MetS Patients Research Articles

Harnessing the Power of the Gut Microbiome: A Review of Supplementation Therapies for Metabolic Syndrome.

Metabolic syndrome (MetS) is a complex condition characterized by abdominal obesity, insulin resistance, dyslipidemia, and hypertension, all of which increase the risk of cardiovascular disease and type 2 diabetes. The gut microbiome plays a significant role in metabolic health, influencing digestion, immune function, and energy metabolism. When the gut microbiota becomes imbalanced due to poor diet and antibiotic use, it can lead to systemic inflammation, insulin resistance, and abnormal lipid metabolism, which are central features of MetS. This review explores the connection between gut microbial imbalances and MetS, focusing on the impact of the gut microbiome on metabolic health. Supplementation therapies targeting the gut microbiome, such as probiotics, prebiotics, synbiotics, and postbiotics, are evaluated for their potential to improve metabolic parameters in MetS patients. These interventions hold promise for enhancing insulin sensitivity, reducing inflammation, and improving lipid profiles. However, further research is needed to optimize these approaches for managing MetS. Understanding how to leverage the gut microbiome could lead to innovative, non-invasive treatments for this growing global health concern.

Obstructive Sleep Apnea in Metabolic Syndrome.

The metabolic syndrome (MetS), a cluster of cardiovascular risk factors, is associated with obstructive sleep apnea (OSA). OSA is a major contributor to cardiac, cerebrovascular, and metabolic disorders as well as to premature death. This cross-sectional study was done for 1 year in 103 patients of MetS diagnosed by the International Diabetes Federation criteria. All patients were subjected to the STOP-Bang questionnaire, and they were classified into low, intermediate, and high risks depending on the score. Patients falling in intermediate-high risk (score 3-8) were taken for overnight polysomnography to confirm the diagnosis of OSA (apnea-hypopnea index [AHI] ≥5) and were considered Group I. Patients with STOP-Bang score ≤2 or score ≥3 with AHI <5 were considered Group II (non-OSA). Out of 103 MetS patients enrolled in the study, only 70 (68.0%) were diagnosed with OSA, so the prevalence of OSA in MetS patients was 68%. The majority of the OSA cases had moderate-to-severe OSA (68.5%), and only 31.4% had mild OSA. The age of patients enrolled in the study ranged between 29 and 78 years, and the mean age of patients was 54.8 ± 9.4 years. Out of 103 MetS enrolled in the study, 59 (57.3%) were male and the rest were female, so the prevalence of severe OSA was higher in males than in females. The prevalence increases with an increase in age groups. Weight, body mass index (BMI), circumference, and waist circumference (WC) of cases of OSA were found to be significantly higher as compared to that of non-OSA. An incremental trend of increase in weight, BMI, neck circumference, and WC was observed with the increase in the severity of OSA. Patients of OSA as compared to non-OSA had significantly increased WC, blood pressure (BP), fasting, postprandial, random blood sugar, and triglyceride (TG) levels. A trend of increase in WC, BP fasting, postprandial, random blood sugar, and TG levels was associated with an increase in the severity of OSA. Snoring and daytime sleepiness were observed in a significantly higher proportion of OSA cases as compared to non-OSA cases. This study shows that OSA has a high prevalence in subjects with MetS. A high index of clinical suspicion is required for early diagnosis.

Association of cardiorenal biomarkers with mortality in metabolic syndrome patients: A prospective cohort study from NHANES.

Approximately 20%-25% of the global adult population is affected by metabolic syndrome (MetS), highlighting its status as a major public health concern. This study aims to investigate the predictive value of cardiorenal biomarkers on mortality among patients with MetS, thus optimizing treatment strategies. Utilizing data from the National Health and Nutrition Examination Survey (NHANES) cycles between 1999 and 2004, we conducted a prospective cohort study involving 2369 participants diagnosed with MetS. We evaluated the association of cardiac and renal biomarkers with all-cause and cardiovascular disease (CVD) mortality, employing weighted Cox proportional hazards models. Furthermore, machine learning models were used to predict mortality outcomes based on these biomarkers. Among 2369 participants in the study cohort, over a median follow-up period of 17.1 years, 774 (32.67%) participants died, including 260 (10.98%) from CVD. The highest quartiles of cardiac biomarkers (N-terminal pro-B-type natriuretic peptide [NT-proBNP]) and renal biomarkers (beta-2 microglobulin, [β2M]) were significantly associated with increased risks of all-cause mortality (hazard ratios[HRs] ranging from 1.94 to 2.06) and CVD mortality (HRs up to 2.86), after adjusting for confounders. Additionally, a U-shaped association was observed between high-sensitivity cardiac troponin T (Hs-cTnT), creatinine (Cr), and all-cause mortality in patients with MetS. Machine learning analyses identified Hs-cTnT,NT-proBNP, and β2M as important predictors of mortality, with the CatBoost model showing superior performance (area under the curve[AUC] = 0.904). Cardiac and renal biomarkers are significant predictors of mortality in MetS patients, with Hs-cTnT, NT-proBNP, and β2M emerging as crucial indicators. Further research is needed to explore intervention strategies targeting these biomarkers to improve clinical outcomes.

Association of rs2241766 and rs1501299 polymorphisms in the adiponectin gene with metabolic syndrome.

To investigate the influence of adiponectin (APN) rs2241766 and rs1501299 polymorphisms on adiponectin levels and their association with metabolic syndrome (MetS). Analyzed two polymorphisms (rs2241766 and rs1501299) of the adiponectin gene (ADIPOQ) in 210 MetS patients and 102 control patients using the polymerase chain reaction-restriction fragment length polymorphism method and DNA sequencing technology. The genotypes of the rs2241766 T/G and rs1501299 G/T polymorphism were significantly associated with serum APN levels in MetS patients. The ADIPOQ polymorphisms were associated with a risk of MetS when compared with that in healthy controls. TG and GG genotypes of rs2241766 were associated with a significantly elevated risk of MetS as compared with the TT genotype (OR = 1.32 and OR = 2.53). Subjects with the G allele appeared to have higher susceptibility to MetS than those with the T allele (OR = 2.21). In common with the findings for rs2241766, the rs1501299 GT and TT genotypes were associated with a significantly increased risk of MetS as compared with the GG genotype (OR = 1.51 and OR = 2.24). The susceptibility to MetS appeared to be higher in subjects with the T allele than in those with the G allele (OR = 1.88). The occurrence of MetS may be associated with genetic variations at the rs2241766 and rs1501299 loci, especially in individuals with T to G mutations (rs2241766) and G to T mutations (rs1501299). These mutations may lead to decreased APN levels and a higher risk of developing MetS.

СРАВНИТЕЛЬНАЯ ОЦЕНКА ДИАГНОСТИЧЕСКИХ КРИТЕРИЕВ МЕТАБОЛИЧЕСКОГО СИНДРОМА У ВЗРОСЛЫХ ПАЦИЕНТОВ С ИЗБЫТОЧНОЙ МАССОЙ ТЕЛА/ОЖИРЕНИЕМ

Background. Diagnostic criteria for metabolic syndrome (MetS), which is a cluster of risk factors for noninfectious diseases, continue to be discussed and refined by various professional communities. The aim of the study was determination of the incidence of MetS in overweight/obese adult cardiac hospital patients according to the IDF (2005), AHA/NHLBI (2004)/AHA (2023) diagnostic criteria and criteria agreed by IDF/AHA/NHLBI and other scientific societies (2009). Material and methods. 222 patients (103 men and 119 women) with overweight/obesity aged 18 years and older were examined using clinical, laboratory, and instrumental research methods. Results. Among adult patients (46.4% men, 53.6% women), 85.6% (95% CI 80.4-89.6) were found to have MetS according to the IDF (2005) criteria, 82.4% (95% CI 76.9-86.9) according to the AHA/NHLBI (2004) and AHA (2023) criteria, and 87.4% (95% CI 82.4-91.1) according to the criteria agreed by IDF/AHA/NHLBI and other scientific communities (2009). Metabolic syndrome established on the basis of the IDF criteria (2005) and the criteria agreed by the IDF/AHA/NHLBI and other scientific communities (2009) was more often four-component, while that based on the AHA/NHLBI (2004) and AHA (2023) criteria was three-component. Arterial hypertension occurred in 100% of patients with MetS. Conclusion. The presence of four and five components of MS, in particular arterial hypertension in all MetS patients included in the study, indicates the severity of cardiometabolic disorders.

The Association of Glycated Hemoglobin and Lipid Profile with Peripheral Artery Disease in Metabolic Syndrome Patients from Northwestern Algeria

تم إدماج الهيموجلوبين السكري (Hb1Ac) كمؤشر لخلل السكر في الدم بدلا من غلوكوز الدم الصائم (FGB)، لتصنيف المرضى بناء على حوادث الأوعية الدموية ،حيث يرتبطHb1Acارتباطا وثيقا بعوامل الأوعية الدموية مثل سرعة موجة النبض وسمك الوسائط الداخلية، نسبة الألبومين / الكرياتينين (ACR) ومع ذلك فإن العلاقة بينHb1Acونسبة الدهون في تطور أمراض الشرايين لاتزال غير مؤكدة. هدفنا الرئيسي من هذه الدراسة هو التحقيق في ارتباطHb1Acونسبة الدهون مع أمراض الأوعية الدموية الطرفية (PAD) في المرضى الذين يعانون من الاضطراب الأيضي (MetS) في شمال غرب الجزائر. أجريت دراستنا المقطعية لمدة ستة أشهر. تم حساب مؤثر كتلة الجسم كالتالي: (BMI (kg/m²)=weight(kg)/height²(m²، تم استخدام مؤشر الكاحل والعضد (ABI) أقل من 0.9 وتصوير الأوعية لتشخيص PADوحددنا MetS وفقا لمعاييرNECP-ATPIII. تم استعمال اختبار تحليل الارتباط (correlation test) والانحدار الخطي (linear regression) لدراسة الصلة بينHb1Ac، نسبة السكر في الدم، نسب الدهون وحدوث أمراض الشرايين الطرفية لدى الأفراد المصابين بالاضطراب الأيضي. من بين 300 مصاب الاضطراب الأيضي، 53 % تمثل الذكور. لوحظ وجود ارتباطات إيجابية بينHb1Ac،(r=0.753, p&lt;0.001) FGB والتري غلسيريد ((TG (r=0.288, p&lt;0.001) وارتباط سلبي مع البروتين الدهني عالي الكثافة (HDL) (r=-0.356, p&lt;0.001). لم يظهرHb1Ac أي ارتباط مع الكوليسترول الكلي (TC) و البروتين الدهني منخفض الكثافة (LDL). أظهرت نسب الدهون(TG/HDL ,LDL/HDL , TC/HDL) ارتباطات ايجابية مع)Hb1Acr=0.332 r=0.232, r=0.43.(أكد اختبار الانحدار الخطي هذه النتائج. أظهر Hb1Ac ارتباطات ايجابية مع FGB و TG في حين أنه يرتبط سلبا بالبروتين الدهني عالي الكثافة(HDL) . و مستقل عن البروتين الدهني منخفض الكثافة (LDL) والكوليسترول الكلي (TC) و الجدير بالذكر أن نسب الدهون الثلاثة TG/HDL) LDL/HDL , TC/HDL (أظهرت ارتباطات ايجابية معHb1Ac .

Prevalence of Metabolic Syndrome in Patients With Psoriasis Vulgaris: A Hospital-Based Cross-Sectional Study.

Introduction Psoriasis is a chronic, recurrent inflammatory skin condition that affects 1-3% of the global population. Increasing evidence suggests a higher prevalence of metabolic syndrome (MetS) among individuals with psoriasis. This study aims to investigate the prevalence of MetS in patients with psoriasis and compare the findings with existing literature. Methods This cross-sectional, hospital-based study included 311 patients with psoriasis. Data were retrospectively collected from hospital records. Results The study included 311 patients with psoriasis (144 females and 167 males), with a mean age of 41.6 years (range 18-87). The mean BMI was 27.13 ± 5.29 kg/m², and the average waist circumference was 93 cm. Mean fasting blood sugar levels were 100 mg/dL, mean high-density lipoprotein (HDL) cholesterol was 44 mg/dL, and mean triglycerides were 132 mg/dL. MetS was diagnosed in 60 patients (19.3%). Patients with MetS had significantly higher mean waist circumference, higher rates of hypertriglyceridemia, hyperglycemia, and hypertension, and lower mean HDL levels (p < 0.05). There was no significant association between MetS and psoriasis severity, disease duration, family history, smoking, or alcohol consumption habits. Conclusions In this study, the prevalence of MetS among patients with psoriasis was 19.3%. MetS prevalence was not linked to smoking status, alcohol consumption, family history of psoriasis, disease duration, or severity. It is crucial for dermatologists treating psoriasis patients to be aware of MetS, its components, and associated cardiovascular risks.

A Cross-Sectional Study on the Prevalence of Subclinical Hypothyroidism in Metabolic Syndrome Patients at a Tertiary Care Hospital.

Metabolic syndrome (MetS) is defined as a "constellation" of cardiometabolic risk factors, characterized by hypertension, atherogenic dyslipidemia, hyperglycemia, prothrombotic and proinflammatory conditions which, jointly, increase the risk of suffering cardiovascular diseases (CVD) and type 2 diabetes mellitus.Thyroid dysfunction is also believed to affect parameters such as high-density lipoprotein (HDL) cholesterol, triglycerides, plasma glucose, and blood pressure, in turn increasing the risk of CVD. Subclinical hypothyroidism (SCH), which independently raises the risk of CVDs and their associated complications, is more frequently detected in patients with MetS compared to the general population. When both conditions coexist, the risk of CVD and its complications is significantly heightened. The objective of the study was to find out the prevalence of SCH in patients with MetS. A prospective cross-sectional study was conducted in the Department of General Medicine, New Civil Hospital, Surat, Gujarat, India. Eighty patients who fulfilled the criteria for MetS by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), were taken into the study. A detailed history, anthropometric measurements, blood pressure, fasting blood glucose, lipid profile, and thyroid profile (Free T3, Free T4, and serum thyroid-stimulating hormone (TSH)) were undertaken. The thyroid profile was done by chemiluminescence immunoassay (CLIA) method. Out of 80 patients with MetS, 48 were female and 32 were male, with the overall mean age of the study population being 46.5±9.5 years. Among them, 23.7% of the population was found to be having thyroid dysfunction. Among the thyroid dysfunction, SCH was highly prevalent (18.8%), 3.8% patients had overt hypothyroidism and 1.3% patients had subclinical hyperthyroidism. There were no overt hyperthyroid patients in our study.HDL (mg/dl) and TSH (mIU/L) were significantly higher in the SCH group as compared to other types of hypothyroidism group (p-value < 0.05). There is a statistically significant prevalence of SCH (18.8%) in MetS patients. It is clear from the study that one-fifth of MetS patients or every fifth patient with MetS had SCH. Thus, looking proactively for SCH in MetS and treating it would prevent conversion to overt hypothyroidism and complications of MetS.

Understanding the Role of the Complement System in Insulin Resistance and Metabolic Syndrome in Patients With Rheumatoid Arthritis.

The complement system has been associated with the etiopathogenesis of rheumatoid arthritis (RA). Insulin resistance (IR) and metabolic syndrome (MetS) are prevalent among patients with RA. The aim of this study was to explore the relationship between a comprehensive evaluation of the complement system and IR, as well as MetS, in patients with RA. A total of 339 nondiabetic patients with RA were recruited. Functional assays of the 3 complement pathways were assessed. Additionally, serum levels of the following individual components of the complement system were measured: C1q (classical); lectin (lectin); C2, C4, and C4b (classical lectin); factor D and properdin (alternative); C3 and C3a (common); C5, C5a, and C9 (terminal); as well as the factor I and C1 inhibitor regulators. IR and β cell function indices were calculated using the homeostatic model assessment. Criteria for MetS were applied. Multivariable linear regression analysis was performed to investigate the association between the complement system and IR in patients with RA. Many elements of the upstream and common complement pathways, but not the functional tests of the 3 routes, correlated positively with higher levels of IR and β cell function. However, after multivariable adjustment for factors associated with IR, these relationships were lost. Conversely, the presence of MetS in patients with RA maintained a relationship with higher levels of C1q, C4, C3, properdin, and factor I after adjusting for confounders. There is a positive correlation between the complement system and MetS among nondiabetic patients with RA. This association is independent of traditional IR factors.

Causal link between metabolic related factors and osteoarthritis: a Mendelian randomization investigation.

Metabolic syndrome (MetS) is significantly associated with osteoarthritis (OA), especially in MetS patients with blood glucose abnormalities, such as elevated fasting blood glucose (FG), which may increase OA risk. Dietary modifications, especially the intake of polyunsaturated fatty acids (PUFAs), are regarded as a potential means of preventing MetS and its complications. However, regarding the effects of FG, Omega-3s, and Omega-6s on OA, the research conclusions are conflicting, which is attributed to the complexity of the pathogenesis of OA. Therefore, it is imperative to thoroughly evaluate multiple factors to fully understand their role in OA, which needs further exploration and clarification. Two-sample univariable Mendelian randomization (UVMR) and multivariable Mendelian randomization (MVMR) were employed to examine the causal effect of metabolic related factors on hip OA (HOA) or knee OA (KOA). The exposure and outcome datasets were obtained from Open GWAS IEU. All cases were independent European ancestry data. Three MR methods were performed to estimate the causal effect: inverse-variance weighting (IVW), weighted median method (WMM), and MR-Egger regression. Additionally, the intercept analysis in MR-Egger regression is used to estimate pleiotropy, and the IVW method and MR-Egger regression are used to test the heterogeneity. The UVMR analysis revealed a causal relationship between FG and HOA. By MVMR analysis, the study discovered a significant link between FG (OR = 0.79, 95%CI: 0.64∼0.99, p = 0.036) and KOA after accounting for body mass index (BMI), age, and sex hormone-binding globulin (SHBG). However, no causal effects of FG on HOA were seen. Omega-3s and Omega-6s did not have a causal influence on HOA or KOA. No significant evidence of pleiotropy was identified. The MR investigation showed a protective effect of FG on KOA development but no causal relationship between FG and HOA. No causal effect of Omega-3s and Omega-6s on HOA and KOA was observed. Shared genetic overlaps might also exist between BMI and age, SHBG and PUFAs for OA development. This finding offers a novel insight into the treatment and prevention of KOA from glucose metabolism perspective. The FG cutoff value should be explored in the future, and consideration should be given to demonstrating the study in populations other than Europeans.

Association between metabolic syndrome and outcomes of large-artery atherosclerosis stroke treated with reperfusion therapy

AimWe aimed to investigate the impact of metabolic syndrome (MetS) on the outcomes of stroke patients with large-artery atherosclerosis who underwent reperfusion therapy. MethodsA retrospective analysis was carried out on patients receiving reperfusion therapy for atherothrombotic stroke between January 2019 and May 2021. MetS was diagnosed according to the AHA/NHLBI criteria. The primary outcome was the composite outcome of disability (modified Rankin Scale [mRS] score 3-5), death or stroke recurrence within 3 months of stroke onset. Secondary outcomes included disability and death within 3 months as well as hemorrhagic transformation (HT) and symptomatic intracranial hemorrhage (sICH) within 24 hours after reperfusion treatment. The independent association of MetS with the above outcomes and the highly correlated components of MetS was examined using binary logistic regression analysis. ResultsA total of 174 patients were enrolled. MetS patients had a higher proportion of the composite outcome (p = 0.012), disability (p = 0.029) and HT (p = 0.049) than those without MetS, except for death (p = 0.375) and sICH (p = 0.306). Following adjustments, MetS remained independently associated with the composite outcome (adjusted OR, 3.011 [95 %CI 1.372-6.604]; p = 0.006) and disability (adjusted OR, 2.727 [95 %CI 1.220-6.098]; p = 0.015), but not HT (adjusted OR, 1.872 [95 %CI 0.854-4.104]; p = 0.117). Hypertriglyceridemia was remarkedly associated with the composite outcome (adjusted OR, 9.746 [95 % CI 2.402-39.536]; p = 0.001) and disability (adjusted OR, 6.966 [95 % CI 1.889-25.692]; p = 0.004). ConclusionMetS is independently associated with an increased risk of composite outcome and disability in patients with large-artery atherosclerosis stroke receiving reperfusion therapy, and hypertriglyceridemia is the main component that drives the effect of MetS on outcomes.

Association of weight-adjusted waist index with cardiovascular disease and mortality among metabolic syndrome population

Metabolic syndrome (MetS) is prevalent and significantly impacts global public health, with obesity being a major risk factor for cardiovascular diseases (CVD) and mortality. Traditional metrics like body mass index (BMI) have limitations in assessing obesity-related risks. The weight-adjusted waist circumference index (WWI) has emerged as a novel obesity metric, this study aimed to evaluate the association of WWI with CVD and mortality in MetS patients. This study used data from 12,641 participants with MetS, derived from the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2020. The WWI was calculated, and its association with CVD and mortality was assessed using multivariate logistic and Cox regression models. The study controlled for potential confounders and performed subgroup and sensitivity analyses to validate the robustness of the findings. The predictive performance of WWI was evaluated using the area under the receiver operating characteristic curve (ROC). Kaplan–Meier (KM) curves further were used to evaluate the associations between WWI and mortality of the MetS population. As WWI values escalated, there was a proportional rise in the risk of CVD and mortality in MetS. The fully adjusted continuous model revealed a 32.0% elevated likelihood of CVD development, a 69.5% increased probability of heart failure (HF), a 51.1% heightened risk for CVD mortality, and a 22.8% augmented risk for all-cause mortality with each one-unit increment in WWI. Comparing the highest to the lowest quartile of WWI, the top quartile exhibited a significantly increased risk of CVD (odds ratio [OR] = 1.883; 95% confidence interval [CI]: 1.276–2.633, p-value = 0.001), HF (OR = 2.909; 95% CI: 1.490–5.677, p-value = 0.002), CVD mortality (hazard ratio [HR] = 2.088; 95% CI: 1.279–3.409, p-value = 0.003), and all-cause mortality (HR = 1.394; 95% CI: 1.070–1.816, p-value = 0.014) among individuals with MetS. Sensitivity and subgroup analyses substantiated the consistency and stability of these associations across various demographic groups. The ROC analysis demonstrated that WWI outperforms BMI in predicting adverse outcomes in MetS. The KM curves validated that higher WWI values was correlated with diminished survival rates in MetS population. The WWI served as a significant indicator for assessing the risk of CVD and mortality in the MetS population. This study recommended the regular assessment of WWI in MetS individuals for evaluating their risk of CVD and mortality, potentially enhancing preventive and treatment strategies for this patient population.

The correlation between HOMA-IR and cardiometabolic risk index among different metabolic adults: a cross-sectional study.

This study aimed to explore the correlation between homeostasis model assessment of insulin resistance(HOMA-IR)and cardiometabolic risk index(CMRI) among different metabolic adults to evaluate the value of HOMA-IR in predicting cardiometabolic risk. This cross-sectional study was conducted over 18 months (from August 1, 2020 to February 18, 2022) and included 1550 participants divided into non-metabolic syndrome (non-MetS) group (n = 628) and metabolic syndrome (MetS) group (n = 922) in three centers of China. Logistic regression analysis was employed to investigate the correlation between HOMA-IR, body fat percentage, BMI (body mass index), visceral fat index, waist-to-hip ratio, vitamin D, and CMRI. Further analysis was conducted to evaluate the ability of HOMA-IR in diagnosing high CMRI within different metabolic, gender, and age groups to predict the risk of cardiovascular disease (CVD). HOMA-IR was significantly higher in the MetS group compared with the non-MetS group (P < 0.05). CMRI was significantly higher in the MetS group compared to the non-MetS group (P < 0.05). According to ROC curve analysis, HOMA-IR can predict cardiovascular risk (CVR) in the general population, non-MetS individuals, and MetS people. Logistic regression analysis revealed that BMI, visceral fat index, waist-to-hip ratio, and HOMA-IR are independent risk indicators of high CVR, whereas vitamin D may exert a protective role. HOMA-IR was an independent risk factor for increased CVR in MetS patients. Moreover, HOMA-IR elevates the risk of CVD regardless of MetS and thus can be used for screening the general population. The study was registered at the Chinese Clinical Trial Registry (Registration Number: ChiCTR2100054654).

Managing Gout in Patients with Metabolic Syndrome.

Gout is characterized by monosodium urate (MSU) crystal deposition secondary to hyperuricemia. Gout is associated with metabolic syndrome (MetS) and its related comorbid conditions such as cardiovascular disease (CVD). Major advances have been made in the comprehension of the link between MetS and gout. Despite observational studies suggesting an association between MetS-related conditions and hyperuricemia, there is no proof of causality. Most studies using Mendelian randomization did not find hyperuricemia as a causal factor for MetS-related conditions. In contrast, these conditions were found associated with hyperuricemia, which suggests a reverse causality. Among patients with gout, this high CVD risk profile implies the need for systematic screening for MetS-related conditions. Most international guidelines recommend systematic screening for and care of CVD and related risk factors in patients with gout. Some anti-hypertensive agents, such as losartan and calcium channel blockers, are able to decrease serum urate (SU) levels. However, there are potential interactions between gout management therapies and the treatment of metabolic diseases. Some data suggest that anti-inflammatory drugs used for gout flare treatment, such as colchicine or canakinumab, might have benefits for CVD. Regarding the impact of urate-lowering therapies on CVD risk, recent studies found a similar CVD safety profile for allopurinol and febuxostat. Finally, sodium-glucose cotransporter-2 inhibitors are promising for gout because of their ability to decrease SU levels and risk of recurrent flares. In this review, we focus on the clinical challenge of managing MetS in patients with gout, particularly older patients with co-medications.

Factors Influencing Prevalence, C-reactive Protein Levels, and Lymphocyte Counts in Chronic Obstructive Pulmonary Disease Patients With Metabolic Syndrome.

Background This research examined the relationship between C-reactive protein (CRP) levels and lymphocyte counts in individuals with chronic obstructive pulmonary disease (COPD) comparing those with metabolic syndrome (MetS) to those without. Methodology This cross-sectional study involved 100 consecutive COPD patientsattending the outpatient wards at the Department of Medicine, Index Medical College, over 18 months. MetS was assessed using the International Diabetes Federation's guidelines. Pulmonary function tests such as spirometry were conducted following the European Respiratory Society's procedures, including measurements of forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the FEV1/FVC ratio. The Global Initiative for Obstructive Lung Disease criteria were employed to evaluate COPD severity using post-bronchodilator FEV1. Results Our results indicated no significant differences in demographics, anthropometrics, or pulmonary function tests between COPD patients with MetS and those without. Average age, height, weight, body mass index, and blood pressure readings were similar between the groups, with no significant variations (p > 0.05). However, the total white blood cell count was significantly higher in the MetS group (9,214 ± 3,161.8 cells/µL) compared to the non-MetS group (6,657.8 ± 4,218 cells/µL, p = 0.001). CRP levels were markedly elevated in 90.9% of MetS patients compared to 21.4% of non-MetS patients. Pulmonary function tests showed no significant differences in pre- and post-bronchodilator FEV1 or FEV1/FVC ratios (p > 0.05). Conclusions The study found that individuals with COPD and MetS have elevated levels of CRP, suggesting that this association exacerbates systemic inflammation and metabolic issues. Furthermore, the risk of MetS in COPD patients did not significantly differ between smokers and non-smokers, indicating that MetS can affect all COPD patients regardless of smoking status. Additionally, more than half of the COPD patients had hypertension, a common comorbidity that reflects the oxidative stress and inflammatory processes shared by both conditions.

Gut microbiome and metabolism alterations in schizophrenia with metabolic syndrome severity

BackgroundSchizophrenia (SCZ) patients undergoing antipsychotic treatment demonstrated a high prevalence and harmful effects of metabolic syndrome (MetS), which acted as the major cause of cardiovascular disease. The major clinical challenge is the lack of biomarkers to identify MetS episodes and prevent further damage, while the mechanisms underlying these drug-induced MetS remain unknown.MethodsThis study divided 173 participants with SCZ into 3 groups (None, High risk, and MetS, consisting of 22, 88, and 63 participants, respectively). The potential biomarkers were searched based on 16S rRNA gene sequence together with metabolism analysis. Logistic regression was used to test the effects of the genus-metabolites panel on early MetS diagnoses.ResultsA genus-metabolites panel, consisting of Senegalimassilia, sphinganine, dihomo-gamma-linolenoylcholine, isodeoxycholic acid, and MG (0:0/22:5/0:0), which involved in sphigolipid metabolism, fatty acid metabolism, secondary bile acid biosynthesis and glycerolipid metabolism, has a great discrimination efficiency to MetS with an area under the curve (AUC) value of 0.911 compared to the None MetS group (P = 1.08E-8). Besides, Senegalimassilia, 3-Hydroxytetradecanoyl carnitine, isodeoxycholic acid, and DG(TXB2/0:0/2:0) distinguished between subgroups robustly and exhibited a potential correlation with the severity of MetS in patients with SCZ, and may act as the biomarkers for early MetS diagnosis.ConclusionsOur multi–omics study showed that one bacterial genus-five lipid metabolites panel is the potential risk factor for MetS in SCZ. Furthermore, Senegalimassilia, 3-Hydroxytetradecanoyl carnitine, isodeoxycholic acid, and DG(TXB2/0:0/2:0) could serve as novel diagnostic markers in the early stage. So, it is obvious that the combination of bacterial genus and metabolites yields excellent discriminatory power, and the lipid metabolism provide new understanding to the pathogenesis, prevention, and therapy for MetS in SCZ.

MetSCORE: a molecular metric to evaluate the risk of metabolic syndrome based on serum NMR metabolomics

BackgroundMetabolic syndrome (MetS) is a cluster of medical conditions and risk factors correlating with insulin resistance that increase the risk of developing cardiometabolic health problems. The specific criteria for diagnosing MetS vary among different medical organizations but are typically based on the evaluation of abdominal obesity, high blood pressure, hyperglycemia, and dyslipidemia. A unique, quantitative and independent estimation of the risk of MetS based only on quantitative biomarkers is highly desirable for the comparison between patients and to study the individual progression of the disease in a quantitative manner.MethodsWe used NMR-based metabolomics on a large cohort of donors (n = 21,323; 37.5% female) to investigate the diagnostic value of serum or serum combined with urine to estimate the MetS risk. Specifically, we have determined 41 circulating metabolites and 112 lipoprotein classes and subclasses in serum samples and this information has been integrated with metabolic profiles extracted from urine samples.ResultsWe have developed MetSCORE, a metabolic model of MetS that combines serum lipoprotein and metabolite information. MetSCORE discriminate patients with MetS (independently identified using the WHO criterium) from general population, with an AUROC of 0.94 (95% CI 0.920–0.952, p < 0.001). MetSCORE is also able to discriminate the intermediate phenotypes, identifying the early risk of MetS in a quantitative way and ranking individuals according to their risk of undergoing MetS (for general population) or according to the severity of the syndrome (for MetS patients).ConclusionsWe believe that MetSCORE may be an insightful tool for early intervention and lifestyle modifications, potentially preventing the aggravation of metabolic syndrome.

Incidence of metabolic syndrome in patients with unilateral or bilateral staghorn renal stones and its impact on percutaneous nephrolithotomy outcomes

BackgroundTo evaluate the incidence of metabolic syndrome (MetS) in patients with unilateral and bilateral staghorn calculi (SC) and evaluate the impact on the outcome of percutaneous nephrolithotomy (PCNL).MethodsThe clinical data of patients who underwent PCNL for the treatment of SC between 2019 and 2022 were retrospectively reviewed. SC was divided into unilateral and bilateral. The incidence of MetS was compared between the patients with unilateral SC and the patients with bilateral SC, and the impact on the outcome of PCNL was assessed.ResultsA total of 1778 patients underwent PCNL between 2019 and 2022. After screening computed tomography, 379 patients were confirmed to have SC, finally, leaving 310 patients with follow-up and complete data to be included in the study. Eighty-four had bilateral SC and 226 had unilateral SC. The patients with bilateral SC had a significantly higher body mass index and higher rates of complete staghorn stones and metabolic syndrome. Higher body mass index, hypertension, diabetes mellitus, hyperlipidaemia, and MetS were present in 62.58%, 44.84%, 21.94%, 60.65% and 27.42% of all patients, respectively. The number of MetS components remained significantly associated with bilateral SC. Specifically, when the number of MetS components increases from 0 to 3–4, the likelihood of developing bilateral staghorn calculi increases by 21.967 times. Eighty-five patients with MetS( +) had a higher rate of overall complications (number (N)(%), 29 (34.12) vs.33 (14.46), P < 0.001) and a comparable stone-free rate to 225 MetS(-) patients. Multivariable analysis confirmed that hyperlipidaemia (P = 0.044, odds ratio [OR] = 1.991, 95% confidence interval [CI] 1.020–3.888) and MetS (P = 0.005, OR = 2.427, 95% CI 1.316–4.477) were independent risk factors for overall complications.ConclusionsMetS is correlated with the formation of bilateral SC and is the main predictor for complications of PCNL especially for low-grade complications (I-II).

Non-invasive laser therapy effect on lipid profile and renal function in metabolic syndrome: randomized control trial

INTRODUCTION. Metabolic syndrome (MetS) represents an assortment of interconnected metabolic risk factors, particularly central obesity, dyslipidemia, and hyperglycemia. These variables have a detrimental impact on renal function and contribute to increased mortality. This timeline necessitates a prompt approach that enables the deployment of safe and non-intrusive therapeutic equipment in conjunction with therapy for MetS patients. Accordingly, we aim to investigate whether using a low-level laser (LLL) watch device as a non-invasive instrument enhances multiple metabolic parameters, so it may be a practical therapeutic approach for managing metabolic disorders. AIM. To investigate the effect of non-invasive laser therapy on parameters of lipid profile and renal function in patients with metabolic syndrome. MATERIALS AND METHODS. This study enrolled 40 MetS patients of both genders aged 45–65 years. The study group received a 12-week treatment consisting of oral hypoglycemic medication and LLL therapy (LLLT), which involved three weekly sessions performed in the morning, targeting the wrist area using a continual output diode laser (skin contact mode, maximum power: 0.005 W, beam spot area: 0.03 cm2, energy density: 288 J/cm3, and radiation time: 1800 s). The control group only received hypoglycemia medications. Laboratory lipid profile and renal function measurements were conducted prior to and following the trial. RESULTS. Following a 12-week laser watch therapy, the results revealed a significant decline in total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) levels and an increase in high-density lipoprotein (HDL) levels, which was slightly improved in the control (p 0.00). Moreover, glomerular filtration rate (GFR) and creatinine levels were significantly improved, while the control group did not experience any significant improvement (p 0.5). DISCUSSION. Combining non-invasive laser therapy with hypoglycemic medications significantly improved the lipid profile in patients with MetS; however, kidney function, like GFR and creatinine levels, was enhanced. Furthermore, lower TC and TG levels might be due to the reduction of glycation and promoted LDL receptors which increased LDL catabolism. CONCLUSION. Non-invasive laser therapy enhances lipid profile and renal function in MetS patients. Furthermore, the control group had a minimal effect on the lipid profile and no effect on renal function.

Nanomembrane-Based Apheresis: A Simple and Safe Procedure for Preventing Cardiovascular Complications in Metabolic Syndrome

Introduction: Metabolic syndrome (MetS) encompasses various abnormalities, including obesity, arterial hypertension, and diabetes, posing significant cardiovascular risks. Novel interventions are needed to address these risks promptly. This study evaluates the efficacy and safety of Nanomembrane-based low-volume plasma exchange (LVPE) in reducing cardiovascular risk factors in MetS patients. Material and Methods: Forty-eight MetS patients (31.3% female, 68.7% male, mean age 50 years) underwent four cycles of LVPE using the Hemofenix device and nanotech membrane PFM 500. LVPE, performed every other day, removed 30% of circulating plasma, replaced with saline. Blood samples were collected pre- and post-treatment for biomarker assessment. Results: LVPE significantly reduced systolic and diastolic blood pressure (p&lt;0.001), sedimentation rate (p&lt;0.0001), glucose (p&lt;0.001), cholesterol (p&lt;0.001), triglycerides (p&lt;0.011), high-density lipoprotein cholesterol (p&lt;0.006), fibrinogen (p&lt;0.001), C-reactive protein (CRP) (p&lt;0.02), and high-sensitivity CRP (p&lt;0.06). No significant changes occurred in the complete blood count. Conclusions: LVPE emerges as a promising, minimally invasive intervention for reducing cardiovascular risk factors in MetS patients. By targeting proinflammatory and proatherogenic factors, LVPE could revolutionize MetS management and prevent cardiovascular complications. Future studies should optimize LVPE protocols and assess long-term efficacy in larger cohorts.