Management Of Metabolic Syndrome Research Articles

Current Status and Future Perspectives on Therapeutic Potential of Apigenin: Focus on Metabolic-Syndrome-Dependent Organ Dysfunction.

Metabolic syndrome and its associated disorders such as obesity, insulin resistance, atherosclerosis and type 2 diabetes mellitus are globally prevalent. Different molecules showing therapeutic potential are currently available for the management of metabolic syndrome, although their efficacy has often been compromised by their poor bioavailability and side effects. Studies have been carried out on medicinal plant extracts for the treatment and prevention of metabolic syndrome. In this regard, isolated pure compounds have shown promising efficacy for the management of metabolic syndrome, both in preclinical and clinical settings. Apigenin, a natural bioactive flavonoid widely present in medicinal plants, functional foods, vegetables and fruits, exerts protective effects in models of neurological disorders and cardiovascular diseases and most of these effects are attributed to its antioxidant action. Various preclinical and clinical studies carried out so far show a protective effect of apigenin against metabolic syndrome. Herein, we provide a comprehensive review on both in vitro and in vivo evidence related to the promising antioxidant role of apigenin in cardioprotection, neuroprotection and renoprotection, and to its beneficial action in metabolic-syndrome-dependent organ dysfunction. We also provide evidence on the potential of apigenin in the prevention and/or treatment of metabolic syndrome, analysing the potential and limitation of its therapeutic use.

Role of Virechana Karma, Vidangadi Churna and lifestyle modification in Metabolic syndrome (Medoroga): A Case Study

Metabolic syndrome is a group of co-morbidities which pose as a risk factor for cardiovascular disease. It comprises of hypertension, central obesity, impaired glucose metabolism and dyslipidemia. It can be considered under broad umbrella of Santarpaka Nimittaja Vyadhi and can be managed using Chikitsa Sutra for Santarpanottha Vyadhi. In present case study, Virechana was performed to a diagnosed patient of metabolic syndrome, followed with oral medication Vidangadi Churna for 30 days (total duration 45 days). Strict dietary and lifestyle modification including regular physical activity were also suggested to the patient during this period. Patient was assessed on certain symptoms like Kshudra Shwasa, Trisha, Atinidra, etc. together with NCEP ATP III criteria, 2001 before initiation and after the treatment. Symptoms related to Medodushti relieved and also body weight (93 to 81 kg), BMI - 25.3- 24.89, FBS- 118.90 - 103.80, Triglycerides- 239.5-105.3, Total Cholesterol-217.2-191.6 mg/dl, LDL-127.3-112.7 mg/dl, VLDL- 47.9-21.1 mg/dl, HDL- 42.0- 57.8, Average blood pressure - 150/ 100 to 130/ 90 mm. of Hg decreased after treatment. Virechana and Vidangadi Churna accompanied by lifestyle modification are effective in the management of metabolic syndrome.

Public Statement on the Importance of Prevention and Management of Obesity and Metabolic Syndrome during the COVID-19 Pandemic.

Public Statement on the Importance of Prevention and Management of Obesity and Metabolic Syndrome during the COVID-19 Pandemic.

Systematic Review: Vulnerability of Metabolic Syndrome in COVID-19

SARS-CoV-2 infection has become a widely spread disease around the world causing rapid hospitalization and death, especially in people with metabolic syndrome. There is very limited literature that goes to present the clinical implications and management of metabolic syndrome in this pandemic. Hence an attempt has been made towards meeting this end. A literature review has been done extracting articles from scopus database following PRISMA guidelines. The manuscripts were studied to identify articles that report metabolic syndrome and its components in COVID-19 infection. A total of 25 manuscripts were included in this systematic review. These studies report systematic inflammation and organ damage in metabolic syndrome that has up regulated SARS-CoV-2 infection. Various treatment strategies have also been suggested and hypothesized. The results of this analysis indicate that patients suffering from metabolic syndrome are vulnerable to COVID-19 owing a sequence of complications.

Combined Effects of Metabolic Abnormalities and Obesity on Cardiovascular Diseases among Korean Postmenopausal Women.

Combined effects of metabolic abnormalities, including metabolic syndrome and obesity, should be identified to screen postmenopausal women at risk of developing cardiovascular diseases. The purpose of this study was to identify the combined effects of metabolic abnormalities and obesity on cardiovascular diseases among postmenopausal Korean women (aged 40–83 years). Data of 5959 postmenopausal women from the Korean National Health and Nutrition Examination Survey (2015–2018) were secondarily analyzed. Using complex simple analysis procedures, logistic regression analysis was performed to identify the combined effect of metabolic abnormalities and obesity on cardiovascular diseases among postmenopausal Korean women. In combination, metabolic syndrome (more than three metabolic abnormalities) and obesity (overweight [≥23 kg/m2 and <25 kg/m2 in body mass index] and obese [>25 kg/m2 in body mass index]) increased the likelihood of developing cardiovascular diseases but combining more than one metabolic abnormality and obesity did not. Combining metabolic syndrome and non-obesity (underweight and normal weight) increased the likelihood of the prevalence of cardiovascular diseases but combining more than one metabolic abnormality and non-obesity did not. Increased cardiovascular diseases in postmenopausal women may be more commonly associated with metabolic syndrome having multiple metabolic abnormalities, but not obesity. Thus, instead of simple weight control, early management of metabolic syndrome is recommended to prevent cardiovascular disease among postmenopausal Korean women.

Pathogenesis, Diagnosis, and Management of Metabolic Syndrome: A Comprehensive Review

Pathogenesis, Diagnosis, and Management of Metabolic Syndrome: A Comprehensive Review

Performance of Two Novel Obesity Indicators for the Management of Metabolic Syndrome in Young Adults.

BackgroundMetabolic syndrome (MetS) is a pathophysiological change based on the abnormal metabolism of many substances. The study aims to investigate the performance of visceral adiposity index (VAI) and lipid accumulation product (LAP) of MetS in young adults.Methods448 young adults aged between 19 and 24 years old in Qinhuangdao had been included in this cross-sectional study. Receiver operating characteristic (ROC) curve analyses were used to assess the accuracy of these two obesity indicators for MetS.ResultsThe prevalence of MetS was 2.0%. In male subjects, LAP had the highest area under the ROC curve (AUC) value (AUC = 0.963), followed by VAI (AUC = 0.937). In female subjects, LAP also had the highest AUC value (AUC = 0.931), followed by VAI (AUC = 0.861). No significant difference was found between the two obesity indicators (P > 0.05).ConclusionThe two obesity indicators were valuable for the screening of MetS in young adults, and LAP was the simpler of the two.

Kishk Sa′eedi as a potential functional food for management of metabolic syndrome: A study of the possible interaction with pomegranate seed oil and/ or gum Arabic

Introduction: In the present research, the health benefits of the traditional Egyptian food called Kishk Sa′eedi (KS) and KS mixed with gum Arabic (GA) or with a mixture of GA and pomegranate seed oil (PSO) were studied in a rat model of metabolic syndrome (MS) induced by feeding high fructose high hydrogenated fat diet (HFFD). Methods: Rats were divided into a normal control group (NC) fed on a balanced diet (Diet 1), a MS control (MSC) receiving HFFD (Diet 2), and three test groups feeding on HFFD containing KS (Diet 3), KS with GA (Diet 4), and KS with GA and PSO (Diet 5), respectively for five weeks. Biochemical and histopathological changes were assessed. Results: Significant increase in blood glucose, plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST), urea, creatinine, uric acid, malondialdehyde (MDA), dyslipidemia and reduction in reduced glutathione (GSH) were demonstrated in MSC compared to NC (P &lt; 0.05). Significant elevation in liver fat, MDA and gene expression of interleukin-6 (IL-6) with significant down-regulation of peroxisome proliferator-activated receptor (PPAR-α) were noticed in MSC compared to NC (P &lt; 0.05). The three test diets improved plasma high-density lipoprotein-cholesterol (HDL-C), uric acid, MDA, liver PPAR-α and IL-6 expression (P &lt; 0.05) compared to MSC without affecting liver lipids. Blood glucose, plasma dyslipidemia, AST, creatinine and urea were improved by diet 3 and diet 5 (P &lt; 0.05). Diet 3 elevated GSH and reduced ALT and MDA (P &lt; 0.05). Histopathological changes induced by HFFD in both liver and kidney showed variable improvement by feeding the tested diets. Conclusion: The tested diets significantly improved MS rat model with superiority to diet 3.

Exercise Reduces Medication for Metabolic Syndrome Management: A 5-Year Follow-up Study.

This study aimed to determine the effects of a 5-yr exercise intervention on metabolic syndrome (MetS) and health-related variables and medication use for MetS management. Participants were randomly assigned to an exercise intervention (n = 25, 54 ± 2 yr, 20% women) or control group (n = 26, 54 ± 2 yr, 38% women). The intervention lasted 4 months per year and consisted of high-intensity interval training on a cycloergometer thrice a week. Outcomes were MetS z-score and medication use score, MetS-related variables (including blood pressure, blood glucose homeostasis, and lipid profile), and cardiorespiratory fitness (CRF, as determined by maximal oxygen uptake). MetS z-score was similarly reduced over time in both groups (P = 0.244 for group-time interaction). A quasi-significant and significant group-time interaction was found for MetS number of factors (P = 0.004) and CRF (P < 0.001), respectively. Thus, MetS factors tended to decrease over time only in the exercise group with no change in the control group, whereas CRF increased from baseline to 5-yr assessment in the exercise group (by 1.1 MET, P < 0.001) but decreased in the control group (-0.5 MET, P = 0.025). Medicine use score increased twofold from baseline to 5-yr follow-up in the control group (P < 0.001) but did not significantly change (10%, P = 0.52) in the exercise group (P < 0.001 for group-time interaction). The proportion of medicated patients who had to increase antihypertensive (P < 0.001), glucose-lowering (P = 0.036), or total medication (P < 0.0001) over the 5-yr period was lower in the exercise than that in the control group. Exercise training can attenuate the increase in medication that would be otherwise required to manage MetS over a 5-yr period.

Exploring the Potential of Personalized Dietary Advice for Health Improvement in Motivated Individuals With Premetabolic Syndrome: Pretest-Posttest Study.

BackgroundDietary quality plays an essential role in the prevention and management of metabolic syndrome (MetS).ObjectiveThe aim of this pilot study is to organize personalized dietary advice in a real-life setting and to explore the effects on dietary intake, metabolic health, and perceived health.MethodsWe followed a one-group pretest-posttest design and included 37 individuals at risk of MetS, who indicated motivation to change dietary behavior. For a period of 16 weeks, participants received personalized advice (t=0 and t=8) and feedback (t=0, t=4, t=8, t=12 and t=16) on dietary quality and metabolic health (ie, waist circumference, BMI, blood pressure, lipid profile, fasting glucose levels, and C-peptide). Personalized advice was generated in a two-stage process. In stage 1, an automated algorithm generated advice per food group, integrating data on individual dietary quality (Dutch Healthy Diet Index; total score 8-80) and metabolic health parameters. Stage 2 included a telephone consultation with a trained dietitian to define a personal dietary behavior change strategy and to discuss individual preferences. Dietary quality and metabolic health markers were assessed at t=0, t=8, and t=16. Self-perceived health was evaluated on 7-point Likert scales at t=0 and t=16.ResultsAt the end of the study period, dietary quality was significantly improved compared with the baseline (Dutch Healthy Diet Index +4.3; P<.001). In addition, lipid profile (triglycerides, P=.02; total cholesterol, P=.01; high-density lipoprotein, P<.001; and low-density lipoprotein, P<.001), BMI (P<.001), waist circumference (P=.01), and C-peptide (P=.01) were all significantly improved, whereas plasma glucose increased by 0.23 nmol/L (P=.04). In line with these results, self-perceived health scores were higher at t=16 weeks than at baseline (+0.67; P=.005).ConclusionsThis exploratory study showed that personalized dietary advice resulted in positive effects on dietary behavior, metabolic health, and self-perceived health in motivated pre-MetS adults. The study was performed in a do-it-yourself setting, highlighting the potential of at-home health improvement through dietary changes.Trial RegistrationClinicalTrials.gov NCT04595669; https://clinicaltrials.gov/ct2/show/NCT04595669

Evaluation of Mesoporous Silica Nanoparticles as Delivery Vehicles for Novel Hybrid Steroids in Management of Metabolic Syndrome in Mice

This approach aimed to address the efficacy of the newly synthesized hybrid steroids modified by sulfurheterogenous rings and loaded on mesoporous silica nanoparticles in manipulating metabolic syndrome induced by high fructose diet. The designed compounds were synthesized by mechanochemical process and then loaded on mesoporous silica nanoparticles as drug delivery vehicles. Thereafter, these compounds were examined for counteracting metabolic syndrome inmice. The synthesized compounds revealed potentiality to prevent body weight gain as indicated by the decreased BMI of the mice fed high fructose diet. The hypolipidemic effect of the designed compounds was evidenced by the reduction of serum cholesterol, triglycerides, LDL-cholesterol and the enhancement of HDL-cholesterol levels. Moreover, the compounds displayed a significant decline in blood glucose and insulin levels. So, they exhibited significant betterment in insulin resistance of the treated mice. Furthermore, the treatment with these compounds improved serum spexin level in metabolic syndrome-challenged mice. Ultimately, the tested compounds demonstrated powerful free radical scavenging activity manifested by lowering MDA, NO and H2O2 serum levels. Conclusively, the newly modified hybrid steroid compounds proved good performance against metabolic syndrome in mice most probably due to their content of sulfur atom, in addition to their loading on mesoporous silica nanoparticles.

Prophylactic Use of Natural Products against Developmentally Programmed Metabolic Syndrome.

Parental dietary choices and/or nutritional interventions in the offspring are critical to early life development, especially during the periods of active developmental plasticity in the offspring. Exposure to a high-fructose, high-fat diet during the fetal or neonatal period predisposes the affected individuals to the development of one or more features of metabolic syndrome, such as dyslipidemia, insulin resistance, diabetes, and associated cardiovascular diseases, later in their life. Owing to the increasing global prevalence of metabolic syndrome and multiple side effects that accompany conventional medicines, much attention is directed towards medicinal plants and phytochemicals as alternative interventions. Several studies have investigated the potential of natural agents to prevent programmed metabolic syndrome. This present review, therefore, highlights an inextricable relationship between the administration of medicinal plants or phytochemicals during the intrauterine or neonatal period, and the prevention of metabolic dysfunction in adulthood, while exploring the mechanisms by which they exert such an effect. The review also identifies plant products as a novel approach to the prevention and management of metabolic syndrome.

The effects of flaxseed supplementation on metabolic syndrome parameters, insulin resistance and inflammation in ulcerative colitis patients: An open-labeled randomized controlled trial.

The present study aimed to evaluate the efficacy of flaxseed supplementation in the management of metabolic syndrome (MetS)-related parameters among the patients with mild-to-moderate ulcerative colitis (UC). A randomized controlled clinical trial was conducted on 70 patients with UC. Participants were randomized in the intervention group, which received 30 g/day ground flaxseed powder or control group. Anthropometric and biochemical variables were assessed at the beginning and end of 12 weeks of intervention. Of the 70 patients enrolled in this study, 64 subjects were included in the final analysis. From baseline to 12 weeks' intervention, flaxseed supplementation resulted in a significant reduction in the serum concentration of insulin (p < .001), HOMA-IR (p < .001), triglyceride (p=.001), total cholesterol (p < .001), and significant increase in the serum levels of HDL (p=.008). Also, we found a significant improvement in the SCCAI score (p < .001), TNF-α (p=.03), and CRP (p < .001) following the flaxseed supplementation. However, we not observed any significant differences between two groups regarding the body weight, BMI, waist circumferences, systolic, and diastolic blood pressure (p > .05). Overall, 12 weeks of flaxseed supplementation resulted in greater improvement in the some MetS-related parameters.

Clinical outcomes of a community clinic-based lifestyle change program for prevention and management of metabolic syndrome: Results of the 'Vida Sana/Healthy Life' program.

As US Hispanic populations are at higher risk than non-Hispanics for cardiovascular disease and Type 2 diabetes targeted interventions are clearly needed. This paper presents the four years results of the Vida Sana Program (VSP), which was developed and is implemented by a small clinic serving mostly Spanish-speaking, limited literacy population. The eight-week course of interactive two-hour sessions taught by Navegantes, bilingual/cultural community health workers, was delivered to participants with hypertension, or high lipids, BMI, waist circumference, glucose or hemoglobin A1C (A1C). Measures, collected by Navegantes and clinic nurses, included blood chemistries, blood pressure, anthropometry, and an assessment of healthy food knowledge. Most participants (67%) were female, Hispanic (95%), and all were 18 to 70 years of age. At baseline, close to half of participants were obese (48%), had high waist circumference (53%), or elevated A1C (52%), or fasting blood glucose (57%). About one third had high blood pressure (29%) or serum cholesterol (35%), and 22% scored low on the knowledge assessment. After the intervention, participants decreased in weight (-1.0 lb), BMI (-0.2 kg/m2), WC (-0.4 inches), and cholesterol (-3.5 mg/dl, all p<0.001). Systolic blood pressure decreased (-1.7 mm Hg, p<0.001), and the knowledge score increased (6.8 percent, p<0.001). VSP shows promising improvements in metabolic outcomes, similar to other programs with longer duration or higher intensity interventions. VSP demonstrates an important model for successful community-connected interventions.

The role of pharmacy in the management of cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness: a mixed-methods systematic literature review

BackgroundIndividuals with severe mental illness, e.g. schizophrenia have up to a 20% shortened life expectancy compared to the general population. Cardiovascular disease, due to cardiometabolic risk and metabolic syndrome, accounts for most of this excess mortality. A scoping search revealed that there has not been a review of published studies on the role of pharmacy in relation to cardiometabolic risk, metabolic syndrome and related diseases (e.g. type 2 diabetes) in individuals with severe mental illness.MethodsA mixed-methods systematic review was performed. Eleven databases were searched using a comprehensive search strategy to identify English-language studies where pharmacy was involved in an intervention for cardiometabolic risk, metabolic syndrome or related diseases in severe mental illness in any study setting from any country of origin. First, a mapping review was conducted. Then, implementation strategies used to implement the study intervention were classified using the Cochrane Effective Practice and Organisation of Care Taxonomy. Impact of the study intervention on the process (e.g. rate of diagnosis of metabolic syndrome) and clinical (e.g. diabetic control) outcomes were analysed where possible (statistical tests of significance obtained for quantitative outcome parameters reported). Quality assessment was undertaken using a modified Mixed Methods Appraisal Tool.ResultsA total of 33 studies were identified. Studies were heterogeneous for all characteristics. A total of 20 studies reported quantitative outcome data that allowed for detailed analysis of the impact of the study intervention. The relationship between the total number of implementation strategies used and impact on outcomes measured is unclear. Inclusion of face-to-face interaction in implementation of interventions appears to be important in having a statistically significantly positive impact on measured outcomes even when used on its own. Few studies included pharmacy staff in community or general practitioner practices (n = 2), clinical outcomes, follow up of individuals after implementation of interventions (n = 3). No studies included synthesis of qualitative data.ConclusionsOur findings indicate that implementation strategies involving face-to-face interaction of pharmacists with other members of the multidisciplinary team can improve process outcomes when used as the sole strategy. Further work is needed on clinical outcomes (e.g. cardiovascular risk reduction), role of community pharmacy and qualitative studies.Systematic review registrationPROSPERO CRD42018086411

Natural Bioactive Compounds Useful in Clinical Management of Metabolic Syndrome.

Metabolic syndrome (MetS) is a clinical manifestation characterized by a plethora of comorbidities, including hyperglycemia, abdominal obesity, arterial hypertension, and dyslipidemia. All MetS comorbidities participate to induce a low-grade inflammation state and oxidative stress, typical of this syndrome. MetS is related to an increased risk of cardiovascular diseases and early death, with an important impact on health-care costs. For its clinic management a poly-pharmaceutical therapy is often required, but this can cause side effects and reduce the patient’s compliance. For this reason, finding a valid and alternative therapeutic strategy, natural and free of side effects, could represent a useful tool in the fight the MetS. In this context, the use of functional foods, and the assumption of natural bioactive compounds (NBCs), could exert beneficial effects on body weight, blood pressure and glucose metabolism control, on endothelial damage, on the improvement of lipid profile, on the inflammatory state, and on oxidative stress. This review focuses on the possible beneficial role of NBCs in the prevention and in the clinical management of MetS and its comorbidities.

Psoriasis in Patients with Metabolic Syndrome or Type 2 Diabetes Mellitus: Treatment Challenges.

Psoriasis is a chronic inflammatory disease that affects 2-3% of the population worldwide. It is associated with plaques, psoriatic arthritis, and metabolic syndrome and its components, including obesity, diabetes, dyslipidemia, nonalcoholic fatty liver disease, and cardiovascular disease. In this review, we highlight the shared pathogenic pathways leading to the comorbid existence of both diseases and the impact of drugs used for psoriasis on metabolic syndrome and vice versa. Persistent inflammation is common to both diseases. They share increased inflammatory cytokines such as tumor necrosis factor (TNF)-α and interleukin-6. Biologics have revolutionized the treatment of plaque psoriasis and also have a positive impact on metabolic syndrome. There is some evidence that TNFα inhibitors decrease insulin resistance and improve glycemic indices. Some psoriasis treatments may result in decreased body weight. Lifestyle measures used in the management of metabolic syndrome, such as weight loss, exercise, and healthy diet, are beneficial in patients with psoriasis. Considering the association between metabolic syndrome and psoriasis, we recommend screening patients with psoriasis for metabolic syndrome with clinical examinations and laboratory tests. Patients with a co-diagnosis of these diseases deserve special attention for optimal treatment.

FUNCTIONAL BIGNAY CIDERS INHIBIT KEY ENZYMES LINKED TO OBESITY AND DIABETES FOR METABOLIC SYNDROME PROTECTION

Metabolic syndrome has become one of the major health issues worldwide. Cider beverages have several functional properties for health, such as antioxidant, antimicrobial, anti-inflammatory, and antidiabetic effects. In this study, we formulated cider beverages from bignay fruits (Antidesma bunius), identified their compounds, and evaluated their functional effects for metabolic syndrome protection. Ciders were produced from the aqueous extract of bignay fruit powder, fermented using Saccharomyces cerevisiae and Acetobacter xylinum for 3, 7, and 14 days. Compound identification in bignay ciders was done using gas chromatography-mass spectrometry (GC/MS). Antioxidant activity was done by the 1,1-diphenyl-2-picrylhydrazyl assay, while enzymatic inhibitory assays were tested against lipase, α-glucosidase, α-amylase, and angiotensin converting enzyme (ACE). GC/MS profiling showed that most bignay ciders contained major organic acids and amino acids. All ciders exerted high antioxidant activity (&gt;60%). Bignay ciders fermented from A. xylinum demonstrated significant inhibition (&gt;90%) against lipase and α-glucosidase activities. However, ciders had no functional effect on a-amylase and angiotensin-converting enzyme inhibition. These data suggest that bignay ciders may have potential as functional beverages with antioxidant, antiobesity, and antidiabetic effects for management of metabolic syndrome.

Role of yoga as an adjuvant therapy in the management of metabolic syndrome – A randomized control pilot study

Role of yoga as an adjuvant therapy in the management of metabolic syndrome – A randomized control pilot study

A multifunctional ingredient for the management of metabolic syndrome in cafeteria diet-fed rats.

The body weight-lowering properties of a multifunctional ingredient (MIX) based on conjugated linoleic acid at low doses, the flavonoids proanthocyanidins and anthocyanidins and the chicken feet hydrolysate Hpp11 have been previously reported. The aim of this study was to evaluate the effect of long-term administration of MIX on other cardiometabolic risk factors associated with metabolic syndrome (MetS) in rats fed a cafeteria diet (CAF). Male Wistar rats were fed CAF for 11 weeks, and during the last 3 weeks, animals were orally administered MIX or vehicle. Lipid tolerance tests were performed before and after MIX administration. At the end of the experimental period, serum and inguinal white adipose tissue (iWAT) metabolism were analyzed by metabolomics and biochemical approaches. The metabolite signature of serum and iWAT significantly changed after 3 weeks of MIX administration, suggesting an improvement in lipid and glucose homeostasis in these animals. In addition, MIX also exhibited significant antihypertensive properties. These results suggest that MIX could be a good candidate to ameliorate the cardiometabolic risk factors related to MetS.