Metabolic Syndrome Disease Research Articles

Efficacy of a multidimensional self-management intervention on low-education women with metabolic syndrome: a cluster randomized controlled trial

Low-education women, a substantially older population, are subject to increased risks of metabolic syndrome and consequent cardiometabolic diseases; early detection and effective management were urgently needed. Ninety-nine women with metabolic syndrome, age 61 and education ≤ 6 years, from four community units were randomly assigned to either a self-management intervention (n = 51) or a control arm (n = 48). The intervention consisted of five dimensions, physical activity and diet modifications (daily exercise classes and two nutrition courses), goal setting, coaching and peer support, problem-solving, and self-monitoring. The control arm received an education leaflet. Assessments were performed at baseline, six months, and 18 months. Compared with the control, the intervention participants improved the overall rate of meeting the recommended servings for six health foods, including vegetables, dairy products, and nuts (except whole grains, fruits, and protein); the rate of meeting regular leisure-time physical activity; and criteria biomarkers—waist circumference, fasting blood glucose, high-density lipoprotein cholesterol (except blood pressure and triglycerides); as well as body weight and body mass index; consequently decreased the number of risk factors and rate of metabolic syndrome. In conclusion, the multidimensional self-management intervention improved physical activity, healthy eating, and metabolic syndrome risks among low-education women with metabolic syndrome.

Association of metabolic syndrome and insulin resistance in papulosquamous diseases

Background: Metabolic syndrome (MetS), insulin resistance (IR) and papulosquamous diseases with shared pathophysiology leads to conglomeration of risk factors of non-communicable diseases like cardiovascular disease (CVD) and type 2 diabetes (T2D) causing high mortality worldwide. The objective is to study the association of MetS and IR in papulosquamous diseases. Methods: It is a hospital-based case-control study conducted on 200 age-sex matched cases and controls with consent. Subjects were administered a pre-validated questionnaire, diagnosis of papulosquamous diseases was based on clinical examination and skin biopsy. MetS was diagnosed based on national cholesterol education program's- adult treatment plan iii with Asian modification for abdominal circumference criteria. Fasting serum insulin levels (FI) was used as a surrogate marker of IR. Results: Mean serum HDL- C level was low and statistically significant (p=0.017). Mean fasting plasma glucose level was significantly higher in patients (p=0.008). Mean FI level was significant between cases and controls (p=0.013). IR was found in 76% of cases which was significantly higher than in controls (p<0.05). IR was highest in psoriasis 29% followed by LP 22%, PRP 19%, and LS 6% which was statistically significant (p<0.05). MetS was mostly found in psoriasis (17%), LP (9%) and least in PRP, LS. Conclusions: This study intends clinicians to do periodic MetS and IR evaluation in papulosquamous diseases. Thus, subclinical cases of non-communicable diseases can be detected and potential co-morbidities can be prevented.

P-648 Association of severity of menstrual dysfunction with cardiometabolic risk markers in polycystic ovary syndrome

Abstract Study question Is the severity of menstrual dysfunction related to cardiometabolic risk markers in women with polycystic ovary syndrome (PCOS)? Summary answer PCOS women with amenorrhea, compared to those with oligomenorrhea or eumenorrhea, show a higher prevalence of insulin resistance (IR), prediabetes and hypertriglyceridemia. What is known already PCOS is associated robustly with a wide range of unfavorable cardiometabolic risk markers, including obesity, glucolipid metabolism disorders and metabolic syndrome. Many epidemiological studies have found compared to the women with regular menstrual cycles, women with a history of irregular menstruation increased the risks of metabolic syndrome and coronary heart disease. Recently, the association between the severity of menstrual cyclicity and hyperinsulinemia and IR has been demonstrated, suggesting menstrual history could be a simple but clinically important marker of metabolic dysfunction risk. But evidence linking the severity of menstrual cyclicity with cardiometabolic risk in PCOS women is very limited. Study design, size, duration In this prospective cross-sectional study, one hundred and fifty-four women diagnosed with PCOS by the Rotterdam criteria were recruited from July 2021 to September 2022. The association of menstrual cycle regularity with cardiometabolic risk markers including obesity, hypertension, glycemic abnormalities, dyslipidemia and metabolic syndrome was systematically analyzed. Participants/materials, setting, methods In a university-affiliated hospital, PCOS participants with eumenorrheic (Eumeno, n = 24), oligomenorrhea (Oligo, n = 73) and amenorrhea (Ameno, n = 57) underwent history and physical examination, gonadal steroid hormone measurement, lipid profile, oral glucose tolerance test (OGTT) and homeostasis model assessment of IR. Main results and the role of chance Adjusting for age, BMI and waist circumference, a trend toward an increase of unfavorable cardiometabolic risk markers including obesity, hypertension, prevalence of IR, prediabetes, hypertriglyceridemia and prevalence of metabolic syndrome was observed in Ameno group than in other menstrual categories. A significantly higher prevalence of IR, prediabetes and hypertriglyceridemia was demonstrated in Ameno group compared to the Eumeno or Oligo group. In logistic regression, adjusting for age, BMI, and waist circumference, Ameno women were more likely to have: IR than Eumeno women (odds ratio [OR]: 2.90; 95% CI: 1.01 to 8.31); prediabetes than Eumeno women (OR: 4.06; 95% CI: 1.05 to 15.77) and hypertriglyceridemia than Oligo women (OR: 4.43; 95% CI: 1.74 to 11.26). Moreover, the prevalence of IR, prediabetes and hypertriglyceridemia was still significantly higher in Ameno group than that in the Oligo or Eumeno group when further adjusted for free androgen index in the logistic regression. The proportion of Type 2 Diabetes, high total cholesterol, high low-density lipoprotein (LDL) cholesterol and low high-density lipoprotein (HDL) cholesterol was similar across the three groups. Limitations, reasons for caution Our study was limited by its cross-sectional nature, and another limitation was the cycle regularity question relied on the participant’s interpretation of irregular, although we have acquired the detailed menstrual cycle history and further reviewed at consultation, yet some exposure misclassification might also be present. Wider implications of the findings Our study used menstrual cycle as a readily obtainable marker for identification of PCOS women at greatest risk of IR, prediabetes and hypertriglyceridemia, which would emphasize the importance of menstrual cycle regularity and help refine the current recommendations concerning the screening of PCOS subjects for cardiometabolic diesases. Trial registration number 20210728

1586-P: Post-OGTT Low Blood Glucose in Individuals with Metabolic Syndrome, Metabolic Phenotypes, and Metabolic-Associated Fatty Liver Disease

Introduction: Post-prandial low blood glucose (LBG) is usually associated with late postprandial hyperinsulinemia in metabolic syndrome (MetS), but have not been well studied. Objectives: We aimed to 1) characterize insulin/glucose metabolism associated with LBG post 75g OGTT in a sample of individuals with MetS; and 2) assess the association between MAFLD (≥ 5% liver fat at MRI) and LBG. Methods: Plasma glucose, insulin and c-peptide concentrations were measured on OGTT over 180 mins. Insulin sensitivity and secretion were assessed with the Oral Minimal Model. During OGTT, we defined glucose ≤ 50 mg/dl as LBG, glucose > 70 mg/dl as no LBG and glucose 51-70 mg/dl as undefined status and were excluded from this analysis. Results: Of 82 participants, 50 were included and 15 (18 %) experienced LBG. Of the 33 participants who underwent MRI, 48% had MAFLD. Median age and BMI were 59 [IQR: 49-74] years and 28 [IQR: 26-31] kg/m2 respectively. Women represented 70% (n=35) of participants and experienced less LBG (p=0.0002) than men. Individuals experiencing LBG had higher insulin sensitivity (p=0.02), higher ß cell function (p=0.03), earlier glucose peaks (p<0.0001) and lower c-peptide peaks (p=0.007) than those without LBG. MAFLD was not associated with more LBG (p=0.7), but was associated with a different insulin curve. LBG+MAFLD status was associated with higher and later c-peptide and insulin levels compared to LBG without MAFLD status. Conclusion: In contrary to our hypothesis, individuals with MetS without MAFLD experiencing glucose ≤ 50 mg/dl during OGTT displayed a healthier metabolic profile. However, individuals with MAFLD experiencing a LBG during OGTT had a glucose phenotype similar to the late post-prandial hyperinsulinemic hypoglycemia often found in prediabetes state and associated with worst metabolic parameters. This suggests that MAFLD may be an important feature of MetS associated with a different post-OGTT glucose metabolism. Disclosure T.Gignac: None. A.Morissette: None. A.Agrinier: None. C.Gagnon: Advisory Panel; Novo Nordisk, Other Relationship; Ascendis Pharma A/S, Research Support; Novo Nordisk. M.Vohl: None. A.Marette: Advisory Panel; Valbiotis, Amancia, Plexus, Acasti. A.Carreau: Advisory Panel; Novartis, Consultant; Valbiotis, Speaker's Bureau; Novo Nordisk Canada Inc.

1590-P: Post-Oral Glucose Load Hyperinsulinemia in Individuals with Metabolic Syndrome and Metabolic-Associated Fatty Liver Disease—First Steps toward the Development of Type 2 Diabetes?

Introduction: Metabolic associated fatty liver disease (MAFLD) increases the risk of incident type 2 diabetes (T2D), but mechanisms involved have not been clearly elucidated. Objective: To assess post-oral glucose tolerance test (OGTT) glucose metabolism, insulin resistance, secretion and clearance in individuals with metabolic alterations, with or without increased liver fat. Methods: Individuals with a BMI >25 kg/m2 and at least 1 criteria for metabolic syndrome were included in this analysis. Liver fat was quantified using MRI and participants were assigned to 2 groups according to > 5% liver fat (MAFLD group) or ≤ 5%. A 3h frequently-sampled OGTT was performed and oral minimal model was used to measure insulin sensitivity, secretion and disposition index. Results: Fifty participants were included in this analysis and 50% had a liver fat > 5%. Post-OGTT glucose concentrations and iAUC glucose were not different between groups (p -≥ 0.50), whereas post-OGTT insulin concentrations and iAUC were significantly higher in the MAFLD group (p < 0.03) and significantly associated with liver fat. The components of insulin secretion (dynamic, static and total) were not different between groups (p -≥ 0.27). Insulin sensitivity and dynamic disposition indices were lower in the MAFLD group and significantly associated with liver fat. but in a multivariable regression model including sex and BMI, liver fat was not statistically associated with these indices. Insulin clearance indices were significantly lower in the MAFLD group, and liver fat statistically explained most of the variance in the multivariate model (p< 0.02). Conclusion: Among individuals with metabolic alterations, the presence of MAFLD is associated with impaired insulin clearance and post-oral glucose load hyperinsulinemia. Insulin sensitivity and dynamic beta-cell function are also altered, features of the early pathophysiology of T2D. Disclosure G.Trépanier: None. T.Gignac: None. M.Pradeau: None. A.Morissette: None. A.Agrinier: None. C.Gagnon: Advisory Panel; Novo Nordisk, Other Relationship; Ascendis Pharma A/S, Research Support; Novo Nordisk. M.Vohl: None. A.Marette: Advisory Panel; Valbiotis, Amancia, Plexus, Acasti. A.Carreau: Advisory Panel; Novartis, Consultant; Valbiotis, Speaker's Bureau; Novo Nordisk Canada Inc.

Psoriasis immunometabolism: progress on metabolic biomarkers and targeted therapy.

Psoriasis is a common inflammatory disease that affects mainly the skin. However, the moderate to severe forms have been associated with several comorbidities, such as psoriatic arthritis, Crohn's disease, metabolic syndrome and cardiovascular disease. Keratinocytes and T helper cells are the dominant cell types involved in psoriasis development via a complex crosstalk between epithelial cells, peripheral immune cells and immune cells residing in the skin. Immunometabolism has emerged as a potent mechanism elucidating the aetiopathogenesis of psoriasis, offering novel specific targets to diagnose and treat psoriasis early. The present article discusses the metabolic reprogramming of activated T cells, tissue-resident memory T cells and keratinocytes in psoriatic skin, presenting associated metabolic biomarkers and therapeutic targets. In psoriatic phenotype, keratinocytes and activated T cells are glycolysis dependent and are characterized by disruptions in the TCA cycle, the amino acid metabolism and the fatty acid metabolism. Upregulation of the mammalian target of rapamycin (mTOR) results in hyperproliferation and cytokine secretion by immune cells and keratinocytes. Metabolic reprogramming through the inhibition of affected metabolic pathways and the dietary restoration of metabolic imbalances may thus present a potent therapeutic opportunity to achieve long-term management of psoriasis and improved quality of life with minimum adverse effects.

Prebiotic Supplementation during Lactation Affects Microbial Colonization in Postnatal-Growth-Restricted Mice.

An inadequate perinatal nutritional environment can alter the maturation of the intestinal barrier and promote long-term pathologies such as metabolic syndrome or chronic intestinal diseases. The intestinal microbiota seems to play a determining role in the development of the intestinal barrier. In the present study, we investigated the impact of consuming an early postnatal prebiotic fiber (PF) on growth, intestinal morphology and the microbiota at weaning in postnatal-growth-restricted mice (PNGR). Large litters (15 pups/mother) were generated from FVB/NRj mice to induce PNGR at postnatal day 4 (PN4) and compared to control litters (CTRL, 8 pups/mother). PF (a resistant dextrin) or water was orally administered once daily to the pups from PN8 to PN20 (3.5 g/kg/day). Intestinal morphology was evaluated at weaning (PN21) using the ileum and colon. Microbial colonization and short-chain fatty acid (SCFA) production were investigated using fecal and cecal contents. At weaning, the PNGR mice showed decreased body weight and ileal crypt depth compared to the CTRL. The PNGR microbiota was associated with decreased proportions of the Lachnospiraceae and Oscillospiraceae families and the presence of the Akkermansia family and Enterococcus genus compared to the CTRL pups. The propionate concentrations were also increased with PNGR. While PF supplementation did not impact intestinal morphology in the PNGR pups, the proportions of the Bacteroides and Parabacteroides genera were enriched, but the proportion of the Proteobacteria phylum was reduced. In the CTRL pups, the Akkermansia genus (Verrucomicrobiota phylum) was present in the PF-supplemented CTRL pups compared to the water-supplemented ones. PNGR alters intestinal crypt maturation in the ileum at weaning and gut microbiota colonization. Our data support the notion that PF supplementation might improve gut microbiota establishment during the early postnatal period.

Cardio-metabolic risk in Rotterdam clinical phenotypes of PCOS

Background and aimsElevated anti-Müllerian hormone (AMH) in polycystic ovary syndrome (PCOS) characterizes the clinical severity of the 4 phenotypes; but whether it also reflects the corresponding differences in cardio-metabolic risk remains to be elucidated. This study aimed to compare metabolic profile between the 4 clinical phenotypes of PCOS and to determine the influence of AMH levels on metabolic severity. MethodsOne hundred and forty-four women with PCOS, aged between 20 and 40years, were recruited in this cross-sectional study and categorized according to the 4 phenotypes of the Rotterdam criteria. Anthropometry and blood pressure were recorded. Fasting lipid profile, fasting glucose, fasting insulin, homeostasis model assessment insulin resistance, total testosterone and AMH were estimated. Clinical, anthropometric and metabolic profiles were compared between the 4 phenotypes. ResultsThere were significant differences in menstrual abnormalities, weight, hip circumference, clinical hyperandrogenism, ovarian volume and AMH levels between the 4 phenotypes. Cardio-metabolic risk factors and rates of metabolic syndrome (MS) and insulin resistance (IR) were comparable. ConclusionCardio-metabolic risk is similar in all phenotypes of PCOS despite differences in anthropometry and AMH levels. All women diagnosed with PCOS should undergo screening and lifelong surveillance for MS, IR and cardiovascular diseases, irrespective of clinical phenotype or AMH level. This needs further validation in prospective multi-center studies across the country, with larger sample sizes and adequate power.

Fat-to-lean mass ratio as a tool to detect the dysmetabolic profile in childhood cancer survivors

IntroductionSurvival after childhood cancer has significantly improved in recent decades. Nevertheless, an increased incidence of metabolic syndrome and cardiovascular disease among childhood cancer survivors (CCS) has been reported. The aim of this study was to evaluate whether fat-to-lean mass ratio (FLR) is associated with a dysmetabolic profile in CCS. MethodsAt least 2 years from completion of therapy, data from CCS aged 10 to 16 years at follow-up and without any concurrent steroid treatment were collected. Body mass index, waist circumference (WC), WC-to-height ratio, laboratory blood tests, and FLR calculated by dual-energy X-ray absorptiometry measurements were considered. Body mass index >85th percentile and >97th percentile, WC >90th percentile, and WC-to-height ratio > 0.5 were chosen as criteria of overweight and obesity, visceral obesity, and increased cardiovascular risk, respectively. ResultsWe enrolled 205 CCS previously treated for hematologic cancer or solid or central nervous system tumor. The best cutoff of FLR was 0.6. CCS; those with FLR ≥0.6 (43%) were more frequently overweight and obese (P < 0.001), and presented with higher levels of triglycerides (P = 0.011), homeostatic model assessment for insulin resistance (P = 0.001), alanine transaminase (P = 0.004), and trunk fat (P < 0.001) and lower levels of insulin-like growth factor 1 (P < 0.001) and lean mass (P = 0.009). WC >90th percentile (P = 0.007), insulin-like growth factor 1 (P = 0.002), and trunk fat (P = 0.006) were independent predictors of FLR ≥0.6 in a model including all the previous variables. ConclusionsAn increased FLR is suggestive of altered body composition phenotype, allowing identification of CCS at higher risk of metabolic syndrome. Diet and physical activity are needed from commencement of oncological treatments to preserve overall nutritional status and maintain it over the long term.

Fecal microbiota transplantation: modulation of metabolic and inflammatory intestinal diseases

Therapeutic properties of fermented feces for the treatment of common diseases, such as diarrhea, have been exploited for a long time. Recent studies have revealed that the benefit comes from the intestinal microbiota, which acts as a new metabolic and inflammatory modulating organ, showing favorable potential when well-regulated and unfavorable in the presence of dysbiosis. This review aims to evaluate the therapeutic modulation of this flora in endocrine and intestinal inflammatory diseases through transplantation. The study used PubMed, Cochrane, and Google Scholar as databases, without language restrictions, from 1989 onwards due to their historical relevance up to works from 2023. The descriptors used were "fecal microbiota transplantation," "metabolic diseases," "endocrine diseases" and "intestinal inflammatory diseases." It is observed that there is therapeutic benefit in regulating the microbiome of patients with obesity, metabolic syndrome, or intestinal inflammatory diseases, although the techniques for improvement are still under study. It is important that new studies be conducted to refine this process, as it shows great promise in modulating the enteroendocrine and inflammatory axes.

Estimation of fatty liver disease clinical role on glucose metabolic remodelling phenotypes and T2DM onset.

Metabolic syndrome (MetS), prediabetes (PreDM) and Fatty Liver Disease (FLD) share pathophysiological pathways concerning type 2 diabetes mellitus (T2DM) onset. The non-invasive assessment of fatty liver combined with PreDM and MetS features screening might provide further accuracy in predicting hyperglycemic status in the clinical setting with the putative description of singular phenotypes. The objective of the study is to evaluate and describe the links of a widely available FLD surrogate -the non-invasive serological biomarker Hepatic Steatosis Index (HSI)- with previously described T2DM risk predictors, such as preDM and MetS in forecasting T2DM onset. A retrospective ancillary cohort study was performed on 2799 patients recruited in the Vascular-Metabolic CUN cohort. The main outcome was the incidence of T2DM according to ADA criteria. MetS and PreDM were defined according to ATP III and ADA criteria, respectively. Hepatic steatosis index (HSI) with standardized thresholds was used to discriminate patients with FLD, which was referred as estimated FLD (eFLD). MetS and PreDM were more common in patients with eFLD as compared to those with an HSI < 36 points (35% vs 8% and 34% vs. 18%, respectively). Interestingly, eFLD showed clinical effect modification with MetS and PreDM in the prediction of T2DM [eFLD-MetS interaction HR = 4.48 (3.37-5.97) and eFLD-PreDM interaction HR = 6.34 (4.67-8.62)]. These findings supported the description of 5 different liver status-linked phenotypes with increasing risk of T2DM: Control group (1,5% of T2DM incidence), eFLD patients (4,4% of T2DM incidence), eFLD and MetS patients (10,6% of T2DM incidence), PreDM patients (11,1% of T2DM incidence) and eFLD and PreDM patients (28,2% of T2DM incidence). These phenotypes provided independent capacity of prediction of T2DM incidence after adjustment for age, sex, tobacco and alcohol consumption, obesity and number of SMet features with a c-Harrell=0.84. Estimated Fatty Liver Disease using HSI criteria (eFLD) interplay with MetS features and PreDM might help to discriminate patient risk of T2DM in the clinical setting through the description of independent metabolic risk phenotypes. [Correction added on 15 June 2023, after first online publication: The abstract section was updated in this current version.].

Obesity management for the pre–liver transplant and post–liver transplant patient

Obesity management for the pre–liver transplant and post–liver transplant patient

Uric acid and neurological disease: a narrative review.

Hyperuricemia often accompanies hypertension, diabetes, dyslipidemia, metabolic syndrome, and chronic renal disease; it is also closely related to cardiovascular disease. Moreover, several epidemiological studies have linked hyperuricemia and ischemic stroke. However, uric acid may also have neuroprotective effects because of its antioxidant properties. An association between low uric acid levels and neurodegenerative diseases has been suggested, which may be attributed to diminished neuroprotective effects as a result of reduced uric acid. This review will focus on the relationship between uric acid and various neurological diseases including stroke, neuroimmune diseases, and neurodegenerative diseases. When considering both the risk and pathogenesis of neurological diseases, it is important to consider the conflicting dual nature of uric acid as both a vascular risk factor and a neuroprotective factor. This dual nature of uric acid is important because it may help to elucidate the biological role of uric acid in various neurological diseases and provide new insights into the etiology and treatment of these diseases.

A data-driven cluster analysis of stroke phenotypes in Asian patients with atrial fibrillation: refinement of the CHA2DS2-VASc score

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Atrial fibrillation (AF) is a disease with heterogeneous underlying conditions which usually encompass several cardiovascular comorbidities. There is a lack of large studies investigating the heterogeneity of patients with AF in Asian population. A refined classification may contribute on individual precise treatment and prognosis. Methods This cohort study was conducted utilizing a database from a tertiary medical center. Between 2014 and 2019, a total of 5002 adult patients with AF were enrolled for analysis. We performed an unsupervised hierarchical cluster analysis based on CHA2DS2-VASc score after model assessment. The risk of transient ischemia accident (TIA)/ischemic stroke, heart failure (HF) hospitalization, cardiovascular mortality, and all-cause mortality were assessed. Results We identified four replicable distinct clusters of patients with AF: cluster I included diabetic patients with HF with preserved ejection fraction and chronic kidney disease; cluster II included elder patients with a low BMI and pulmonary hypertension; cluster III included patients with metabolic syndrome and atherosclerotic disease; and cluster IV included patients with left heart dysfunction including reduced ejection fraction and enlarged left atrium. The incidence of stroke were 12.7%, 15.1%, 9.9%, and 6.3% in clusters I to IV respectively. Cox regression analyses showed that the differences in risk of TIA/ischemic stroke risk across clusters (cluster I, II, III vs. IV) were statistically significant (Hazard ratio (HR) 1.87 [95% CI 1.00–3.48], 2.06 [95% CI 1.06–4.01], 1.70 [95% CI 1.02–2.84]). Cluster II was independently associated with highest risk for stroke (HR 2.06 [1.06-4.01]), HF hospitalization (HR 1.19 [95% CI 0.79-1.80]), cardiac death (HR 2.51 [95% CI 1.21-5.22]), and all-cause death (HR 2.98 [95% CI 1.98-4.50]). Conclusion The study indicated the feasibility of clinical application of the cluster analysis in a highly heterogeneous cohort of patients with AF after accounting for CHA2DS2-VASc risk scores. Patients can be divided into four phenotypes with distinct patient characteristics and cardiovascular outcomes.

Effect of Baduanjin Exercise on Metabolic Syndrome Risk: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

While people's living standards are improving, the incidence of chronic diseases due to a lack of exercise is increasing. Complex health conditions (e.g., metabolic syndrome) are becoming common, and means to lower their incidence are essential. This study systematically reviewed the literature and performed a meta-analysis on the effects of Baduanjin exercise on metabolic syndrome-related factors. Using four English databases and three Chinese databases, randomized controlled trials on the effects of Baduanjin exercise on metabolic syndrome were identified. We analyzed whether Baduanjin could alleviate various metabolic syndrome indicators according to our selection guidelines. We found that Baduanjin exercise had positive effects on blood pressure (systolic blood pressure: mean difference (MD)=-6.39; 95% confidence interval (CI): -9.86 to -2.92; I2=12%; diastolic blood pressure: MD=-2.86; 95% CI: -5.96 to -0.23; I2=35%; P=0.07) and total cholesterol (standardized mean (SMD)= -0.55; 95% CI: -1.11 to 0.02; I2=86%; P=0.06), triglyceride (SMD=-0.29; 95% CI: -1.13 to - 0.56; I2=94%; P<0.51), and low-density cholesterol (SMD =-0.33; 95% CI: -0.52 to -0.14; I2=0%; P<0.0007) levels. This evidence shows that Baduanjin exercise provides beneficial effects by improving metabolic syndrome and cardiovascular disease in adults. This suggests that Baduanjin exercise could be an effective alternative or complementary approach to conventional treatments for adults with metabolic problems. Additionally, these findings suggest that more rigorous randomized control trials are needed in the future.

Predictability of the Development of Insulin Resistance Based on the Risk Factors Among Female Medical Students at a Private College in Saudi Arabia.

Insulin resistance (IR) is currently an underlying phenomenon in the etiology of mostnon-communicable diseases. IR has been proposed as the key linking factor for the metabolic syndrome disease cluster of glucose intolerance. This study's target was to assess the predictability of risk factors for IR among female medical students Methods: A cross-sectional study involving female medical students was carried out. The sample size was 272, and a suitable non-probability sampling method was employed. A correlation test was done, and a P value less than 0.05 is considered statistically significant.Each participant underwent assessment of anthropometric measurements and biochemical testing. For assessing lifestyle, validated questionnaires on physical activity, sleep pattern, dietary pattern, and stress were adopted. The anthropometric data such as height, weight, and waist circumference were collected. Biochemical testing involved estimation of the postprandial capillary blood glucose level on campus. Additionally, systolicblood pressure and diastolic blood pressurewere measured. The association of lifestyle risk factors with waist circumference as an indicator of IR was done wherethe majority of those with high waist circumference were physically inactive and more prone to stress which was statistically significant when compared to those with normal waist circumference. However, poor sleep and unhealthy diet were high among those with high waist circumference, but they were not statistically significant. The correlation of waist circumference as an indicator of IR was highly significant with body mass index, postprandial blood sugar, systolic blood pressure, and diastolic blood pressure. A series of unhealthy lifestyle habits was contributable to developing obesity and therefore IR among medical students in Saudi Arabia.

Adipokines in Pregnancy: A Systematic Review of Clinical Data.

Adipokines are signaling proteins involved in metabolic, endocrinological, vascular and immunogenic processes. Associations of various adipokines with not only insulin resistance but also with increased insulin sensitivity, increased systolic blood pressure, and atherosclerosis highlight the significance of adipokines in several components of metabolic syndrome and metabolic diseases in general. As pregnancy presents a unique metabolic state, the role of adipokines in pregnancy, and even in various pregnancy complications, appears to be key to elucidating these metabolic processes. Many studies in recent years have attempted to clarify the role of adipokines in pregnancy and gestational pathologies. In this review, we aim to investigate the changes in maternal adipokine levels in physiological gestation, as well as the association of adipokines with pregnancy pathologies, such as gestational diabetes mellitus (GDM) and preeclampsia (PE). Furthermore, we will analyze the association of adipokines in both maternal serum and cord blood with parameters of intrauterine growth and various pregnancy outcomes.

Platelet polymorphism rs5918T > C in the integrin B3 gene modulates comorbidities in patients with psoriasis

Psoriasis Vulgaris is a complex multifactorial dermatological disease, with various genetic and environmental factors implicated in the onset and progression of the disease and comorbidities. Cardiovascular disease (CVD) and metabolic syndrome are essential psoriasis comorbidities that suggest a potential hypercoagulable background of the disease. To better understand the link between psoriasis, hypercoagulation and comorbidities, we investigated the prothrombotic polymorphism rs5918T > C in integrin B3 (ITGB3) in 102 patients diagnosed with psoriasis and 97 healthy controls, all Caucasian. The patients, carriers of rs5918T > C polymorphism, were compared with non-carriers for metabolic risk factors related to metabolic syndrome and CV disease. Our results revealed that the incidence of ITGB3rs5918(C) allele carriage was only slightly increased in psoriatic patients compared to healthy controls (20.6% vs 18.6%), and psoriatic patients with the polymorphism showed an increased incidence of metabolic risk factors. Dyslipidemia, high triglycerides (42.9% vs 27.5%), high cholesterol (66.7% vs 45.5%) and low High Density Lipoprotein (HDL) (47.6% vs 32.8%) were significantly more prevalent (p = .019) among psoriatic carriers of the rs5918(C) polymorphism compared to psoriatic non-carriers. The incidence of metabolic syndrome was significantly higher among polymorphism carriers (52.4%) compared to non-carriers (20.5%) within the psoriatic patient group (p = .014), whereas CVD incidence was higher but non-significantly. The carriage of ITGB3rs5918(C) polymorphism in patients with psoriasis was associated with a higher risk of metabolic syndrome and dyslipidaemias and a higher but non-significant prevalence of CVD compared to non-carriers. However, the frequency of this polymorphism was similar in psoriasis patients and healthy controls.

Progesterone Has No Impact on the Beneficial Effects of Estradiol Treatment in High-Fat-Fed Ovariectomized Mice

In recent decades, clinical and experimental studies have revealed that estradiol contributes enormously to glycemic homeostasis. However, the same consensus does not exist in women during menopause who undergo replacement with progesterone or conjugated estradiol and progesterone. Since most hormone replacement treatments in menopausal women are performed with estradiol (E2) and progesterone (P4) combined, this work aimed to investigate the effects of progesterone on energy metabolism and insulin resistance in an experimental model of menopause (ovariectomized female mice-OVX mice) fed a high-fat diet (HFD). OVX mice were treated with E2 or P4 (or both combined). OVX mice treated with E2 alone or combined with P4 displayed reduced body weight after six weeks of HFD feeding compared to OVX mice and OVX mice treated with P4 alone. These data were associated with improved glucose tolerance and insulin sensitivity in OVX mice treated with E2 (alone or combined with P4) compared to OVX and P4-treated mice. Additionally, E2 treatment (alone or combined with P4) reduced both hepatic and muscle triglyceride content compared with OVX control mice and OVX + P4 mice. There were no differences between groups regarding hepatic enzymes in plasma and inflammatory markers. Therefore, our results revealed that progesterone replacement alone does not seem to influence glucose homeostasis and ectopic lipid accumulation in OVX mice. These results will help expand knowledge about hormone replacement in postmenopausal women associated with metabolic syndrome and non-alcoholic fatty liver disease.

Abstract #1395812: Patterns and Influence of Cardio-Metabolic Insufficiency in Patients with Essential Hypertensive Disease and Concomitant Type 2 Diabetes Mellitus

Metabolic syndrome diseases, MSD (Hypertension, Adiposity, Diabetes mellitus and Dyslipidemia) are interrelated diseases with very high morbidity and mortality rates, thus requiring the search for new and effective treatment options [1]. The objective of the research was to study the patterns and influence of cardio-metabolic insufficiency in patients with essential hypertensive disease (EHD) and concomitant type 2 diabetes mellitus (T2DM). 105 patients (56 females and 49 males), aged 41-70 years were examined for 3 months. The average age was (60.5±2.5) years. Group I (GI) included 25 patients with treatment-compensated essential hypertensive disease, II stage, 1-2 degree; Group II (GII) - 25 patients with subcompensated type 2 diabetes mellitus (glycated hemoglobin (HbA1C) - from 7.0 to 11.0%); Group III (GIII) - 55 patients with treatment-compensated essential hypertensive disease, II stage, 1-2 degree and concomitant subcompensated type 2 diabetes mellitus (HbA1C - from 7.0 to 11.0%). The control group consisted of 15 practically healthy volunteers, 10 (66.7%) females and 5 (33.3%) males, aged (62.5±4.5) years. The groups were randomized according to age, sex, BMI, duration of EHD and T2DM. In addition to general clinical examination conducted including blood lipid levels – triglycerides (TG), LDL, HDL, total cholesterol (TC); glucose metabolism was assessed using HbA1C index. Statistical analyses of the results of the research were carried out using "Statistica 13.4 for Windows" and Student’s t-test series. Research was conducted with strict adherence to the Declaration of Helsinki (DoH) 2013 concerning human research. More severe dyslipidemia (and a higher risk of cardiovascular disease) was found in patients with type 2 diabetes mellitus and concomitant essential hypertension [2, 3]. Dyslipidemia was more pronounced in patients with EHD and concomitant T2DM. TG, LDL and TC levels were 20.14%, 28.72% and 24.21% higher compared with GI (p<0.05). HDL was 13.7% lower in GII compared with GI (p<0.05). HbA1C in GIII patients was (9.41±0.42) % and in GII patients was (7.21±0.45) % (p<0.05). Correlations between HbA1C with TG, LDL and TC levels were (r=+0.42; r=+0.60; r=+0.49 respectively, p<0.05). Correlations between SBP (systolic blood pressure) with TG, LDL and TC were (r=+0.41; r=+0.52; r=+0.45 respectively, p<0.05). Correlations between HbA1C and SBP was (r=+0.62; p˂0.05). In patients with essential hypertensive disease and concomitant type 2 diabetes mellitus, there is a remarkable tendency towards cardio-metabolic insufficiency as evidenced by increase in systolic blood pressure, hyperglycemia, and dyslipidemia.