Components Of Metabolic Syndrome In Patients Research Articles

Metabolic Syndrome in Psoriasis and Psoriatic Arthritis in a Mixed Race Population: Comparison of Their Prevalences.

There is a growing body of evidence suggesting the association between psoriasis (PsO) and psoriatic arthritis (PsA) separately with metabolic syndrome (MS) in different populations. The literature is relatively scarce in terms of comparing the prevalence of MS in PsO and PsA with controls without systemic inflammatory diseases. We aimed to assess the prevalence of MS among patients with PsO, PsA, and a control group without systemic inflammatory disease, in addition to investigating the risks of MS occurrence and its different components in each group. This is a cross-sectional case-control study with three groups of patients: PsO, PsA, and control. The diagnosis of MS was defined according to the modified 2009 NCTEP ATP III criteria. Patients underwent thorough physical examination and fasting blood samples. A total of 195 patients were included in this analysis (PsO = 50; PsA = 64, and controls = 81). The prevalence of MS in the control, PsO, and PsA groups was 37%, 56%, and 57.8%, respectively (p < 0.001). Waist circumference (p = 0.013) and arterial hypertension (p < 0.001) were the most significant components of MS in patients with PsO and PsA. Multivariate analysis confirmed an independent risk of MS in women, elderly patients, obese patients, patients with hyperglycemia, and patients with psoriasis, especially PsA (OR = 6.2 [CI 95% 2.4-16.2], p < 0.001). MS is more prevalent in patients with PsA, which can be determined by the increase in inflammatory pathways.

TO STUDY THYROID DYSFUNCTION IN PATIENTS WITH METABOLIC SYNDROME

Background: Metabolic syndrome (MetS) is a cluster of risk factors associated with increased cardiovascular disease and diabetes risk. Thyroid dysfunction (TD), especially hypothyroidism, has been observed more frequently in individuals with MetS. However, the relationship between thyroid function and metabolic syndrome components remains debated. This study aimed to explore the prevalence of thyroid dysfunction and its association with metabolic syndrome components in patients. Methods: A cross-sectional study was conducted at Sri Aurobindo Medical College &amp; P.G. Institute, Indore. A total of 120 patients meeting the International Diabetes Federation (IDF) criteria for metabolic syndrome were included. Detailed history, anthropometric measurements, blood pressure recordings, fasting blood sugar, lipid profile, and thyroid assays were performed. Statistical analysis using SPSS22 and Excel was employed to assess thyroid dysfunction prevalence and its correlation with metabolic syndrome components. Results: Among 120 patients with metabolic syndrome, 28% had thyroid dysfunction. Hypothyroidism was predominant, with subclinical hypothyroidism being the most common type. Females and older individuals (&gt;45 years) showed a higher prevalence of thyroid dysfunction. Patients with thyroid dysfunction exhibited altered metabolic syndrome components, including increased waist circumference, decreased HDL-C, elevated blood pressure, fasting glucose, and triglyceride levels. Conclusion: The study highlights a high prevalence of thyroid dysfunction, especially hypothyroidism, among patients with metabolic syndrome. These findings suggest a potential association between thyroid status and metabolic syndrome components. Screening for thyroid dysfunction in individuals with metabolic syndrome could aid in optimizing clinical management strategies. Further research with larger sample sizes and prospective designs is warranted to explore the impact of thyroid dysfunction management on metabolic syndrome outcomes.

The Effect of Laparoscopic Sleeve Gastrectomy on Body Mass Index and the Resolution of Other Metabolic Syndrome Components in Patients over 50 Years Old during a Two Year Follow-Up.

Background/Objectives: Metabolic syndrome, defined by the coexistence of central obesity, dyslipidemia, hypertension, and insulin resistance, is a significant contributor to increased cardiovascular morbidity and mortality in the aging population. We aimed to determine whether age influences the efficacy of LSG in treating obesity-related comorbidities. Methods: A retrospective analysis of lipid profiles, glycemic and clinical parameters was conducted in a group of 786 patients in two age groups (under 50 years old and over 50 years old) who underwent laparoscopic sleeve gastrectomy with follow-ups 1, 3, 6, 12 and 24 months after surgery. Results: There was a significant improvement in lipid metabolism with no significant differences between the two age groups in these parameters throughout the observation period. Furthermore, there was significant weight loss (54.82 kg vs. 54.56 kg) and BMI reductions (47.71 kg/m2 vs. 47.01 kg/m2 to 29.03 kg/m2 vs. 30.73 kg/m2). Total cholesterol decreased from 198 mg/dL to 184.9 mg/dL (<50 years old) and from 206.4 mg/dL to 193 mg/dL (>50 years old). LDL dropped from 136.2 mg/dL to 116.7 mg/dL and from 141.0 mg/dL to 121.0 mg/dL. Mean HbA1c decreased to comparable levels (5.66% vs. 5.53%). Both groups showed similar rates of remission for type 2 diabetes and hypertension. Conclusions: Our findings suggest that LSG is an effective method for treating components of metabolic syndrome regardless of age, supporting its use as a therapeutic tool for older patients.

Evaluation of Insulin Resistance and Metabolic Syndrome Components in Patients with Seborrheic Dermatitis

Objective: Seborrheic dermatitis (SD) is a common inflammatory skin disorder. There is scarce data regarding SD and metabolic syndrome. We aimed to investigate the prevalence of metabolic syndrome in patients with seborrheic dermatitis. Methods: Sixty-six patients with seborrheic dermatitis and 52 healthy controls were enrolled. Subjects’ height, weight, waist circumference, smoking status, and comorbidities were recorded. Blood pressure, fasting blood glucose, triglyceride, HDL, total cholesterol, and insulin levels were measured. Seborrheic dermatitis area and severity index (SASI) score, body mass index (BMI), and Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) were calculated. The presence of metabolic syndrome was evaluated. Results: BMI, waist circumference, glucose, HOMA-IR, and C-reactive protein (C-RP) were significantly higher in the SD group. The prevalence of hypertension and type II diabetes was significantly higher in the SD group than in the controls. There was no difference between the patient and control groups regarding metabolic syndrome. However, the duration of SD was significantly higher in SD with metabolic syndrome than those of SD without metabolic syndrome. There were no significant differences in age and SASI score between seborrheic dermatitis patients with and without metabolic syndrome. Conclusion: SD patients may have an increased risk of metabolic syndrome development and may have higher inflammation and insulin resistance status compared with controls.

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

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

Metabolic Syndrome Components in Patients with Pituitary Adenoma.

Pituitary adenomas are benign tumors of the anterior portion of the pituitary gland (adenohypophysis), representing the 25% of all the tumor alterations. Pituitary adenomas are classified by the type of hormone secreted, cellularity, size, and structural alterations by the hormonal segregation. The diagnosis consists on the histopathological identification of cell types and the image-guided by magnetic resonance or tomography; the treatment can be both pharmacological and surgical. Metabolic Syndrome is the set of clinical conditions that increase the risk of cardiovascular diseases with an estimated prevalence of 25% worldwide. The alterations of metabolic syndrome are obesity, hypertension, dyslipidemia, insulin resistance, and diabetes mellitus type II. Pituitary adenomas and metabolic syndrome have an important relationship, hormone-secreting by pituitary adenomas affects a myriad of signaling pathways, which allows a favorable environment for the appearance of the metabolic syndrome. Moreover, patients with pituitary adenomas are shown to have an improvement in metabolic parameters after the medical/surgical treatment. The objective of this review is to explore the possible mechanisms through which PAs contributes to MetSx.

Assessment of Metabolic Syndrome Components in Patients with Normocalcemic Hyperparathyroidism: A Retrospective Study

Assessment of Metabolic Syndrome Components in Patients with Normocalcemic Hyperparathyroidism: A Retrospective Study

Atherogenic index of plasma, lipid accumulation and visceral adiposity in metabolic syndrome patients.

Metabolic syndrome is a cluster of various clinical and biochemical abnormalities, needs early diagnosis and treatment to reduce morbidity and mortality. The present study is designed to compare Atherogenic Index of Plasma, Lipid Accumulation Product and Visceral Adiposity Index with metabolic syndrome components in patients with metabolic syndrome. The study comprises of 150 metabolic syndrome patients and 150 age and sex matched healthy controls of both genders in the age group of 20 - 65 years. Atherogenic Index of Plasma, lipid accumulation and Visceral Adiposity Index product index were calculated for all participants. Pearson Correlation was used to compareatherogenic Index of plasma, lipid accumulation and Visceral Adiposity Index product between cases and controls. The receiver operating characteristic curve (ROC) was used to compare the area under the ROC curve (AUC) of Atherogenic Index of Plasma, lipid accumulation and Visceral Adiposity Index product with metabolic syndrome. The comparisons between the BMI, WC, Atherogenic Index of Plasma ,lipid accumulation and Visceral Adiposity Index product were significantly higher in metabolic syndrome cases (p<0.001).Although the entire index were independently associated with Mets, AIP showed the highest area under the curve (0.954, 95% CI 0.929 0.978,p value p<0.0001) in identifying metabolic syndrome.

Порушення вуглеводного обміну та компоненти метаболічного синдрому в пацієнток із гіпертонічною хворобою на тлі фізіологічної та постхірургічної менопаузи

Мета — порівняння характеристик вуглеводного обміну, наявності інших компонентів метаболічного синдрому (МС) на тлі фізіологічної та постхірургічної менопаузи, а також оцінка можливого впливу замісної гормональної терапії (ЗГТ), призначеної для запобігання посткастраційним клімактеричним симптомам у жінок із гіпертонічною хворобою (ГХ) відповідних клінічних груп. Матеріал та методи. Обстежені 112 жінок із ГХ II ст. 1–2-го ступеня, середній вік яких становив 46,14 ± 1,60 року: I група — 37 хворих (середній вік — 45,70 ± 1,45 року) із ГХ II ст. і постхірургічною менопаузою в репродуктивному віці без ЗГТ; II група — 37 хворих (середній вік — 44,90 ± 1,82 року) із ГХ II ст. і постхірургічною менопаузою, яким призначалася комбінована ЗГТ; ІІІ група — 38 хворих (середній вік — 47,83 ± 1,70 року) із ГХ II ст. на тлі фізіологічної менопаузи без ЗГТ. Виявлення МС проводилося відповідно до Консенсусу Міжнародної діабетичної федерації (2009 р.). Результати. У жінок репродуктивного віку з постхірургічною менопаузою на тлі маніфестної гіпоестрогенемії без ЗГТ формуються порушення вуглеводного обміну, що проявляються вірогідним (р &lt; 0,01) зростанням рівнів глюкози натще, у глікемічному профілі, характеристик інсулінорезистентності (ІР) за індексом НОМА та глікованого гемоглобіну, що асоціюється з мінімальним відсотком виявленої нормоглікемії (37,8 %), найбільшим відсотком ІР (89,2 %) і ЦД (29,7 %) на відміну від значно вищих показників нормоглікемії на тлі прийому ЗГТ (83,7 %) та ранньої фізіологічної менопаузи (63,1 %), нижчих відсотків ІР (70,3 та 65,8 %) і ЦД (2,7 та 0 %) у двох останніх групах хворих. Призначення ЗГТ жінкам репродуктивного віку з постхірургічною менопаузою оптимізує вуглеводний і ліпідний обмін, що проявляється майже вдвічі меншим числом випадків (45,9 проти 81,1 %) реєстрації МС та вірогідно (р &lt; 0,01) меншою кількістю виявлених компонентів МС. Висновки. У жінок як із постхірургічною, так і з ранньою фізіологічною менопаузою на тлі гіпоестрогенемії присутні значні порушення вуглеводного обміну у вигляді гіперглікемії, ІР, ЦД, що асоціюються з кластером кардіометаболічних симптомів, які формують менопаузальний МС. Усі вищезгадані зрушення максимально маніфестують у хворих із пост-хірургічною менопаузою без ЗГТ, призначення якої в другій групі дозволило запобігти гіпоестрогенемії та уповільнити перебіг продіабетогенних змін вуглеводного обміну.

Prevalence of metabolic syndrome and predictors of metabolic risk in Indian children, adolescents and youth with type 1 diabetes mellitus.

Children with type 1 diabetes (T1D) are at the same risk of developing metabolic syndrome (MS) as the general population. Several environmental factors such as lifestyle, exogenous insulin therapy (over-insulinization) and genetic/familial factors are thought to underlie the phenotype of 'double diabetes' (co-existence of MS components in patients with T1D). To determine the prevalence of overweight/obesity and MS and to identify its predictors in Indian children, adolescents and young adults with T1D. This cross-sectional study included 355 children and youth aged 6-23 years with T1D. Demographic data were obtained from patients using questionnaires. Anthropometry, blood pressure, sexual maturity rating, biochemical measurements and body composition measurements were performed using standard protocols. Insulin resistance (IR) was calculated using estimated glucose disposal rate (eGDR) and MS was diagnosed using the international diabetes federation (IDF) consensus definition 2017. The prevalence of overweight/obesity and MS in our study was 15.5% and 4.5%, respectively. Abnormal HDL-cholesterol was the most common component of MS (55.6%) among children with T1D. Age, gender, body mass index (BMI) and eGDR were identified as significant predictors of the likelihood of MS. We found a similar prevalence of MS in children with T1D as compared to other healthy children, which emphasises the need for monitoring of eGDR to determine IR in these children.

Melatonin and melatonin-agonists for metabolic syndrome components in patients treated with antipsychotics: A systematic review and meta-analysis.

Metabolic side effects are a limiting factor in the use of antipsychotics, which remain the cornerstone of long-term management of patients with severe mental illness. There is contrasting evidence on a possible role of melatonin and melatonin-agonists in attenuating antipsychotic-induced metabolic abnormalities. We conducted a systematic review (PubMed, PsycInfo, Cochrane databases, up to August 2020) and a random-effect meta-analysis of double-blind, randomized placebo-controlled trials (RCTs) involving melatonin and melatonin-agonists in the treatment of antipsychotic-induced metabolic changes. The primary outcome was the standardized mean difference (SMD) of composite metabolic outcomes built with metabolic syndrome components. Secondary outcomes were individual metabolic syndrome components, and other anthropometric, glucose metabolism, lipid profile, and psychopathology measures. Out of the initial 41 studies, six documented five separate RCTs randomizing 248 patients (126 to melatonin/ramelteon, 122 to placebo) affected by schizophrenia-spectrum disorders and bipolar disorder. Melatonin/ramelteon outperformed placebo on the primary outcome (SMD -0.28, 95% CI=-0.39÷-0.168), as well as on all individual components of metabolic syndrome (systolic blood pressure MD -3.266, 95% CI=-6.020÷-0.511; fasting glucose MD -3.766, 95% CI=-5.938÷-1.593; triglycerides MD -9.800, 95% CI=-19.431÷-0.169; HDL MD 2.995, 95% CI=0.567÷5.423), except waist circumference. Melatonin/ramelteon augmentation may be beneficial for non-anthropometric metabolic syndrome components in patients treated with antipsychotics.

Relationship between metabolic syndrome components in patients with resistant arterial hypertension

Metabolic syndrome (MS) is a complex of interrelated pathological conditions based on insulin resistance, obesity, dyslipoproteinemia, arterial hypertension (AH). MS is a predictor of the cardiovascular disease, type 2 diabetes mellitus (DM), cancer and premature death. The incidence of type 2 diabetes increases with age and is 25.2% among the elderly. The prevalence of prediabetes or metabolic syndrome was approximately three times higher. Heart failure is another important cause of morbidity and mortality from the cardiovascular disease. Recent studies have shown that the incidence of hospitalizations for heart failure (adjusted for age and gender) was twice as high in patients with diabetes compared with patients without diabetes. Patients with hypertension and abdominal obesity (AO) have an increased risk of various complications: type 2 diabetes -5-9 times, stroke - 7 times, coronary heart disease - 4 times and mortality - 2 times. Objective: To analyze the relationship between the components of the metabolic syndrome in patients with resistant arterial hypertension (RAH). Materials and methods. A retrospective analysis of case histories of 120 patients, including 52 men (43.33%) and 68 women (56.67%) with a diagnosis of RAH and signs of MS. The presence of concomitant pathology, the level of office arterial pressure, pulse pressure (PP) were calculated; body weight, height with calculation of body mass index (BMI); waist circumference (WC), the levels of low-density lipoprotein (LDL) and high-density lipoprotein (HDL), triglycerides (TG), and plasma glucose were studied. Student's criterion was used to assess the degree of significance of the differences, p≤0.05 was taken as the critical level of significance. Pearson's correlation coefficient was used. Disorders of carbohydrate metabolism among patients with MS and RAH is 67.50%, of which type 2 diabetes makes 50.83%, impaired glucose tolerance - 16.67%. Patients with impaired carbohydrate metabolism are 2 times more likely to have complications of hypertension and lower HDL. Women with MS and RAH were significantly older than men and more often had concomitant pathology: morbid obesity (p &lt;0.05), type 2 diabetes mellitus (p &lt;0.05), chronic cerebral ischemia (p &lt;0.05), higher body mass index (p &lt;0.01). Strong correlation between WC and BMI (r = 0.707; p˂0.001), weak direct correlations between WC and PP (r = 0.231; p˂0.05) and WC and TG (r = 0.221; p˂0.05), weak feedback between WC and age (r = -0.188; p˂0.05), and for men direct correlations between WC and TG were confirmed (r = 0.454; p˂0.001), BMI and TG (r = 0.454, p˂0.002).

Mechanistic Effects of Vitamin D Supplementation on Metabolic Syndrome Components in Patients with or without Vitamin D Deficiency.

The prevalences of metabolic syndrome (MetS) and vitamin D deficiency are increasing dramatically worldwide. MetS is a major challenge because it can increase the risk of most non-communicable diseases. The beneficial effect of vitamin D on MetS components remains controversial, so the present review focused on the clinical effects of vitamin D supplementation on MetS components. Vitamin D can inhibit the protein expression of nuclear factor beta; improve arterial stiffness; decrease renin-angiotensin-aldosterone system activity, parathyroid hormone levels, inflammatory cytokines, 3-hydroxy-3-methylglutaryl-coenzyme A reductase, and lanosterol 14 α-demethylase enzyme activity; increase the activity of lipoprotein lipase; alter gene expression in C2C12 cells; and improve phospholipid metabolism and mitochondrial oxidation. We tried to elucidate and analyze almost all evidence from randomized controlled trial studies of the efficacy of vitamin D supplementation in patients with MetS. The findings of the present study reported beneficial effects of vitamin D supplementation on mentioned factors. Vitamin D supplementation is recommended in people with vitamin D deficiency even if it has no considerable effect on most MetS factors. However, existing data from interventional studies are insufficient to reach a definitive conclusion about the effect of vitamin D supplementation on MetS components in patients without vitamin D deficiency. Thus, new clinical studies are needed to test the hypothesis that vitamin D supplementation could alleviate MetS components in patients with sufficient intake of vitamin D.

Evaluation of serum FoxO1, mTORC1, IGF-1, IGFBP-3 levels, and metabolic syndrome components in patients with acne vulgaris: A prospective case-control study.

Recently, insulin-like growth factor-1 (IGF-1), forkhead box transcription factor (Fox) O1, and mechanistic target of rapamycin complex 1 (mTORC1) signaling have been introduced as key elements in acne pathogenesis. The aim of this study is to investigate the relationship between serum levels of IGF-1, insulin-like growth factor binding protein-3 (IGFBP-3), FoxO1 and mTORC1, and the components of metabolic syndrome (MS) and AV. This prospective case-control study was carried out on 89 participants, including 49 AV patients and 40 controls. The serum levels of IGF-1, IGFBP-3, insulin, FoxO1, and mTORC1 were measured along with the components of MS. The blood pressure (BP) measures were significantly higher in the AV patients than in the controls (P = .001). The mean high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in the AV patients than in the controls (P = .040). The numbers of accompanying MS components were significantly higher in the AV patients than in the controls (P = .001). The IGFBP-3 levels were significantly higher in the AV patients than in the controls (P = .02). The IGF-1, mTORC1, and FoxO1 levels were higher in the AV patients than in the controls; neither were statistically significant (P = .093, P = .741, and P = .564, respectively). The higher BP and IGFBP-3 levels, the lower HDL-C levels and the common presence of MS components demand caution in terms of new therapeutic strategies and possible associated comorbidities.

Evolution of metabolic syndrome components in patients with autosomal-dominant polycystic kidney disease: a six-year follow-up study

Aim: Long-term studies show that some metabolic syndrome (MS) components deteriorate renal function in autosomal dominant polycystic kidney disease (ADPKD) patients. The aim of this 6-year follow-up was to analyze early changes of all MS components and their associations with kidney function in the nondiabetic ADPKD patients with normal renal function, compared to controls. Material/Methods: The follow-up physical and laboratory examinations were performed for 39 ADPKD patients (age 43.7 ± 11.4 years) and 44 controls (43.5 ± 9.1 years). Results: We noticed a significant increase in weight, body mass index (BMI), waist, total and LDL cholesterol, C-peptide, uric acid, creatinine and significant decline of HbA1c and e-GFR in the ADPKD group. Increases in waist, uric acid and creatinine concentrations were significantly higher in the ADPKD patients than controls. Both groups showed similar rates of prediabetes, while diabetes developed in 5 controls (with 4 cases of type 2 diabetes and one case of type 1), but not in the ADPKD group (11% vs 0%, P = 0.06 for diabetes, 9% vs 0%, P = 0.12 for type 2 diabetes). The ADPKD group showed a significantly higher percentage of obesity, waist circumferences, systolic/diastolic blood pressure, concentrations of creatinine, urea and uric acid and lower e-GFR. The MS prevalence was comparable; however, the number of MS components was significantly higher in the ADPKD patients (median 2 vs. 1, p = 0.001). Conclusions: The presence of MS does not influence the rate of renal failure progression in nondiabetic ADPKD patients with normal renal function at a 6-year follow-up.

ASSOCIATIONS OF IRS-1 POLYMORPHISM WITH VARIOUS COMPONENTS OF THE METABOLIC SYNDROME IN HYPERTENSIVE PATIENTS

The metabolic syndrome is one of the most discussed cross-disciplinary problems of modern medicine. Now there are various definitions and criteria of diagnostics of metabolic syndrome. The abdominal obesity is considered the main component of the metabolic syndrome, as a reflection of visceral obesity which degree is offered to be estimated on an indirect indicator – a waist circumference. Alongside with abdominal obesity, a number of classifications distinguish insulin resistance (IR) as a diagnostic criterion of metabolic syndrome. It is proved that IR is one of the pathophysiological mechanisms influencing the development and the course of arterial hypertension (AH), type 2 DM and obesity. There are two components in the development of IR: genetic (hereditary) and acquired. In spite of the fact that IR has the accurate genetic predisposition, exact genetic disorders of its appearance have not been identified yet, thus demonstrating its polygenic nature. To establish possible associations of the insulin receptor substrate-1 (IRS-1) gene polymorphism with the severity of the metabolic syndrome components in patients with arterial hypertension (AH). 187 patients with AH aged 45-55 years and 30 healthy individuals. Methods: anthropometry, reactive hyperemia, color Doppler mapping, biochemical blood analysis, HOMA-insulin resistance (IR), glucose tolerance test, enzyme immunoassay, molecular genetic method. Among hypertensive patients, 103 had abdominal obesity, 43 - type 2 diabetes, 131 - increased blood triglycerides, 19 - decreased high density lipoproteins, 59 - prediabetes (33 - fasting hyperglycemia and 26 - impaired glucose tolerance), 126 had IR. At the same time, hypertensive patients had the following distribution of IRS-1 genotypes: Gly/Gly - 47.9%, Gly/Arg - 42.2% and Arg/Arg - 10.7%, whereas in healthy individuals the distribution of genotypes was significantly different: Gly/Gly - 86.8% (p <0.01), Gly/ Arg - 9.9% (p <0.01) and Arg/Arg - 3.3% (p <0.05). Hypertensive patients with Arg/Arg and Gly/Arg genotypes had significantly higher HOMA-IR (p <0.01), glucose, insulin and triglycerides levels (p <0.05), than in Gly/Gly genotype. At the same time, body mass index, waist circumference, blood pressure, adiponectin, HDL, interleukin-6, C-reactive protein, degree of endothelium-dependent vasodilation, as well as the frequency of occurrence of impaired glucose tolerance did not significantly differ in IRS-1 genotypes. In hypertensive patients, the genetic polymorphism of IRS-1 gene is associated with such components of the metabolic syndrome as hypertriglyceridemia and fasting hyperglycemia; it is not associated with proinflammatory state, endothelial dysfunction, dysglycemia, an increase in waist circumference and decrease in HDL.

Association between the intima-media thickness of the extracranial carotid arteries and metabolic syndrome in ethnic Kyrgyzs

BackgroundIt is known that atherosclerosis is the leading cause of cardiovascular disease. We aimed to study the correlation between components of metabolic syndrome (MS) and subclinical carotid atherosclerosis in a group of ethnic Kyrgyzs.MethodsIn а descriptive study we assessed 144 ethnic Kyrgyzs (69 males, 75 females) aged 36–73 years (average age 51.03 ± 8.2). All participants underwent a clinical investigation and an anthropometric evaluation (weight, height, waist circumference (WC)). Abdominal obesity (АО) was confirmed at WC ≥ 94 cm in males and ≥ 88 cm in females. Fasting plasma glucose and lipid spectrum tests were performed. An ultrasound assessment of carotid intima-media thickness (IMT) was performed using a 7.5 MHz transducer (Phillips-SD 800).ResultsMS was revealed in 61 (42.4%; 47.8% in men and 37.3% in women) of the investigated patients. IMT was significantly increased with the presence of MS components in males (no components vs 2 components of MS: 0.67 ± 0.007 and 0.81 ± 0.009 respectively; р < 0.05) and females (no components vs 3 components of MS: 0.63 ± 0.007 and 0.76 ± 0.01 respectively; р < 0.01). IMT trended towards an increase in the presence of a greater number of MS components in patients with and without AO (р < 0.01). In order to identify independent factors affecting IMT we carried out a multifactorial logistic regression analysis. Arterial hypertension was found to have the greatest influence on the development of MS (OR = 3.81, p < 0.0001).ConclusionIn the group of ethnic Kyrgyzs, a greater number of MS components, with AO or without AO, is associated with higher carotid IMT.

Characteristics of pulmonary infection after mitral valve repair in patients with metabolic syndrome and its relationship with blood pressure, blood glucose and blood lipid.

Characteristics of pulmonary infection after mitral valve repair in patients with metabolic syndrome (MS) and its relationships with blood pressure, blood glucose and blood lipid were investigated. Clinical data of 126 patients were retrospectively analyzed, and patients were divided into infection group (n=19) and non-infection group (n=107). The differences of MS components in patients between the two groups were compared, and the distribution of pathogens and related factors of pulmonary infection were analyzed. The postoperative pulmonary infection rate was 15.08% (19/126); the body mass index (BMI), blood pressure, fasting blood glucose (FBG), triglyceride, total cholesterol, low-density lipoprotein cholesterol, the extubation time of trachea cannula, ventilator use time, rethoracotomy hemostasis rate, sternal dehiscence rate and incidence of low-cardiac-output syndrome were higher and high-density lipoprotein (HDL-C), left ventricular ejection fraction (LVEF) was lower in the infection group than that in the non-infection group (p<0.05). The rate of postoperative pulmonary infection in patients with MS was higher than in those without MS (p<0.05). Cardiac function, BMI, FBG, HDL-C, LVEF value, extubation time of trachea cannula, ventilator use time, sternal dehiscence, rethoracotomy hemostasis and low-cardiac-output syndrome were independent risk factors for pulmonary infection after mitral valve repair in patients with MS. In conclusion, pulmonary infection easily occurs in patients with MS after mitral valve repair. Taking intervention measures according to the characteristics of pulmonary infection pathogens and predisposing factors is expected to reduce the incidence of pulmonary infection.

Frequency of metabolic syndrome components in patients with ischemic heart disease

&amp;lt;p&amp;gt;Introduction. Metabolic syndrome is a cluster of metabolic disorders that increase the risk of type 2 diabetes and cardiovascular diseases. The aim of the study is to determine the frequency of certain metabolic syndrome components by applying International Diabetes Federation (IDF) criteria prior to and after diagnosing ischemic heart disease. Methods. In a retrospective-prospective study, risk factors for metabolic syndrome prior to and after the ischemic heart disease were analyzed. The sample included 107 patients suffering from ischemic heart disease. All patients with ischemic heart disease treated in the Primary Healthcare Centre Lakta&amp;amp;scaron;i (Bosnia and Herzegovina) from 1st January 2010 to 30th November 2015 were included in the study. The patients were diagnosed with the ischemic heart disease by cardiology examination, ergometric testing and coronagraphy. All patients were subjected to anthropometric and blood pressure measurement and their blood samples were taken after 12 hours of being famished in order to determine the glucose and lipid levels. Results. After cardiovascular event a statictically significant decrease in the number of patients with increased body mass index (46 vs. 38, p &amp;amp;lt; 0.001), increased levels of triglycerides (53 vs. 37, p &amp;amp;lt; 0.001), low levels of HDL cholesterol (31 vs. 30, p = 0.100), increased systolic blood pressure (77 vs. 23, p = 0.004) was registered. Statistically significant increase in the number of patients with central obesity (61 vs. 92, p &amp;amp;lt; 0.001), increased fasting blood glucose (68 vs. 73, p &amp;amp;lt; 0.001), as well as those receiving pharmacotherapy for hypertension (49 vs. 90, p = 0.002) and diabetes (14 vs. 24, p &amp;amp;lt; 0.001) was recorded. Conclusion. After diagnosing ischemic heart disease, the majority of metabolic syndrome parameters were reduced by applying pharmacological and non-pharmacological measures. Family physicians have an important role in an early identification of patients with metabolic syndrome as well as in the prevention of ischemic heart disease.&amp;lt;/p&amp;gt;

The relationship between food insecurity with cardiovascular risk markers and metabolic syndrome components in patients with diabetes: A population-based study from Kerman coronary artery disease risk study.

Background:We sought the prevalence of food insecurity and whether cardiovascular risk markers and metabolic syndrome components are significantly different in categories of food insecurity in patients with type 2 diabetes.Materials and Methods:In this cross-sectional study, 520 patients with type 2 diabetes from the Kerman coronary artery disease risk study aged between 23 and 87 years (60.8 ± 11.4) who selected by one-stage cluster sampling were assigned into four groups of “food secure” and “mild,” “moderate,” and “severe” food insecure. Household food insecurity was assessed by a 9-item household food insecurity access scale questionnaire.Results:The prevalence of food security and mild, moderate, and severe food insecurity in patients with diabetes was 24.4%, 33.1%, 28.9%, and 13.6%, respectively. There was a significant difference among the food-secure/insecure sex groups (P = 0.001). The prevalence of food insecurity and risk factors such as total cholesterol, high low-density lipoprotein cholesterol, and visceral obesity in mild food-insecure females was significantly higher than males (P < 0.001, 0.001, and 0.001, respectively). The fasting blood sugar significantly increased (P = 0.020) in diabetic females with food security than the other female groups. Diastolic blood pressure significantly increased (P = 0.028) in diabetic females with severe food insecurity than the other female groups. The glycosylated hemoglobin significantly increased (P = 0.013) in diabetic males with severe food insecurity than the other male groups. Food insecurity odds ratio in females was 1.74 (95% confidence interval [CI]: 1.10–2.70), 2.39 (95% CI: 1.48–3.88), and 2.73 (95% CI: 1.49–5.01) times higher than in males for mild, moderate, and severe food insecurity, respectively.Conclusion:Food insecurity may deteriorate some cardiometabolic biomarkers in type 2 diabetes. Improving food security in patients with diabetes may help reduce cardiovascular disease.