was found.Conclusion Given the multifunctionality and safety of exogenous MT preparations, its use in the complex therapy of menopausal metabolic syndrome should be considered.

Association between Renal Function and Individual and Combined Components of Metabolic Syndrome in Elderly People in Brazil

Background: Current literature highlights that chronic kidney disease (CKD) is a public health problem and that metabolic syndrome (MS) is a potential risk factor, especially among the elderly population, since aging seems to create metabolic disorders such as hypertension, hypertriglyceridemia, and glycemic decompensation. Despite this, some mechanisms/events of the relationship between kidney damage and MS remain controversial. Objective: The objective of this study is to investigate the association of compromised glomerular filtration rate with metabolic syndrome and its components in a population of Brazilian elderly. Methods: This is a cross-sectional study carried out in Northeast Brazil with 273 elderly men and women aged between 60 and 93 years. Clinical, sociodemographic, anthropometric, and lifestyle data, as well as biochemical, blood pressure, and glomerular filtration rate variables, were evaluated. Data were analyzed using Stata® (Statacorp, College Station, Texas, USA), version 14, adopting a significance level of p&lt;0.05. The research has ethical approval (no. 2,216,538). Results: There was a significant difference between impaired renal function and adequate values of WC (p = 0.044), triglycerides (p = 0.018), LDL-c (p = 0.015), and the presence of more than three components of MS (p = 0.036). High values of triglycerides (PR 1.48; p = 0.025) and LDLc (PR 1.44; p = 0.017) and presence of more than three components of MS (PR 1.45; p = 0.023) increase the chance of kidney damage. Conclusion: The presence of individual and combined components of MS (high triglycerides, cholesterol and LDL-c, and low HDL-c) promotes the impairment of renal function among the elderly studied. It is noteworthy that MS does not represent a significant independent factor to generate losses to GFR.

A study of correlation between clinical profile of patients with non- alcoholic fatty liver disease and individual components of metabolic syndrome at a tertiary care centre in Uttarakhand region: an observational cross-sectional study

Background: Research indicates that the occurrence of non-alcoholic fatty liver disease (NAFLD) in India is reported to range from approximately 9% to 32%. This study aims to examine the clinical characteristics of subjects diagnosed with NAFLD and investigate the association between NAFLD and individual components of metabolic syndrome. Methods: This was a cross-sectional, hospital-based study, conducted over a period of 2 months from May 2017 to June 2017 in patients attending medicine OPD or admitted in IPD in AIIMS Rishikesh. Study population included sonologicaly diagnosed cases of NAFLD of age group 18 to 70 years. Patients with a history of jaundice, positive viral markers for hepatitis C or hepatitis B, pregnant women, individuals who consume alcohol, and patients with a history of hepatotoxic drug consumption were excluded. Results: A total of 40 NAFLD cases, as confirmed ultrasonographically, were included in the study. Out of all the patients diagnosed with NAFLD, 26 (65%) were found to have metabolic syndrome based on the NCEP ATP III criteria. Upon investigating the correlation between NAFLD and individual components of metabolic syndrome, a significant association (p&lt;0.05) was observed with BMI, waist circumference, systolic and diastolic blood pressure, as well as serum triglyceride levels. Conclusions: Uttarakhand being hilly region mainly, it is expected that lifestyle will be healthy due to cultural and environmental factors, but rapid urbanisation has led to change in lifestyle which needs to be addressed in the population of this Himalayan state.

Correlation between Primary Knee Osteoarthritis and Metabolic Syndrome among Egyptian Patients

Abstract Background Previous studies have suggested that metabolic syndrome is associated with osteoarthritis (OA). However, analyses have not addressed whether levels of individual metabolic syndrome components are related to OA. This study was undertaken to examine the relationship of metabolic syndrome and its components with radiographic and symptomatic knee OA Objective To assess the impact of metabolic syndrome and its components on the degree of structural damage and function impairment in a sample of Egyptian patients with symptomatic primary knee OA. Patients and Methods In this study, 116 Egyptian osteoarthritic patients were included, Patients were divided into 2 groups: Group A: includes 58 osteoarthritic patients with metabolic syndrome. Group B: includes 58 osteoarthritic patients without metabolic syndrome. Results There was a positive correlation detected between HAQ and hypertension with P-Value 0.002. There was a positive correlation detected between WOMAC and hypertension with P-Value 0.000.we found that OA was sever in hypertensive patients, old age, patients with high waist circumference and high levels of CRP, TG, FBG and 2HPP with P-value &amp;gt; 0.001. While there was no correlation between X-ray grading with and ESR, uric acid, cholesterol, LDL, HDL, HBA1C and insulin resistance with P-Value &amp;gt; 0.05 Conclusion We concluded that patients with knee OA and metabolic syndrome has more radiological damage and severe grades of functional disability in comparative to patients with OA without MS.

Metabolic Syndrome among Patients with Psoriasis Attending the Outpatient Department of Dermatology, Venereology and Leprology in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction: Metabolic syndrome, a constellation of features such as obesity, hypertension, dyslipidemia and insulin resistance is of common occurrence in patients with psoriasis. Systemic inflammation is supposed to play a significant role in both conditions. The co-occurrence of metabolic syndrome and psoriasis can result in clinical consequences. The aim of this study was to find out the prevalence of metabolic syndrome among patients with psoriasis attending the Outpatient Department of Dermatology, Venereology and Leprology in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Outpatient Department of Dermatology, Venereology and Leprology from 4 July 2022 to 4 May 2023. The ethical approval was obtained from Institutional Review Committee (Reference number: CMC-IRC/078/079-300). Patients aged more than 18 years diagnosed with psoriasis who provided written consent were enrolled in the study. Pregnant female patients and those who did not give informed consent were excluded from the study. Convenience sampling method was used. Point estimate and 90% Confidence Interval were calculated. Results: Among 72 patients with psoriasis, the prevalence of metabolic syndrome was 15 (20.83%) (12.98-28.68, 90% Confidence Interval). Obesity 13 (86.67%) and hypertriglyceridemia 13 (86.67%) were the frequent most individual components of metabolic syndrome. Conclusions: The prevalence of metabolic syndrome among psoriatic patients was lower than other studies done in similar settings.

Individual components of metabolic syndrome as a prognostic factor for morbidity and mortality in COVID-19

Background: COVID-19 has emerged as a rapidly spreading pandemic with millions of deaths. We aimed to investigate whether metabolic syndrome can be used as a prognostic factor for the outcome of patients infected with this viral disease, regarding the ICU stay, the requirement of mechanical ventilation (MV) and mortality. Methodology: This retrospective study included 90 patients admitted to intensive care unit (ICU) of Ain Shams University for pneumonic COVID-19 with a confirmed positive RT-PCR for COVID-19 and positive changes on chest computed tomography, over a period of 10 months from July 2021 to April 2022. They were divided into two groups according to the presence or absence of metabolic syndrome. The primary outcome measured was the length of ICU stay. Secondary outcome was the percentage of patients requiring mechanical ventilation (MV) and the mortality rate in the two groups. Results: Patients with metabolic syndrome had higher liver transaminases, random blood glucose, triglycerides, ferritin, and P/F ratio compared to those without metabolic syndrome (P &lt; 0.05). Components of metabolic syndrome such as hypertension, type 2 diabetes mellitus, and obesity significantly increased the risk of hospitalization and mortality in COVID-19 patients (P &lt; 0.05). Conclusion: Metabolic syndrome is a better prognostic indicator for severe disease outcomes in patients with COVID-19 than its individual components. Although patients with metabolic syndrome didn’t have a higher need for mechanical ventilation, they had longer duration of ICU stay and a higher mortality rate. Abbreviations: ACE-2: angiotensin-converting enzyme-2, hs-CRP: High sensitivity C-reactive protein,ICU: Intensive care unit, MV: Mechanical ventilation, MS: Metabolic syndrome, ROC: Receiver operating characteristic Key words: Metabolic Syndrome; COVID-19; ICU; Mechanical ventilation; Mortality Citation: Refaat SA, Elshaer AN, Hamza AH, Abdou AMH, SakrHAM. Individual components of metabolic syndrome as a prognostic factor for morbidity and mortality in COVID-19. Anaesth. pain intensive care 2023;27(3):343−350. DOI: 10.35975/apic.v27i3.2225 Received: February 14, 2023; Reviewed: March 08, 2023; Accepted: March 16, 2023

0282 Behavioral–social rhythms and metabolic syndrome prevalence in retired night shift and day workers

Abstract Introduction Disrupted sleep and circadian rhythms, such as those occurring during night shift work, are established cardiovascular disease (CVD) risk factors like hypertension, obesity, and insulin resistance. However, we do not know whether the effects of shift work on CVD risk factors persist into retirement. Conversely, regularity in behavioral-social rhythms – the systematic patterning or timing of daily routines like work/housework, sleeping, eating and social interactions – may keep endogenous circadian rhythms synchronized to the 24-hour day and reduce CVD risk. This study examined: 1) whether behavioral–social rhythms are associated with a major CVD risk factor, prevalent metabolic syndrome, in retired night shift workers and day workers; and 2) whether past night shift work exposure moderates the associations between behavioral–social rhythm and metabolic syndrome prevalence. Methods Participants were 71 retired night shift workers (39 women (54.9%), 32 men (45.1%)) and 83 retired day workers (46 women (55.4%), 37 men (44.6%)), with mean age 68.4 (5.4) years. Logistic regression models were used to examine associations between behavioral–social rhythms and metabolic syndrome prevalence. Independent variables included Social Rhythm Metric-5 (SRM5; a 5-item scale to quantify rhythms of daily life) score and actigraphy rest-activity rhythm inter-daily stability (IS; rhythm stability across days) and intra-daily variability (IV; rhythm fragmentation within days). The dependent variable was metabolic syndrome prevalence. Results More regular behavioral-social rhythms were associated with lower odds of having metabolic syndrome (SRM5: OR=0.57, 95%CI [0.35, 0.88]; IV (Higher score means lower regularity): OR=2.05, 95%CI [1.23, 3.44]). In addition, more regular behavioral-social rhythms were associated with lower odds of having two individual components of metabolic syndrome , body mass index (SRM5: OR=0.56, 95%CI [0.37, 0.85]; IV: OR=2.05, 95%CI [1.30, 3.23]) and high-density lipoprotein cholesterol level (SRM5: OR=0.49, 95%CI [0.30, 0.80]; IV: OR=1.78, 95%CI [1.06, 2.98]). Shift work exposure did not moderate the association between behavioral–social rhythms and metabolic syndrome prevalence. Conclusion Behavioral–social rhythms are related to metabolic syndrome prevalence in retired adults regardless of prior shift work exposure. Older retired workers may benefit from interventions that promote behavioral–social rhythm regularity. Support (if any) This research was supported by the NIH grants AG047139, HL082610, MH019986, and AG07517

(068) Total Testosterone is Inversely Associated with C-reactive Protein Levels in Men: Findings from the Baltimore Longitudinal Study of Aging

Abstract Introduction Elevated C-Reactive Protein (CRP) and testosterone deficiency are associated with advanced age and chronic inflammatory diseases, such as cancer, obesity, diabetes, and cardiovascular disease. Further, serum CRP has proven to be a robust predictor of major adverse cardiovascular events. Testosterone decreases inflammation through several mechanisms, and testosterone replacement therapy (TRT) has been shown to consistently lower CRP levels in aging, hypogonadal men. While cross-sectional studies have shown an inverse relationship between CRP and total testosterone (TT) levels, mixed findings have been reported when individual components of metabolic syndrome and additional comorbidities are considered. Given that androgens have been implicated in anti-inflammatory pathways, we hypothesize that men with testosterone deficiency will have low CRP levels, independent of added comorbidities. Objective We evaluated the relationship between CRP and TT levels in men from 2004-2018 using the Baltimore Longitudinal Study of Aging. Methods Male participants with a documented serum TT level measured via mass spectroscopy during two separate visits &amp;gt;3 years apart were included in our cohort. CRP, High-Density Lipoprotein (HDL), and Triglyceride levels were collected via blood specimens. Comorbidity data were documented for all participants at each follow-up visit. Patients with serum TT or CRP levels &amp;gt;3 standard deviations from the mean of each respective variable were removed. Men with documented use of any form of TRT or a history of prostate cancer were excluded. Panel regression, a statistical technique implemented to analyze the relationship of a series of independent variables collected in pooled cross-sectional observations over time with a dependent variable, was used for univariable and multivariable modeling of CRP. P-value &amp;lt; 0.05 was considered statistically significant. Results A total of 347 patients (694 visits) met the inclusion criteria of this study. The median age of our sample was 71 years with a follow-up time of 8 years (range: 3-13 years). Participants had a median CRP level of 1.03 mg/dL [0.52, 2.11] and a median TT level of 446 ng/dL [339, 560]. In terms of comorbidities, diabetes was documented most frequently, followed by congestive heart failure (CHF) and cancer (Table 1). On univariable analysis TT, cancer, and HDL were associated with a decline in CRP, while BMI, CHF, Diabetes, and Triglycerides were associated with increased CRP. Age was not associated with CRP (Table 2). On multivariable analysis, we found that increasing TT was associated with a decline in CRP levels, independent of comorbidities (p = 0.022; Table 2). The strengths of our study include having well-documented laboratory values and comorbidity information for patients at multiple visits. However, causal associations cannot be inferred due to the retrospective nature of the data. Conclusions We report that an increase in TT is associated with a decline in CRP levels, after controlling for components of metabolic syndrome and other related comorbidities. This finding is consistent with the anti-inflammatory effects of androgens, which decrease pro-inflammatory mediators and leukotriene biosynthesis. Our study further highlights the benefits of restoring eugonadal testosterone levels in older, hypogonadal men via hormone replacement, potentially lowering CRP levels and reducing cardiovascular risk. Disclosure No

PD26-07 TESTOSTERONE IS ASSOCIATED WITH ABDOMINAL BODY COMPOSITION DERIVED FROM COMPUTED TOMOGRAPHY: A LARGE CROSS SECTIONAL STUDY

You have accessJournal of UrologyCME1 Apr 2023PD26-07 TESTOSTERONE IS ASSOCIATED WITH ABDOMINAL BODY COMPOSITION DERIVED FROM COMPUTED TOMOGRAPHY: A LARGE CROSS SECTIONAL STUDY Ji Hyung Yoon, Chongsuk Chae, Taekmin Kwon, Sungchan Park, Kyung Hyun Moon, Sang Hyeon Cheon, and Seong Cheol Kim Ji Hyung YoonJi Hyung Yoon More articles by this author , Chongsuk ChaeChongsuk Chae More articles by this author , Taekmin KwonTaekmin Kwon More articles by this author , Sungchan ParkSungchan Park More articles by this author , Kyung Hyun MoonKyung Hyun Moon More articles by this author , Sang Hyeon CheonSang Hyeon Cheon More articles by this author , and Seong Cheol KimSeong Cheol Kim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003304.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A close relationship exists among testosterone, metabolic syndrome, and abdominal body composition. However, few studies have evaluated the relationship between testosterone and abdominal body composition after adjusting for metabolic syndrome. We evaluated the association between serum testosterone and abdominal body composition based on abdominopelvic computed tomography measurements after adjusting for individual metabolic syndrome components in a large cohort who voluntarily underwent health examinations. METHODS: We performed a cross-sectional study using subjects who underwent a general health examination with abdominopelvic computed tomography and testosterone measurements at our hospital between March 2014 and June 2019. Body composition was evaluated with abdominopelvic computed tomography. To confirm an association between testosterone and abdominal body composition, we conducted linear regression analysis. The effect of abdominal body composition was adjusted for important clinical factors such as age, albumin, and metabolic components in the multivariable regression analysis. RESULTS: Overall, 1,453 subjects were included in the primary analysis. The mean age of the study participants was 55.2±8.4 years, and the mean serum testosterone level was 4.36±1.73 ng/ml. In the univariable linear regression analyses, the loge-transformed testosterone had a negative correlation with hemoglobin A1c (unstandardized β=-0.060, p<0.001) and C-reactive protein ≥2.0 mg/dL (unstandardized β=-0.381, p<0.001). All metabolic syndrome components had a negative correlation with the loge-transformed testosterone. Regarding abdominal body composition, subcutaneous fat area index (unstandardized β=-0.048, p<0.001), visceral fat area index (unstandardized β=-0.026, p<0.001), total abdominal muscle area index (unstandardized β=0.110, p<0.001), and normal attenuation muscle area index (unstandardized β=0.076, p<0.001) had an association with the loge-transformed testosterone. After adjustment for age, individual metabolic syndrome components, albumin, hemoglobin A1c, and C-reactive protein ≥2 mg/dL, we found that subcutaneous fat area index (unstandardized β=-0.042, p<0.001), total abdominal muscle area index (unstandardized β=0.115, p<0.001), normal attenuation muscle area index (unstandardized β=0.070, p<0.001), and loge-transformed lower attenuation muscle area index (unstandardized β=0.140, p=0.002) had an association with loge-transformed testosterone level. CONCLUSIONS: After adjusting for individual metabolic syndrome components, testosterone was significantly associated with subcutaneous fat, but not visceral fat. In addition, testosterone was positively correlated with abdominal muscle regardless of qualitative features such as fat-rich and fat-free. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e737 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ji Hyung Yoon More articles by this author Chongsuk Chae More articles by this author Taekmin Kwon More articles by this author Sungchan Park More articles by this author Kyung Hyun Moon More articles by this author Sang Hyeon Cheon More articles by this author Seong Cheol Kim More articles by this author Expand All Advertisement PDF downloadLoading ...

Association of acanthosis nigricans with metabolic syndrome – An analytic cross-sectional study

BackgroundGlobally, few studies have been undertaken to assess the association of acanthosis nigricans (AN) with metabolic syndrome (MS). Most of the available studies have either focused on a particular age group, gender, ethnicity or on a single component of MS. ObjectivesTo determine the association between AN and MS as a whole and with all individual components of MS in adult patients of either gender. Material and methodsThis was a cross-sectional study with a comparative group. Eighty-one subjects were recruited in each group. Fasting plasma glucose (FPG) and lipid profile were done. MS was defined by using the international diabetic federation (IDF) criteria. Association of body mass index (BMI), waist circumference, blood pressure, FPG, high-density lipoprotein (HDL) and triglycerides (TG) with AN was assessed by Pearson’s chi-square test followed by univariate and multivariate analysis. ResultsThe prevalence of MS was found to be significantly higher in the group with AN. On univariate analysis, a significant association of AN was found with BMI, waist circumference, high systolic and diastolic blood pressure, HDL, and TG. Multivariate analysis revealed a significant association between waist circumference, high systolic and diastolic blood pressure, and high TG levels with AN. The risk of MS was found to be eight times higher in cases of AN. Study limitationsThe small sample size and single-center data are the limitations of the present study. ConclusionAN is strongly associated with MS as a whole and with its individual components including increased waist circumference, hypertension, and dyslipidemia.

A review of research on the intersection between breast cancer and cardiovascular research in the Women's Health Initiative (WHI).

Both obesity and metabolic syndrome are linked to increased incidence of type 2 diabetes, cardiovascular disease (CVD), and cancers of the breast (post-menopausal), and other obesity-related cancers. Over the past 50 years, the worldwide prevalence of obesity and metabolic syndrome has increased, with a concomitant higher incidence of associated co-morbidities and mortality. The precise mechanism linking metabolic syndrome to increased cancer incidence is incompletely understood, however, individual components of metabolic syndrome have been linked to increased breast cancer incidence and worse survival. There is a bidirectional relationship between the risk of CVD and cancer due to a high burden of shared risk factors and higher rates of CVD among cancer survivors, which may be impacted by the pro-inflammatory microenvironment associated with metabolic syndrome and cancer-directed therapies. The Women's Health Initiative (WHI) is an excellent resource to study a dual relationship between cancer and CVD (cardio-oncology) with extensive information on risk factors and long-term outcomes. The purpose of this review is to provide an overview of research on cardio-oncology conducted utilizing WHI data with focus on studies evaluating both breast cancer and CVD including shared risk factors and outcomes after cancer. The review also includes results on other obesity related cancers which were included in the analyses of breast cancer, articles looking at cancer after heart disease (reverse cardio-oncology) and the role of Clonal Hematopoiesis of Indeterminate Potential (CHIP) as a shared risk factor between CVD and cancer. A summary of pertinent WHI literature helps to delineate the direction of future research evaluating the relationship between CVD and other cancer sites, and provides information on the opportunity for other novel analyses within the WHI.

Abstract P564: Prevalence of Metabolic Syndrome in a Young Sub-Saharan African Community

Background: Metabolic syndrome is known as a predictor of cardiovascular disease (CVD), a leading cause of death globally. The factors that comprise metabolic syndrome are on the rise in Sub-Saharan Africa, and data regarding the prevalence of metabolic syndrome in communities of aged less than 40 years old remain scarce. Methods: Data were collected between March and April 2013 from 3 regions of the Northern Senegal (i.e., Saint-Louis, Matam et and Louga) using a cluster sampling method and the survey base of the national statistical and demographical agency. Subjects aged between 18 and 80 years were recruited, however, the present study focused on adult populations below 40 years of age. Participants underwent a face-to-face questionnaire to collect demographics and data on cardiovascular history/risk factors. Blood pressure (BP) and anthropometric measurements were performed in addition to a blood test measuring fasting triglycerides, high density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and plasma glucose. Metabolic syndrome was defined as fasting plasma glucose ≥110 mg/dl, serum triglycerides ≥150 mg/dl, serum HDL cholesterol &lt;40 mg/dl, BP ≥130/85 mmHg or on BP medication, or waist girth &gt;102 cm in males or &gt;89 cm in females. Comparisons used the χ2 test for categorical variables and Student’s t test for continuous variables. Multiple logistic regression was used to identify factors associated with CFI, after considering potential confounders. Covariates with significant association (P&lt;0.05) in univariate analysis were included in the multivariate logistic model. Results: Of the 2,440 subjects recruited, 1080 participants were less than 40 years old and included in the current analysis. The mean age of these participants was 31 ± 7.53I. There were 296 (27%) male participants in our study. . Overall, there were 41 participants (3.8%) with metabolic. For individual components of metabolic syndrome, body mass index of 25 or higher was present in 32% of the population with a significant increase among women (38 vs 15% vs 3,7%, p&lt;0,001). The prevalence of hypertension was28% and more than half of the population presented with dyslipidaemia (554 participants). Among those with dyslipidemia, 339 have a high total cholesterol index (61%, 95% CI: 57-65%). Conclusion: Our community-based cross-sectional study revealed a low prevalence of metabolic syndrome among younger participants in northern Senegal. However, the prevalence of dyslipidaemia was high.

Implementation of weekday time-restricted eating to improve metabolic health in breast cancer survivors with overweight/obesity.

This study aimed to evaluate the implementation of telephone-based delivery of weekday-only time-restricted eating (TRE), its preliminary efficacy for metabolic outcomes, and concurrent lifestyle changes. Twenty-two breast cancer survivors aged 60+ years with overweight/obesity completed an 8-week feasibility study of 12 to 8p.m. weekday-only ad libitum TRE. The intervention was delivered by one registered dietitian call, twice-daily automated text messages asking about eating start and stop times, and three support phone calls. Magnetic resonance imaging, venipuncture, and 3 days of diet records and accelerometry were performed at baseline and after intervention. Participants had a mean age of 66 (SD 5) years with BMI of 31.8 (4.8)kg/m2 . Intervention implementation was successful, including excellent adherence (98%), participant acceptability, and a low symptom profile and cost ($63/participant). There were no significant changes in individual components of metabolic syndrome, lipid profile, or hemoglobin A1c , despite clinically relevant changes occurring within individual participants. Magnetic resonance imaging-derived hepatic steatosis and thigh myosteatosis did not change. Dietary intake changes included reduced energy (-22%) and protein (-0.2g/kg). Physical activity and sleep did not change. Eight weeks of telephone-delivered weekday TRE is a feasible, acceptable, low-symptom, and low-cost intervention. Future studies may consider a longer intervention length for more consistent metabolic improvements and counseling to enhance protein intake.