Main Components Of Metabolic Syndrome Research Articles

Obesity as a main component of metabolic syndrome and a risk factor for comorbidity

Obesity is an important medical and social problem, it occupies one of the leading places among cardiovascular risk factors. Obesity is a major component of the metabolic syndrome. It has a close pathogenetic relationship with its other manifestations, as a result of which a portrait of a comorbid patient is formed. The article presents data on the prevalence, criteria for diagnosing obesity, the relationship of obesity with other components of the metabolic syndrome is shown. The role of adipose tissue dysfunction in obesity on the development and progression of insulin resistance, atherosclerosis, as well as its relationship with non-alcoholic fatty liver disease and arterial hypertension is discussed. It is shown that obesity is a comorbidity factor and the basis of the metabolic syndrome, the leading pathogenetic mechanism in the formation and progression of its components, preceding their occurrence. This allows us to conclude that weight loss can reduce cardiovascular risks, reduce the manifestations of the metabolic syndrome, and in some cases even eliminate them completely.

Unraveling Light-Activated Insulin Action in Regulating Blood Glucose: New Photoactivatable Insight as a Novel Modality in Diabetes Management.

Diabetes, particularly type 2 diabetes (T2D), is the main component of metabolic syndrome. It is highly prevalent and has drastically increased with sedentary lifestyles, notably behaviors linked to ease of access and minimal physical activity. Central to this condition is insulin, which plays a pivotal role in regulating glucose levels in the body by aiding glucose uptake and storage in cells, and what happens to diabetes? In diabetes, there is a disruption and malfunction in insulin regulation. Despite numerous efforts, effectively addressing diabetes remains a challenge. This article explores the potential of photoactivatable drugs in diabetes treatment, with a focus on light-activated insulin. We discuss its advantages and significant implications. This article is expected to enrich the existing literature substantially, offering a comprehensive analysis of potential strategies for improving diabetes management. With its minimal physical intrusion, light-activated insulin promises to improve patient comfort and treatment adherence. It offers precise regulation and localized impact, potentially mitigating the risks associated with conventional diabetes treatments. Additionally, light-activated insulin is capable of explicitly targeting RNA and epigenetic factors. This innovative approach may pave the way for more personalized and effective diabetes treatments, addressing not only the symptoms but also the underlying biological causes of the disease. The advancement of light-activated insulin could revolutionize diabetes management. This study represents a pioneering introduction to this novel modality for diabetes management.

Metabolic syndrome and hyperuricemia: features of patient management (clinical case)

Metabolic syndrome (MS) is a group of interrelated metabolic disorders such as high blood pressure, central obesity, insulin resistance (IR), dyslipidemia. The main mechanisms that indicate a metabolic disorder and contribute to its development are IR and a large amount of circulating free fatty acids. In turn, tissue IR is often combined with other abnormalities including disorders of uric acid metabolism, changes in the hemostasis system, endothelial dysfunction, increased levels of C-reactive protein. At the same time, metabo­lic disorders are a risk factor for hyperuricemia. MS occurs in 25–60 to 90 % of all gout patients. About 50 % of patients with hyperuricemia have symptoms of MS. Hyperuricemia as a component of MS is a predictor of cardiovascular mortality, development of diabetes mellitus, hypertension and nephrolithiasis. Hyperuricemia is closely related to diabetes, obesity, coronary heart disease, hypertension. On the example of a clinical case, the main components of MS are considered, as well as the issue of the relationship between hyperuricemia, gout and the components of MS. The main idea behind the creation of the MS concept is to select a population of patients at a high cardiovascular risk in whom preventive measures such as lifestyle modification and the use of adequate drugs can significantly affect the main health indicators. The goal of managing patients with MS is to minimize cardiovascular risk and mortality as much as possible. Accordingly, the therapeutic strategy should include optimal ways to modify the lifestyle; lowering blood pressure to the target level and treating comorbid conditions; reducing low-density lipoprotein cholesterol according to the risk profile: > 50 %, and < 70 mg/dL (1.4 mmol/L) in patients at a very high cardiovascular risk; > 50 %, and < 100 mg/dL (1.8 mmol/l) in high-risk patients; reducing fasting serum glucose < 126 mg/dl (7 mmol/l) or glycated hemoglobin < 7 % (53 mmol/mol); maintaining uric acid level < 6.5 mg/dL (0.387 mmol/L), in patients with gout — below 6 mg/dL (0.357 mmol/L). Thus, according to the results of the research, a causal relationship was found between insulin resistance and serum uric acid levels in patients with metabolic syndrome. The strategy for managing patients with metabolic syndrome should include screening and correction of hypertension, carbohydrate purine metabolism, dyslipidemia, and prevention of cardiovascular events.

Systolic function of the left and right ventricles and myocardial strain in young adults with metabolic syndrome

The purpose of this article is to evaluate the systolic function of the left and right ventricles and measure myocardial Strain in young people (from 18 to 44 years old) with a newly established clinical and laboratory diagnosis of metabolic syndrome (MS) according to the criteria of the International Diabetes Federation (IDF), to identify possible early markers of myocardial dysfunction. All patients underwent standard transthoracic echocardiography (EchoCG) with assessment of systolic function of the left and right ventricles (LV and RV). The work detects early markers of ventricular myocardial dysfunction using speckle tracking 2D and 4D EchoCG, and also investigates the relationship between the main components of MS and echocardiographic parameters. With the help of a comparative analysis, statistical data were revealed on the low global longitudinal strain of the left and right ventricle in 2D and 4D in the main group compared with the control group. In individuals with MS, the mean values of global circular strain (GCS), radial (GRS) strain and global area strain (GAS) of the left ventricle were also significantly lower than the control group. Indicators obesity diseases (body weight and waist circumference) had a negative correlation with the ejection fraction (EF) and parameters of ventricular strain.

Relationship between serum testosterone and sex hormone- binding globulin levels and some metabolic changes in Iraqi men with type 2 diabetes mellitus

The present study aimed to assess the interrelationship between serum total testosterone (S.Tes) as well as sex hormone binding globulin (SHBG) and the main components of metabolic syndrome (MetS) in type 2 diabetic men. One hundred and sixty patients having T2DM were enrolled in this study. The following characteristics were reported: age, gender, duration of T2DM , Body mass index (BMI) and arterial blood pressure.. Serum hormonal profile analyses (S.Tes, SHBG and prolactin). Serum lipid analyses (T.ch TG, HDL-C, and LDL-C). The mean age of study subjects was 49.8 5.7 years and the mean duration of disease was 5.45.2 years. Body mass index (BMI) of study group was found to be within the range of either overweight or obese class . The means of HbA1c ratio and FSG levels were 9.4 %  2.1 and 200.9  75.2 mg/dl respectively which indicated that our patients were in a bad glycemic control. All components of S. lipid profile were within normal range . Serum Testosterone and SHBG levels were within normal range but in the low values( 4.49±2.11 ,28.88±18.12 ng/ml respectively) while serum prolactin level was within normal range but in the high values (11.22±9.42 ng/ml). When study analytes were compared according to the presence of one or more metabolic syndrome characteristic then there was a significant decrease in mean value of testosterone level between obese and non obese diabetics ( 3.89±1.87 vs. 4.79±2.17 ng/ ml, P < 0.001) . If hypertension was present in addition to obesity and diabetes then SHBG level was also significantly decreased in comparison with diabetics who were hypertensive but not obese (25.16±13.42 vs. 33.58±13.73 ng/ ml respectively , P <0.05 ). If hypertension and obesity were present as well as lower HDL-C then significant decreases in both S. SHBG and S. Tes were detected ( (30.63±14.93 vs. 40.7± 6.33 ng/ ml and 3.73±1.9 vs. 5.57±1.53 ng/ ml respectively , P<0.01). In conclusion; our T2DM patients have a bad glycemic state and are characterized by a significantly lower S. Tes mean level if they were obese. Still, the accumulation of other main characteristics of MetS which included hypertension and lower S. HDL- C results in a significantly lower mean levels of both S. Tes and S. SHBG. Obesity, among the other core characteristics of MetS, seems to have the main suppressor effect on serum testosterone and SHBG in T2DM.

Effect of income level on stroke incidence and the mediated effect of simultaneous diagnosis of metabolic syndrome diseases; a nationwide cohort study in South Korea

BackgroundThis study aimed to determine whether a simultaneous diagnosis of main components of metabolic syndrome (MetS) (hypertension, diabetes mellitus, and dyslipidemia) plays a mediator between income level and stroke.MethodsWe used the National Health Insurance Service National Sample Cohort database from 2006 to 2015. The mediator variables were the number of main MetS components diagnosed simultaneously (two or more/three or more). We used a weighting approach method of causal mediation analysis to apply counterfactual frameworks to the Cox proportional hazards regression model.ResultsA total of 213,526 people were included with 1,690,665.3 person-years of followed up. Compared with the high-income group, the risk of being diagnosed with two or more components of MetS significantly increased in all other income groups [middle-income OR 1.05 (95% CI 1.02–1.08); low-income OR 1.09 (95% CI 1.05–1.12); Medical Aid beneficiaries OR 1.39 (95% CI 1.32–1.47)]. A lower level of income was significantly associated with a higher risk of stroke compared with the high-income group [middle-income HR 1.15 (95% CI 1.07–1.25); low-income HR 1.19 (95% CI 1.10–1.29); Medical Aid beneficiaries HR 1.63 (95% CI 1.48–1.80)]. In the Medical Aid beneficiaries, simultaneous diagnosis of the main metabolic components acted as a significant mediator between income levels and stroke incidence, with 26.6% mediated when diagnosed with two or more diseases and 21.1% when diagnosed with all three.ConclusionsCo-diagnosis of MetS components played a significant mediator role between income level and stroke incidence.

Сучасні уявлення про патогенез і лікування хронічної серцевої недостатності: фокус на метаболічний синдром і його наслідки

In recent decades, there has been a steady increase in the prevalence of chronic heart failure worldwide, which is estimated to affect up to 2% of the adult population and up to 10% of the elderly. The pathogenesis of chronic heart failure is closely linked to metabolic syndrome. Metabolic syndrome is observed in 60% of patients with chronic heart failure. The most common and potent risk factors for chronic heart failure are the components of metabolic syndrome such as visceral obesity, hyperinsulinemia, insulin resistance, dyslipidemia, hypertension and type 2 diabetes. Adequate treatment of the main components of metabolic syndrome with lifestyle adjustments and modern drug therapy can inhibit the development and progression of chronic heart failure. This article summarizes the common pathogenetic mechanisms of metabolic syndrome and chronic heart failure, as well as current opportunities for their correction.

Metabolic syndrome in kidney transplant recipients with adverse cardiovascular events

Abstract Introduction Kidney transplantation helps reduce cardiovascular mortality in patients receiving renal replacement therapy but the incidence of cardiovascular disorders in kidney transplant recipients remains significantly higher than in the general population. Metabolic syndrome is a combination of cardiovascular risk factors that can reinforce each other and increase the risk of cardiovascular disease and death in the general population. Purpose To study the incidence of the preceding metabolic syndrome in kidney transplant recipients with adverse cardiovascular events. Methods 237 recipients six months after kidney transplantation were included in the study. 79 (33.3%) of them had adverse cardiovascular events during three years of observation. Other patients had no cardiovascular complications. The study groups were comparable by gender, age and traditional cardiovascular risk factors. Results The average waist circumference in kidney transplant recipients with adverse cardiovascular events was 98±14 cm, which was higher than in kidney transplant recipients without adverse cardiovascular events – 94±13 cm, p<0.05. The triglyceride level in the group of kidney transplant recipients with adverse cardiovascular events was 1.70 (1.30–2.50) mmol/L, which was higher than in kidney transplant recipients without cardiovascular complications – 1.45 (1.08–1.80) mmol/L, p<0.01. Hypertriglyceridemia was more frequently diagnosed in recipients with adverse cardiovascular events – 44.3% (n=35) versus 27.8% (n=44), p<0.05. In the study groups no statistically significant differences were found in the level of high-density lipoproteins and the incidence of their reduced level depending on the occurrence of adverse cardiovascular events – 1.30 (1.21–1.42) mmol/L and 20.3% (n=16) versus 1.31 (1.21–1.45) mmol/L and 8.4% (n=29). The blood pressure level and the incidence of arterial hypertension was comparable in the study groups – 77.2% (n=61) and 69.6% (n=110). Blood glucose levels and the incidence of hyperglycemia did not differ in the study groups, but post-transplant impaired glucose tolerance or post-transplant diabetes mellitus in recipients with adverse cardiovascular events were more common – 20.3% (n=16) versus 9.5% (n=15), p<0.05. So 41.8% (n=99) of the study patients had metabolic syndrome. The previous metabolic syndrome was more frequent in recipients with adverse cardiovascular events – 58.2% (n=46) versus 33.5% (n=53), p<0.001. Conclusion Based on the study it was found that the metabolic syndrome increases the risk of adverse cardiovascular events in kidney transplant recipients. The main components of metabolic syndrome that have prognostic value in kidney transplant recipients were an increase in waist circumference, high blood triglyceride levels and the incidence of hypertriglyceridemia, a high incidence of post-transplant impaired glucose tolerance or post-transplant diabetes mellitus. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Belarusian State Medical UniversityMinsk Scientific and Practical Center of Surgery, Transplantology and Hematology

Clinical features and risk factors of metabolic syndrome in adult hypopituitary patients

Objective: To investigate the clinical features and risk factors of metabolic syndrome (MS) in adult hypopituitary patients (HP). Methods: Patients diagnosed with HP in the outpatient or inpatient department of the endocrinology department in West China Hospital from January,2012 to December,2019 were selected as the experimental group (HP group), and patients with normal pituitary function treated for saddle lesions were selected as the control group. HP patients with or without MS were divided into MS group and non-MS group HP patients were divided into four groups according to the level of growth hormone by the quartile method (GH>0.35 μg/L、0.13 μg/L<GH≤0.35 μg/L、0.05 μg/L<GH≤0.13 μg/L and GH≤0.05 μg/L). And then we compared the differences in clinical characteristics between groups. Results: A total of 264 patients with HP (136 males, 51.5%) and 53 patients with normal pituitary function (22 males, 41.5%) were included. There were no significant differences between the two groups in age[(41±13)vs(40±12) years old] and body mass index(BMI)[(23.3±4.5)vs(23.1±3.9) kg/m2]. Delays in diagnosis and treatment were common in HP, and less than 50% of HP patients received standard alternative therapy. The prevalence of MS (39.4% vs 24.4%) and non-alcoholic fatty liver disease (30.9% vs 12.5%), waist circumference [(87.2±10.6) vs (82.2±12.6) cm], triglyceride [M(Q1,Q3)1.81(1.15, 2.83) vs 1.14(0.80, 1.69) mmol/L] in HP group were higher than those in control group (P<0.05). Blood pressure [systolic blood pressure:(112±19) vs (124±16) mmHg; diastolic blood pressure:(70±12) vs (81±12) mmHg; 1 mmHg=0.133 kPa] and HDL cholesterol [1.06(0.83, 1.35) vs 1.49(1.14, 1.78) mmol/L] in HP group were lower than those in control group (P<0.05). The levels of GH [0.11 (0.03, 0.35) vs 0.20 (0.05, 0.41) μg/L] and IGF-1 [58.33 (38.12, 76.03) vs 65.54 (51.78, 101.76) μg/L] in MS group were lower than those in non-MS group (P<0.05). The lower the GH level(GH>0.35 μg/L、0.13 μg/L<GH≤0.35 μg/L、0.05 μg/L<GH≤0.13 μg/L and GH≤0.05 μg/L) in patients with HP, the higher the prevalence of MS (25.5%, 30.0%, 42.9%, 48.6%, P=0.031). Conclusions: The prevalence of MS in adult HP patients is higher than in patients with normal pituitary function. Abdominal obesity and dyslipidemia are the main components of MS, and GH deficiency is related to MS in HP patients.

Characterization of Differentially Expressed Circulating miRNAs in Metabolically Healthy versus Unhealthy Obesity.

Obese individuals without metabolic comorbidities are categorized as metabolically healthy obese (MHO). MicroRNAs (miRNAs) may be implicated in MHO. This cross-sectional study explores the link between circulating miRNAs and the main components of metabolic syndrome (MetS) in the context of obesity. We also examine oxidative stress biomarkers in MHO vs. metabolically unhealthy obesity (MUO). We analysed 3536 serum miRNAs in 20 middle-aged obese individuals: 10 MHO and 10 MUO. A total of 159 miRNAs were differentially expressed, of which, 72 miRNAs (45.2%) were higher and 87 miRNAs (54.7%) were lower in the MUO group. In addition, miRNAs related to insulin signalling and lipid metabolism pathways were upregulated in the MUO group. Among these miRNAs, hsa-miR-6796-5p and hsa-miR-4697-3p, which regulate oxidative stress, showed significant correlations with glucose, triglycerides, HbA1c and HDLc. Our results provide evidence of a pattern of differentially expressed miRNAs in obesity according to MetS, and identify those related to insulin resistance and lipid metabolism pathways.

Latest Advances in Hydrogel-Based Drug Delivery Systems for Optimization of Metabolic Syndrome Treatment.

Drug delivery systems such as hydrogels have become relevant in cardiovascular and metabolic therapies due to their sustained and controlled release properties of drugs, versatile polymer structures, safety, and biodegradability. The literature presented demonstrates that a hydrogel-based controlled release system increases the therapeutic efficacy in different components of the metabolic syndrome. Hypertension has been the most explored component with advances in in vitro and murine models. However, clinical evidence in humans is scarce, and more translational studies are needed. Hydrogel-based systems for diabetes, obesity, and dyslipidemia have been little explored. Observations mainly demonstrated an increase in therapeutic efficacy, in vitro and in vivo, for the use of insulin, leptin, and natural components, such as epigallocatechin gallate. In all cases, the hydrogel systems achieve better plasma levels of the loaded compound, higher bioavailability, and low cytotoxicity compared to conventional systems. Also, the evidence existing suggests that the development of an injectable hydrogel system for controlled release of drugs or therapeutic compounds is presented as an attractive option for MeS treatment, and due to the possibility of sustained pharmacological release, there is no need for repeated doses and a safe administration route. The following review aims to evaluate the use of the hydrogel systems in the therapy of diabetes, obesity, hypertension, and dyslipidemia, which are the main components of metabolic syndrome.

Pathogenetic aspects of the development of cholelithiasis in patients with metabolic syndrome

Nowadays there is a steady tendency to increase the number of patients with gallstone disease and metabolic syndrome. Increasingly, gallstone disease is called a non-canonical cluster of metabolic syndrome, because the main components of metabolic syndrome are also modifiable risk factors for gallstone disease. This article discusses the pathogenetic parallels in the development of gallstone disease and metabolic syndrome - insulin resistance and hormones of adipose tissue, lipid metabolism disorders, immune factors and the cytokine system. There are described possible effects of cholecystectomy on metabolism in patients with metabolic syndrome.

Etiopathogenetic parallels and unresolved issues of pathogenesis of comorbidity COPD and metabolic syndrome (review)

The review analyzes the etiological and pathogenetic factors (including immunopathogenesis factors) of chronic obstructive pulmonary disease (COPD) and metabolic syndrome (MS), cites data on clinical and pathogenetic characteristics of combined pathology, emphasizes the commonality of risk factors and individual links of pathogenesis in syntropy.The clinical and pathogenetic features of the comorbidity of COPD and MS are closely related to the severity of chronic “metabolic” inflammation induced by elements of adipose tissue. Functional and biochemical disorders recorded in metabolic syndrome (insulin resistance, hyperglycemia, dyslipidemia) are considered as factors contributing to dysfunction of the components of innate and adaptive immunity.The review formulates a number of unresolved issues of the pathogenesis of comorbid pathology, the study of which is necessary to search for the mutual aggravating effect of COPD and MS mechanisms. In view of the clinical and laboratory metabolic syndrome equivalents variety, the authors emphasize the relevance of future studies of the pathogenetic features of chronic inflammation associated with the comorbidity of the main components of metabolic syndrome and COPD, to develop effective methods of prevention and pathogenetic therapy of comorbid pathology.

Non-alcoholic fatty liver disease in children: relationship with the main components of metabolic syndrome in children

There is a high frequency of combination of components of metabolic syndrome (MS) and liver damage in obese patients.Of interest is the study of clinical and pathogenetic relationships between the morphofunctional state of the liver and the development of MS in children.Objective: to Study the functional state of the liver in children with MS and to assess the relationship with its main components.Materials and methods. 483 obese children (SDS BMI≥2.0) aged from 5 to 16 years (285 boys and 198 girls) were examined: I gr. — 237 children with MS, II gr. — 246 obese children without MS. Comprehensive examination included anamnesis, anthropometry, clinical and biochemical blood tests, lipid spectrum and carbohydrate metabolism, ultrasound examination of the abdominal cavity and retroperitoneal space, CT of the abdominal cavity. Statistical processing of the results was carried out using the package «STATISTIKA 6.0».Research result. Ultrasound-signs of nonalcoholic fatty liver disease (NAFD) in I gr. revealed significantly more often than in II gr. (166 — 70% and 125 — 51%, respectively, p&lt;0.05). The majority (91%) of children with NAFD are 10–16 years old. Boys slightly more than girls (58% and 42%). The increase of ALT in the I gr. it was registered at 27% of children, in II gr. — in 18% of children (p&lt;0.05). Increase of ALT in boys was detected 2 times more often than in girls (26% and 13%, p&lt;0.05). In patients with NAFLD, regardless of the group, signs of atherogenic dyslipidemia (increased triglycerides, decreased HDL), impaired carbohydrate metabolism (insulin, C‑peptide and IR index) were more often diagnosed. A higher frequency of hyperglycemia in children I gr. was established. regardless of the liver condition (68% of children without NAFLD and 69% of children with NAFLD), whereas in II gr. it was registered more often in the presence of NAFLD (16% and 8%). In both groups, the level of MC in children with NAFLD was higher than without it, and in I gr. this indicator was significantly higher than in children of II gr. Mean fibrinogen levels were also higher in children with NAFLD, and these differences were significantly significant in I gr.Conclusion.1. Ultrasound criteria for NAFLD in children with MS are diagnosed significantly more often (70%) than in children with uncomplicated obesity (51%).2. CT-changes in liver parenchymain NAFLD are characterized by the presence of diffuse focal process with the presence of different sites with changes in the type of fatty dystrophy and steatohepatitis against the background of unchanged parenchyma.3. Adolescents over 12 years of age and males predominate among children with NAFLD.4. Waist circumference in children with NAFLD, regardless of the group, significantly exceeds that of children without it, which indicates the relationship of functional disorders of the liver with the development of abdominal typeof obesity — the main component of MS.5. Hyperfermentemia in the form of increased ALT levels is most often registered in children with MS in the presence of NAFLD (27%), in 15% of them the values exceed the normative indicators by 1.5 or more times, which indicates a high risk of developing an inflammatory process of the type of steatohepatitis.6. Lipid metabolism disorders in the form of an increase in TG and a decrease in HDL in children with NAFLD are recorded more often than in children without it, regardless of the presence of MS, but their combination is diagnosed exclusively in children with MS: in children with NAFLD — in 29% of cases, without it — in 23%.7. Regardless of the group, changes in carbohydrate metabolism in the presence of NAFLD were more pronounced than in children without it, while children with MS and NAFLD showed a more significant increase in glycemia, insulin and IR index.8. Children with MS and NAFLD have a higher incidence of purine metabolism disorders.9. A correlation between hepatic metabolism and disorders in the fibrinolysis system, which progress with the duration of the disease, was obtained.

Lipid Accumulation Product Index to Predict Metabolic Syndrome in People Living with HIV.

Dyslipidemia and central obesity are the main components of metabolic syndrome, which represent important risk factors for cardiovascular diseases in people living with human immunodeficiency virus (HIV). The lipid accumulation product (LAP) index has been shown in studies as an efficient marker of metabolic syndrome in general adult population and its applicability in HIV-infected population is not discussed. We aimed to assess the accuracy of the LAP index to identify metabolic syndrome in people living with HIV. It is a cross-sectional study with 141 HIV-infected patients on antiretroviral therapy, conducted in a reference centre of infectious diseases in southeast Brazil. Evaluations included LAP index, anthropometric measurements and clinical and laboratorial variables. Metabolic syndrome was defined by International Diabetes Federation (IDF) criteria. The prevalence of metabolic syndrome in our sample was 10.6%. A positive and significant correlation was found between the metabolic syndrome and LAP (r=0.401; P<0.01), metabolic syndrome and body mass index (r=0.361; P<0.01) and metabolic syndrome and waist circumference (r=0.427; P<0.01) in our sample. The analysis of the receiver-operating characteristic (ROC) curve revealed that the best cut-off value for LAP index to define metabolic syndrome was 59.4 (sensitivity 80%, specificity 79% and area under the curve (AUC) of 0.875. In female and male, analysis of the ROC curve revealed that the best cut-off value for LAP index to define metabolic syndrome was 56.3 (sensitivity 100%, specificity 82% and AUC of 0.929) and 52.0 (sensitivity 78%, specificity 74% and AUC of 0.838), respectively. Despite the low prevalence of metabolic syndrome in our sample, the ROC curves analyzes demonstrated a good diagnostic accuracy as an additional screening tool of metabolic syndrome according to the IDF.

Metabolic syndrome in children.

Despite plenty of currently available information on metabolic syndrome (MetS) in children and adolescents, there are still uncertainties regarding definition, prevention, management and treatment of MetS in children. The first approach to MetS in children consists of lifestyle interventions (nutritional education, physical activity). These recommendations are often difficult to achieve, especially for adolescents, therefore, there is usually a lack of successful outcomes. A pharmacological intervention in obese children may be needed in some cases, with the aim to improve the effects of these primary prevention interventions. Metformin seems to be safe and presents evident positive effects on insulin sensitivity, but long-term and consistent data are still missing to establish its role in the pediatric population and the possible effectiveness of other emergent treatments such as glucagon-like peptide-1 analogues, dipeptidylpeptidase-4 inhibitors, dual inhibitors of SGLT1 and SGLT2 and weight loss drugs. Bariatric surgery might be helpful in selected cases. The aim of this review is to present the most recent available treatments for the main components of metabolic syndrome, with a focus on insulin resistance. A short mention of management of congenital forms of insulin resistance will be included too.

Relationships of Obesity-Related Indices and Metabolic Syndrome with Subclinical Atherosclerosis in Middle-Aged Untreated Japanese Workers.

Aim: Obesity is a social problem due to the prevalence of the Western lifestyle. In particular, visceral fat accumulation, which is a main component of metabolic syndrome, is closely associated with the progression of atherosclerosis. This study aimed to investigate the relationships of obesity-related indices and metabolic syndrome with subclinical atherosclerosis in middle-aged untreated workers.Methods: Employees undergoing their periodic health check-up but without previous cardiovascular events or cardiovascular medications were enrolled in this study (n = 7,750). Body mass index (BMI), percent body fat, waist circumference, and visceral fat area were evaluated as obesity-related indices. Assessment of visceral fat area was performed by computed tomography (CT). Subclinical atherosclerosis was assessed by measuring arterial stiffness using cardio-ankle vascular index (CAVI) and by ultrasound examination of carotid intima-media thickness (IMT).Results: Obesity-related indices were significantly correlated with each other and were positively associated with carotid IMT but negatively associated with CAVI in multivariate regression analysis. In a logistic regression analysis including CAVI and carotid IMT simultaneously, CAVI was negatively associated, but carotid IMT was positively associated, with obesity defined by each obesity-related index. In contrast, both CAVI and carotid IMT were positively associated with the presence of metabolic syndrome based on visceral fat accumulation.Conclusions: Obesity-related indices were negatively associated with CAVI and positively associated with carotid IMT in middle-aged untreated workers, while both CAVI and carotid IMT were worsened in the presence of metabolic syndrome.

Association between periodontitis and the main components of metabolic syndrome

The prevalence of metabolic syndrome (MetS) is increasing worldwide, and itappears to increase independently the risk of cardiovascular disease. Periodontitis hasbeen shown to have an association with the risk of cardiovascular disease.The aim of the present study is to investigate the association between periodontalstatus and the main components of metabolic syndrome, singly, and in combination intype 2 diabetic patients.One hundred and seventy five patients (96 males and 79 females) with type 2diabetes mellitus (T2DM) were enrolled in the study. The following clinicalcharacteristics were reported: age and gender, body mass index (BMI) and bloodpressure. Periodontal status was assessed using periodontal disease index whichincludes plaque, calculus, and periodontal component of the index. An assessment ofserum lipid analytes included estimation of serum triglycerides (TG) and serum highdensity lipoprotein cholesterol (HDL-C).There was a significant difference in mean value of periodontal disease index(PDI) between normotensive and hypertensive diabetic patients (3.31±0.83 vs.3.82±0.65, P&lt;0.001). Also there was a significant difference in PDI between normaland high TG groups (3.49±0.73 vs. 3.81±0.61, P&lt;0.01). There was a significantincrease in TG level in hypertensive compared to normotensive diabetic patients(P&lt;0.01). Only in presence of hypertension and obesity in addition to diabetes thatPDI was significantly increased in comparison with diabetic hypertensive non obesepatients (4.1±0.58 vs. 3.62±0.64, P&lt;0.001). There were no significant differences inTG level between obese and non obese diabetic patients while there was a significantincrease in TG level in patients who were hypertensive obese compared tonormotensive non obese (174.64 ±61.39 vs. 150.80±54.96 respectively, P&lt;0.05).Presence of two or more characteristics of MetS has resulted in a significant increaseof PDI when compared with patients who had only diabetes (P&lt;0.001).In conclusion, hypertension and hypertriglyceridemia as main components ofMetS are singly associated with periodontitis in T2DM and the presence of any twostudied components of MetS in addition to diabetes will attain the worst deteriorationin periodontal status.

Association between periodontitis and the main components of metabolic syndrome

The prevalence of metabolic syndrome (MetS) is increasing worldwide, and itappears to increase independently the risk of cardiovascular disease. Periodontitis hasbeen shown to have an association with the risk of cardiovascular disease.The aim of the present study is to investigate the association between periodontalstatus and the main components of metabolic syndrome, singly, and in combination intype 2 diabetic patients.One hundred and seventy five patients (96 males and 79 females) with type 2diabetes mellitus (T2DM) were enrolled in the study. The following clinicalcharacteristics were reported: age and gender, body mass index (BMI) and bloodpressure. Periodontal status was assessed using periodontal disease index whichincludes plaque, calculus, and periodontal component of the index. An assessment ofserum lipid analytes included estimation of serum triglycerides (TG) and serum highdensity lipoprotein cholesterol (HDL-C).There was a significant difference in mean value of periodontal disease index(PDI) between normotensive and hypertensive diabetic patients (3.31±0.83 vs.3.82±0.65, P&lt;0.001). Also there was a significant difference in PDI between normaland high TG groups (3.49±0.73 vs. 3.81±0.61, P&lt;0.01). There was a significantincrease in TG level in hypertensive compared to normotensive diabetic patients(P&lt;0.01). Only in presence of hypertension and obesity in addition to diabetes thatPDI was significantly increased in comparison with diabetic hypertensive non obesepatients (4.1±0.58 vs. 3.62±0.64, P&lt;0.001). There were no significant differences inTG level between obese and non obese diabetic patients while there was a significantincrease in TG level in patients who were hypertensive obese compared tonormotensive non obese (174.64 ±61.39 vs. 150.80±54.96 respectively, P&lt;0.05).Presence of two or more characteristics of MetS has resulted in a significant increaseof PDI when compared with patients who had only diabetes (P&lt;0.001).In conclusion, hypertension and hypertriglyceridemia as main components ofMetS are singly associated with periodontitis in T2DM and the presence of any twostudied components of MetS in addition to diabetes will attain the worst deteriorationin periodontal status.

Possible reasons of insufficient efficacy of laparoscopic gastric bypass in surgical treatment of metabolic syndrome

OBJECTIVE. The study assessed an efficacy of laparoscopic gastric bypass (LRGB) in correction of main components of metabolic syndrome (MS). The authors revealed the possible reasons of insufficient efficacy of operation. MATERIAL AND METHODS. Results of LRGB were estimated in 228 patients who underwent operation during 5 years. Index of body mass, % EBMIL, lipid spectrum, level of glycemia, content of leptin and ghrelin were considered. RESULTS. The high efficacy of operation influence on MS was found in young age groups. Other groups had lower efficacy of operation. The reason was in gastrointestinal tract reconstruction that resulted in decrease of body mass, regress of associated diseases, change of key hormones which regulated energy metabolism, homeostasis of glucose and lipids. The ghrelin level didn’t have a determining value and didn’t influence on decrease of MT after operation. CONCLUSIONS. The operation effectively influenced on all possible components of MS, but the ghrelin content wasn’t determinative for long-term regulation of body mass loss and reduced the efficacy of operation.