Number Of Metabolic Syndrome Criteria Research Articles

The association of serum uric acid level with metabolic risk factors in patients with type 2 diabetes and their relation to eGFR status

BackgroundThe importance of uric acid has been increasingly appreciated because of its association with the development of diabetes mellitus and related diseases, and with the increasing incidence of diabetes, studying the impact of hyperuricemia in patients with diabetes type 2 is necessary. So we aimed to measure serum uric acid (SUA) levels in patients with diabetes type 2 and to assess the relation between the estimated glomerular filtration rate (eGFR) and the SUA in patients with type 2 diabetes (T2DM).Subjects and methodsThis study is a cross-sectional conducted on 142 adult patients who attended the Outpatients Diabetes Clinic and Endocrinology Center in the Department of Internal Medicine, Assiut University Hospitals, in the period from the 1st of November 2021 up to October 2022. We measured serum uric acid level, serum creatinine, cholesterol, low- and high-density lipoproteins, triglycerides, and eGFR.ResultsOverall, 142 patients were enrolled in the study; all patients had type 2 diabetes. The mean age of the participants was 61.08 ± 9.73 years. Based on SUA level, 46 (32.4%) patients had normal SUA and 96 (67.6%) patients had high SUA. Sixty-nine (48.6%) patients had normal eGFR and 73 (51.4%) patients had reduced eGFR. We found that serum uric acid had a positive significant correlation with the number of metabolic syndrome criteria, cholesterol, low-density lipoproteins, and triglycerides. Meanwhile, it had a negative significant correlation with eGFR and high-density lipoproteins.ConclusionSerum uric acid was strongly associated with metabolic syndrome components and reduced eGFR in patients with T2DM.

HIGH BLOOD PRESSURE IN THE NEWLY DIAGNOSED TYPE 2 DIABETES PATIENTS

Objective: Type 2 diabetes mellitus and hypertension often coexisted in type 2 diabetes patients. Hypertension is often present at the time of diagnosis of type 2 diabetes. Our study aim to evaluate the prevalence of arterial hypertension in newly diagnosed type 2 diabetics and to evaluate the comorbidities associated with hypertension at the time of diagnosis of diabetes. Design and method: Is a prospective study based on 126 newly diagnosed type 2 diabetics, 66 men, and 60 women, aged 45 to 70, hospitalized in Internal Medicine. Blood pressure is taken in consultation according to the recommendations of the ESH, based at least in two consecutive consultations. All patients underwent the assessment of the impact on the target organs, as well as a systematic evaluation for micro and macro-vascular complications. Results: At the time of diagnosis of type 2 diabetes mellitus, the prevalence of arterial hypertension is 56.2%. The patients were already followed for arterial hypertension in 24% of the cases, among them, only 11% considered for therapeutic objectives, and 3% presented with ketosis. Hypertensive diabetics are on average 61.2 years old and have metabolic syndrome in 81.1%. Women are more obese and have a significantly higher waist circumference. Men have higher blood sugar, lower HDL, higher coronary risk, and more frequently present with albuminuria. The level of blood pressure, both systolic and diastolic, rises significantly with the number of metabolic syndrome criteria, and the number of cardiovascular risk factors. We find microangiopathy in 59.1% of cases, and cardiovascular disease in 65.2% of cases. The association of microangiopathy with cardiovascular disease is significantly more frequent in hypertensive diabetics than in non-hypertensives (58% vs 31%, p = 0.005). Conclusions: High blood pressure is very prevalent in newly diagnosed diabetics. The hypertensive diabetic has a higher degree of morbidity, and presents a cardiometabolic profile with a very high cardiovascular risk compared to the non-hypertensive diabetic at the time of diagnosis of diabetes mellitus.

Association of Body Mass Index and Cardiometabolic Factors With Elderly Suicide: A Cohort Study of 101,518 Older Taiwanese

Older people have the highest suicide rate across age groups in most countries. The prevalence of cardiometabolic risk factors also increases with age. We investigated the association between body mass index (BMI), cardiometabolic risk factors, and suicide in a large cohort of older people in Taiwan. We conducted a cohort study using data from an elderly health examination program in Taipei City, Taiwan (2005-2010), linked to the national cause-of-death data files. We used competing risk Cox regression models to investigate the associations of BMI (kg/m2) and cardiometabolic factors with suicide after adjusting for sex, age, socioeconomic variables, chronic diseases, psychological distress, and cognitive function. Among 101,518 individuals aged ≥ 65 years, 92 died by suicide during an average follow-up of 3.9 years. Underweight (BMI<18.5) was associated with increased suicide risk (adjusted hazard ratio [aHR]=2.33, 95% confidence interval [CI] 1.20-4.52) (reference: normal weight). Low diastolic blood pressure was associated with increased suicide risk - aHR was 0.51 (95% CI 0.29-0.91) and 0.55 (95% CI 0.31-0.99) for the third and fourth quartiles of diastolic blood pressure (reference: the lowest quartile), respectively. Older people with a higher waist circumference (aHR per 1-standard-deviation increase=0.60 [95% CI 0.37-0.98]) and a higher number of metabolic syndrome criteria (aHR per 1-criterion increase=0.65 [95% 0.46-0.92]) had lower suicide risk. Systolic blood pressure, pulse rate, fasting blood glucose, and lipid profiles were not associated with suicide risk. Underweight, low diastolic blood pressure, and low waist circumference may be markers of increased suicide risk in older people.

Metabolic dysfunction and obesity-related cancer: Beyond obesity and metabolic syndrome.

The metabolic dysfunction driven by obesity, including hyperglycemia and dyslipidemia, increases risk for developing at least 13 cancer types. The concept of "metabolic dysfunction" is often defined by meeting various combinations of criteria for metabolic syndrome. However, the lack of a unified definition of metabolic dysfunction makes it difficult to compare findings across studies. This review summarizes 129 studies that evaluated variable definitions of metabolic dysfunction in relation to obesity-related cancer risk and mortality after a cancer diagnosis. Strategies for metabolic dysfunction management are also discussed. A comprehensive search of relevant publications in MEDLINE (PubMed) and Google Scholar with review of references was conducted. Metabolic dysfunction, defined as metabolic syndrome diagnosis or any number of metabolic syndrome criteria out of clinical range, inflammatory biomarkers, or markers of metabolic organ function, has been associated with risk for, and mortality from, colorectal, pancreatic, postmenopausal breast, and bladder cancers. Metabolic dysfunction associations with breast and colorectal cancer risk have been observed independently of BMI, with increased risk in individuals with metabolically unhealthy normal weight or overweight/obesity compared with metabolically healthy normal weight. Metabolic dysfunction is a key risk factor for obesity-related cancer, regardless of obesity status. Nonetheless, a harmonized definition of metabolic dysfunction will further clarify the magnitude of the relationship across cancer types, enable better comparisons across studies, and further guide criteria for obesity-related cancer risk stratification.

Прогностичні критерії розвитку метаболічного синдрому в дітей

Вступ. Проведення великомасштабних досліджень поширеності метаболічного синдрому (МС) серед дітей та підлітків ускладнюється відсутністю єдиної думки з приводу використання тих чи інших діагностичних критеріїв у педіатричній практиці. Мета — вивчити особливості спадкового анамнезу в дітей із надлишковою масою тіла та ожирінням і встановити їх діагностично-прогностичне значення. Матеріал та методи. У дослідження були включені 158 дітей із надлишковою масою тіла та ожирінням (100 дітей мали надлишкову масу тіла та 58 дітей — ожиріння) і 70 осіб із нормальною масою тіла (група контролю). Одержані результати дослідження аналізували за допомогою комп’ютерних пакетів Statistica StatSoft Inc. та Excel XP для Windows. Результати. У 32,7 % дітей основної групи спадковість була обтяжена за одним діагностичним критерієм МС, у 30,4 % — за двома й у 24,1 % — відразу за трьома критеріями МС, і чим від більшого надлишку маси тіла страждала дитина, тим значніше була обтяжена її спадковість за кількістю критеріїв МС (p &lt; 0,05). Діти групи контролю мали таку обтяжену спадковість за факторами ризику розвитку серцево-судинних захворювань: 17,2 % — за ожирінням, 18,9 % — за артеріальною гіпертензією, 17,2 % — за ішемічною хворобою серця та 6,8 % — за порушенням метаболізму вуглеводів. Висновки: 1. У 32,7 % дітей із надлишковою масою тіла та ожирінням спадковість була обтяжена за одним діагностичним критерієм МС, у 30,4 % — за двома й у 24,1 % — відразу за трьома критеріями МС. 2. Наявність у дитини позитивного генеалогічного анамнезу вірогідно підвищує ризик виникнення в неї ожиріння: співвідношення шансів 10,59 (95% довірчий інтервал: 3,81–31,79) при Р = 1,68 (95% довірчий інтервал: 1,43–1,82).

Metabolic determinants of proximal aortic stiffness among healthy people with abdominal obesity

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): (1) the Deutsche Forschungsgemeinschaft; (2) Israel Ministry of Health Background Increased proximal aortic stiffness (PAS) is directly associated with cardiovascular risk. Likewise, metabolic syndrome (MS) and abdominal obesity are associated with cardiovascular risk. The direct association between MS determinants and PAS among a healthy population with abdominal obesity remains to be examined. Purpose To examine the association between MS determinants and PAS among healthy participants with abdominal obesity. Methods We utilized the cross-sectional baseline data of the DIRECT-PLUS study (clinicaltrials.gov NCT03020186), where we recruited healthy participants with abdominal obesity/dyslipidemia. Along with anthropometric measurements and blood tests, all participants underwent magnetic-resonance-imaging from which PAS we assessed by calculating the aortic arch pulse-wave-velocity (from the ascending to the descending aorta). We defined MS according to the NCEP-ATP-III criteria. Results Of 282 participants who had a valid PAS estimation [mean-age: 51.0, 88.3% male, mean-body-mass-index: 31.2kg/m2, mean-waist circumference (WC): 109.5cm] 171 (60.9%) had MS. PAS was mainly associated with age (r = 0.735, p &amp;lt; 0.001). PAS was associated with an increased 10-year Framingham Risk Score (β=0.165,p = 0.008 after adjustment for age and gender). Participants with MS had higher PAS than non-MS participants (6.6m/sec vs. 5.4m/sec, p = 0.002 after adjusting for age and gender). PAS increased along with cumulative number of MS criteria (p-of-trend &amp;lt; 0.001). In multivariate models, adjusted for gender, age, and dichotomous-components of the MS, worse PAS remained significantly associated with high-density lipoprotein cholesterol (HDL-c; β=0.-116,p = 0.007) and increased blood-pressure (β=0.165,p &amp;lt; 0.001), but not with fasting-glucose, waist-circumference or plasma-triglycerides (p &amp;gt; 0.05 for all). In models adjusted for age, gender, and continuous determinants of MS, worse PAS remained associated with mean-arterial pressure (β=0.218,p &amp;lt; 0.001) and HDL-c (β=0.-126,p = 0.004). Conclusions Among a healthy population with abdominal obesity, reduced HDL-c levels and increased blood pressure might be the more dominant predictors of poor PAS state, out of the MS components.

Pancreatic Steatosis Is Associated with Both Metabolic Syndrome and Pancreatic Stiffness Detected by Ultrasound Elastography.

There is increasing evidence that pancreatic steatosis (PS) is associated with metabolic syndrome (MS). However, it is not known whether it is associated with PS grade and pancreatic stiffness, or not. We aimed to evaluate the relationship between PS and its grade detected by transabdominal ultrasound, and pancreatic stiffness determined by two-dimensional shearwave elastography (2D-SWE), whether it has clinical significance and its relationship with MS. Patients with and without PS were evaluated prospectively. Patients with PS had higher odds ratio for MS (OR 5.49). Also, ultrasonographic grade of PS was associated with MS parameters and hepatosteatosis. Pancreatic SWE value was significantly higher in PS group and positively correlated with PS grade, liver fat, MS, number of MS criteria. PS and its grade were associated with MS. In this first comprehensive PS-SWE study, we found that pancreas stiffness increased in the presence of PS, in correlation with PS grade and MS.

The Quantitative Relationship Between Autonomous Cortisol Secretion, Dysglycemia and the Metabolic Syndrome

Autonomous cortisol secretion (ACS) is the most common endocrine abnormality in the evaluation of adrenal incidentalomas. The categorization of ACS is derived from a 1 mg dexamethasone suppression test (DST). Impaired DST is associated with several metabolic derangements. In this study we analyzed the association between post-DST cortisol level, analyzed as a continuous parameter, and indices of glycemic metabolism. We prospectively collected data of 1,976 patients evaluated for adrenal incidentalomas in a large tertiary medical center between December 1, 2017, and August 31, 2019. Seventy-three patients completed the evaluation process. Post-DST cortisol levels were analyzed for correlation with various metabolic parameters, including fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) among the general cohort and for subgroups stratified by the number of metabolic syndrome (MS) criteria. Post-DST cortisol demonstrated a linear association with FPG and HbA1c across its entire cortisol range (R = 0.51 and 0.41, respectively; P≤.01). The association between post-DST cortisol and FPG was strengthened with an increased number of metabolic syndrome criteria. Patients with 4 MS criteria show a stronger association (R = 0.92) compared to patients with only a single criterion (R = 0.509). Furthermore, mean post-DST cortisol levels increased as the number of MS criteria accumulated. Post-DST cortisol should be viewed as a continuous parameter in risk stratification algorithms for the development of MS and particularly dysglycemia.

Prevalence of low serum testosterone levels among men with type 2 diabetes mellitus attending two outpatient diabetes clinics in KwaZulu-Natal Province, South Africa.

The reported prevalence of low testosterone among men with type 2 diabetes mellitus (T2DM) is high. However, there is a dearth of information on the prevalence of androgen deficiency symptoms and low serum testosterone levels in men with T2DM from sub-Saharan Africa. Scanty data are available from Nigeria, Ghana and South Africa (SA). To determine the prevalence of low serum testosterone and associated risk factors and the prevalence of androgen deficiency symptoms in men with T2DM. In a cross-sectional observational study, androgen deficiency symptoms in men with T2DM attending two outpatient diabetes clinics in Durban, KwaZulu-Natal Province, SA, were assessed using the Ageing Males' Symptoms Scale (AMS) questionnaire and direct enquiry. Serum total testosterone (TT), sex hormone-binding globulin (SHBG), luteinising hormone (LH), fructosamine, serum lipids and glycated haemoglobin (HbA1c) were measured and free testosterone (FT) was calculated. TT, SHBG and FT levels were measured in control subjects with no history of diabetes. There were 148 men with T2DM in the study group and 50 control subjects in the control group. In the study group, the majority were black Africans (58.8%); Indians (39.2%) and whites (2.0%) constituted the remainder. The mean (standard deviation (SD)) age was 57.5 (11.2) years, the mean duration of diabetes 11.4 (8.9) years and the mean HbA1c 8.6% (1.9%). Of the study group, 85.8% had metabolic syndrome. Mean TT, SHBG and FT and median LH (interquartile range) in the study group were within normal ranges. However, mean (SD) serum TT and FT were lower in the study group than in the control subjects (14.5 (5.8) v. 18.8 (7.2) nmol/L; p&lt;0.001 and 265.9 (90.4) v. 351.7 (127.3) pmol/L; p&lt;0.001, respectively). The prevalence of low serum total testosterone (LSTT) and low serum free testosterone (LSFT) in the study group was 35.8% and 16.2%, respectively. The prevalence of androgen deficiency symptoms using the AMS questionnaire was 74.5% and correlated poorly with LSTT or LSFT. In multivariate analysis, LSFT was significantly associated with age (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.02 - 1.218; p=0.043) and waist circumference (WC) (OR 1.033, 95% CI 0.999 - 1.068; p=0.059). LSTT was associated with body mass index (BMI) only (OR 1.138, 95% CI 1.063 - 1.218; p&lt;0.0001). TT correlated inversely with BMI, WC and the number of metabolic syndrome criteria. FT correlated inversely with BMI, WC and WHR. There was a high prevalence of LSTT, LSFT and androgen deficiency symptoms in this study. Serum TT and FT were lower in men with T2DM than in control subjects. Risk factors associated with LSFT or LSTT included higher BMI and WC and older age. The AMS score was a poor predictor of low testosterone. More research is required locally before any screening policy can be recommended.

A novel biomarker of cardiometabolic pathology in schizophrenia?

BackgroundPersons with schizophrenia and schizoaffective disorder (PwS) have high rates of cardiometabolic pathology that contributes to premature mortality. Adiponectin is a metabolic hormone affecting insulin sensitivity and inflammation, and is active in the brain. High-molecular weight (HMW) adiponectin is considered a more sensitive marker of metabolic dysfunction than total adiponectin, but has been poorly studied in schizophrenia. MethodsThis was a cross-sectional study of 100 PwS, age range 26–68 years (46 women), and 93 age- and sex-comparable non-psychiatric comparison (NC) subjects. Assessments included measures of psychopathology, physical health, cognitive function, and circulating biomarkers of metabolic dysfunction (HMW adiponectin, lipids, insulin resistance) and inflammation (high-sensitivity C-reactive protein or hs-CRP, Tumor Necrosis Factor-α, Interleukin-6, and Interleukin-10). ResultsHMW adiponectin levels were lower in PwS compared to NCs. Lower HMW adiponectin levels were associated with higher body mass index (BMI), higher Framingham risk for coronary heart disease, higher number of metabolic syndrome criteria, greater insulin resistance, lower HDL cholesterol, and higher hs-CRP in both groups. Only in PwS, lower HMW adiponectin correlated with younger age. In the best-fit regression models of HMW adiponectin, lower levels were associated with lower HDL cholesterol and minority race/ethnicity in both groups; but with younger age, non-smoking, higher insulin resistance, and a diagnosis of schizoaffective disorder only among PwS, and with male sex, better cognitive functioning, and higher hs-CRP levels in NCs only. DiscussionHMW adiponectin may be a promising biomarker of cardiometabolic health, especially among PwS. Adiponectin is a potential target for lifestyle and pharmacological interventions. Research on the possible role of HMW adiponectin in modifying cardiometabolic pathology in schizophrenia is needed.

Dietary Plant Protein and the Progression of Metabolic Syndrome over 9 Years (OR27-08-19)

ObjectivesMetabolic syndrome is a precursor to many leading causes of death in the United States including cardiovascular disease, stroke, and diabetes. Diet plays a major role in preventing or exacerbating the development of metabolic syndrome. Increasing plant protein intake may help to reduce risk of developing metabolic syndrome. The purpose of this study was to examine the possible relationship between metabolic syndrome progression and % of protein from plant sources in the diet. MethodsThe ARIC dataset was used to compare changes in the number of metabolic syndrome criteria (0-5) over a 9-year period to average % of protein from plant sources for 10,038 Americans age 45–64. Quartiles of plant protein intake were controlled for important covariates in linear regression. ResultsAs hypothesized, quartiles with higher percentages of protein intake from plant sources showed a decrease in metabolic syndrome score [B (change in metabolic syndrome score over 9 years per plant protein quartile) = -0.039; 95% confidence interval (CI): -0.063, -0.016] over 9 years of follow up. Waist circumference was the most significantly associated metabolic syndrome factor (B = -0.053; 95% CI -0.030, -0.011). A decrease in BMI was similarly correlated with higher intakes of plant proteins (B = -0.077; 95% CI -0.214, -0.0112). ConclusionsThese results suggest that a higher intake of plant proteins could be protective against increased BMI, waist circumference, and worsening metabolic syndrome and therefore may reduce risk of cardiovascular disease, diabetes, and stroke. Funding SourcesUniversity Funding.

High prevalence of non-alcoholic fatty liver disease among healthy male blood donors of urban India.

BackgroundThere is limited data on the community prevalence of non‐alcoholic fatty liver disease (NAFLD). The present study evaluated the prevalence of NAFLD in a large number of healthy male blood donors of urban north India.MethodologyIn a prospective study performed over 18 months, voluntary blood donors fulfilling the requisite blood donation criteria and consenting to participate in the study were evaluated. The study received the approval of the institute's ethics committee. Diagnosis of NAFLD was made by excluding significant alcohol intake, ultrasound showing hepatic steatosis, and exclusion of transfusion associated infections. Subjects were also evaluated for various metabolic risk factors and the presence of metabolic syndrome.ResultsOf 1388 subjects who consented for participation, 386 did not come for evaluation. Three females, nine (0.9%) HBsAg‐positive, and four (0.4%) anti‐HCV positive subjects were excluded. Of the 986 males evaluated with hepatobiliary ultrasound, 543(55.1%) had fatty liver on ultrasonography [15 (1.5%) alcoholic fatty liver and 528 (53.5%) NAFLD]. Among those with NAFLD, 469 (88.8%), 54 (10.2%), and 5 (0.9%) had mild, moderate, and severe hepatic steatosis, respectively. Subjects with NAFLD, when compared to those without NAFLD, had significantly higher age, BMI, waist circumference, blood pressure, total cholesterol and triglycerides, low‐density lipoprotein, and fasting plasma glucose. Multivariate regression analysis demonstrated age, BMI, waist circumference, systolic blood pressure, total cholesterol, and number of metabolic syndrome criteria as independent predictors of NAFLD.ConclusionsUrban Indian healthy male blood donors have a high prevalence of NAFLD.

Prevalence of metabolic syndrome among chronic kidney disease patients attending a tertiary hospital in Nigeria – a cross - sectional study

Objective: Metabolic syndrome and chronic kidney disease are major public health challenges. This study aimed at determining the prevalence of metabolic syndrome among chronic kidney disease patients. Methods: One hundred and sixty patients were enrolled. Glomerular filtration rates were estimated using the Cockcroft Gault formula. Metabolic syndrome was defined by the presence of ≥ 3 of the following: Central obesity (waist circumference of >102 cm in males or >88 cm in females); Hypertriglyceridemia >150 mg/dL, low HDL cholesterol ( 130/85mmHg), Fasting plasma glucose >100 mg/dL. Results: The overall prevalence of metabolic syndrome was 67.5%, CKD stage 5 had the highest prevalence (85.1%) (p = 0.165). Prevalence among diabetics was 82% (p <0.000). CKD stage and number of metabolic syndrome criteria positively correlated. Conclusion: approximately seven out of every 10 CKD patients had metabolic syndrome. It was more associated with advanced CKD. Diabetics compared to non-diabetics were 1.5 times more predisposed. Keywords: Metabolic syndrome, chronic kidney disease, diabetes mellitus

Metabolic syndrome and its components among university students in Kenya

BackgroundMetabolic syndrome refers to a cluster of interrelated disorders which occur together causing an increase in the risk of developing cardiovascular disease and diabetes. The university population is an understudied group despite the increase in the frequency of related disorders and metabolic risk factors e.g. obesity and diabetes, majorly due to the assumption that they are in their most active phase of life therefore healthy. This study looked at metabolic syndrome, the sedentary lifestyles and dietary habits present among university students attending Mount Kenya University, main campus.MethodsStratified sampling was used to select participants. Self-administered questionnaires were issued to participants after a signed consent had been obtained following which clinical assessments and biochemical measures were performed. They included blood pressure, fasting blood glucose, triglycerides, high density lipoprotein-cholesterol, anthropometric measurements; height, weight, BMI and waist circumference. Pearson’s chi-square tests and non-parametric independent t-test were used to analyze the prevalence of metabolic syndrome criteria per gender, the number of metabolic syndrome criteria per BMI and prevalence of metabolic syndrome criteria per BMI category.ResultsThe study established that 1.9% of the participants met the criteria for diagnosis of metabolic syndrome according to HJSS criteria. Among the elements, there was statistical difference in gender BMI and waist circumference. 11.8% of subjects had two metabolic syndrome components while 3.1% had three components while none of the subjects had all six components. Elevated triglycerides was the most prevalent defining component for metabolic syndrome. There is a statistically significant relationship between sedentary lifestyle and dietary habits as risk factors to metabolic syndrome.ConclusionYoung adults in university have begun developing metabolic syndrome and the risk of developing the syndrome continues to increase with the components being reported in early age. Educational initiatives to encourage healthy eating should be conducted within school premises in order to reinforce the message on healthy diets and physical exercise. Pre-admission screening to identify at risk students should be conducted. Targeted interventions development through a mandatory extra co-curricular program should be enforced to positively engage those at risk.

Interleukin-18 and testosterone levels in men with metabolic syndrome

Objective: Interleukin 18 (IL-18) is an adipokine associated with obesity. Data about the relationship of IL-18 to the metabolic syndrome (MS) are still scarce. Low testosterone (T) levels are common in men with MS, but we did not find data about the levels of IL-18 in men with low T. The aim of this study was to determine the levels of IL-18 in men with MS with or without low T. Patients and methods: A total of 251 men were included in the study. Of them 218 had MS (IDF 2005) and they were divided according to their morning total testosterone (TT) level (cutoff 10.4 nmol/l) into two groups: MS-low T (N = 84) and MS-normal T (N = 134). The control group consisted of 33 men without MS and low T. IL-18 was determined in serum using enzyme-linked immunosorbent assay. A small group of eight men with MS and low T levels received testosterone therapy for three months and physical and laboratory parameters were monitored at the end of that period.Results: MS men were at mean age (±SD) = 53.77 ± 9.59 years; body mass index (BMI) = 34.0 ± 6.3 kg/m2; and TT = 12.59 ± 5.66 nmol/l. The control group was at age = 52.12 ± 5.2 years (NS); BMI = 25.6 ± 2.4 kg/m2 (p < .001); and TT = 17.8 ± 5.68 nmol/l (p < .001), respectively. The levels of IL-18 were higher in the MS group – 345 pg/ml compared to the control one – 264 pg/ml (p < .01). There was no significant difference between MS-low T (330.6 pg/ml) and MS-normal T (350.2 pg/ml) subgroups. The MS-normal T differed more significantly from the control group (p < .001). Significant correlation of testosterone with IL-18 levels was not found. IL-18 correlated with parameters of obesity, lipids, fasting blood sugar (p < .05) and the number of criteria for MS (p < .001). Three months on T treatment showed improvement in obesity parameters and only in one patient IL-18 had clear reduction while the rest showed no change.Conclusions: In this study, higher IL-18 levels were found in the presence of MS compared to healthy men, but they did not differ between men having MS with or without LOH.

Abstract 14167: Clinical Characteristics of Subjects With Different Levels of Systemic Erythrocyte-bound Apolipoprotein B

Introduction: The level of apolipoprotein (apo) B-containing lipoproteins in plasma is positively associated with cardiovascular risk. We have previously demonstrated that apo B bound to circulating erythrocytes (ery-apoB) may protect against atherosclerosis. We evaluated the clinical characteristics of subjects with different levels of ery-apoB. Methods: Ery-apoB was measured by flow cytometry in subjects with (n=177) and without (n=208) cardiovascular disease (CVD), and expressed as mean fluorescent intensity in arbitrary units (au). The number of criteria for metabolic syndrome as outlined by the NCEP was scored. Carotid intima media thickness (cIMT) was measured using B-mode ultrasound. Data are given as median (IQR). Results: Ery-apoB was lower in patients with CVD than in controls (0.80 (0.40-1.40) and 0.90 (0.46-1.79) au, respectively, p=0.039). Ery-apoB was inversely associated with cIMT, waist circumference, plasma triglycerides, C-reactive protein and complement C3, and was positively associated with HDL-cholesterol. Ery-apoB was similar in men and women. The number of criteria for the metabolic syndrome was closely associated with ery-apoB, in a dose-depending manner. Median ery-apoB decreased with increasing number of metabolic syndrome criteria (Kruskall Wallis test, p=0.02). Furthermore, ery-apoB was almost 3-fold higher in subjects with blood group O than in subjects with a non-O blood group (1.40 (0.75-2.15) and 0.50 (0.10-0.95) au, respectively, p&lt;0.001). No correlation between ery-apoB and plasma apo B was found, and ery-apoB was unrelated to statin use. Discontinuation of statin use did not affect ery-apoB (n=54). Conclusion: Apo B bound to circulating erythrocytes is associated with several characteristics of the metabolic syndrome, inflammation and ABO blood group. These data provide novel insight into the mechanisms involved in the binding of atherogenic lipoproteins to erythrocytes.

Significance of MPV, RDW with the Presence and Severity of Metabolic Syndrome.

Metabolic syndrome (MS) is a multiplex risk factor that arises from insulin resistance accompanying abnormal adipose deposition and function. It is a risk factor for coronary heart disease, as well as for diabetes, fatty liver, and several cancers. Recent studies showed that there was a correlation between inflammatory mediators and MS. The aim of this study was to investigate the relationship between the MS and new inflammatory markers as mean platelet volume (MPV) and red blood cell distribution width (RDW), they are simple and reliable indicators of inflammation. 200 patients who met the MS criteria and other 100 age- and sex-matched control subjects were included in this randomized controlled trial. Patients were classified into 2 groups each 100 subjects based on the number of MS criteria: group 1 (patients with 3 MS criteria), group 2 (patients with 5 MS criteria). MPV and RDW were calculated from complete blood count. Patients with MS had significantly higher MPV and RDW correspondingly compared to those without MS. (MPV: 8.4±0.61 v 8.80±0.60, 9.56±0.48, respectively, p<0.001) (RDW:12.38±0.77, 13.15±062, 13.90±0.55). Moreover, patients meeting 5 MS criteria had higher MPV and RDW than those meeting 3 criteria (p<0.001) and 0.000, respectively) The present study indicated, for the first time, a significant correlation between the 2 criteria of MS and inflammation based on these new markers that should be simple and reliable indicator of inflammation.

The history of childhood trauma is associated with lipid disturbances and blood pressure in adult first-episode schizophrenia patients

ObjectiveIt has repeatedly been found that early-life traumatic events may contribute to metabolic dysregulation. Therefore, the aim of this study was to investigate the association between the history of childhood trauma and cardiovascular risk factors in first-episode schizophrenia (FES) patients. MethodThe history of childhood trauma was assessed using the Early Trauma Inventory Self Report — Short Form (ETISR-SF) in 83 FES patients. Based on the ETISR-SF, patients were divided into those with positive and negative history of childhood trauma: FES(+) and FES(−) patients. Serum levels of fasting glucose lipids, homocysteine, vitamin B12 and folate, as well as anthropometric parameters and resting systolic and diastolic blood pressure (SBP and DBP) were measured. ResultsThe history of childhood trauma was associated with higher low-density lipoprotein (LDL) levels, SBP and DBP after covarying for age, gender, body mass index, education and chlorpromazine equivalent. There were significant correlations between scores of distinct ETISR-SF subscales and LDL, high-density lipoprotein, SBP, DBP and the number of metabolic syndrome criteria. ConclusionsResults of this study indicate that traumatic events during childhood might be related to higher resting blood pressure and higher LDL levels in adult FES patients.

Association between metabolic syndrome and coronary heart disease in patients on hemodialysis.

Background:The metabolic syndrome (MeS) is a common risk factor for coronary heart disease (CHD) in the general population.Objectives:We examined the association between MeS and its risk in terms of CHD in patients on hemodialysis (HD).Patients and Methods:This study was conducted on 300 patients on HD in six HD centers during March 2012. Patients were divided in two groups regarding presence of MeS. The rate of CHD were evaluated in each group and compared with each other.Results:A total of 300 patients on HD, 173 males and 127 females with mean age of 61.7 ± 14.2, were enrolled in the study. Prevalence of MeS was 50.3%; hypertension, 83.7%; diabetes mellitus, 52%; high triglyceride level, 34%, low HDL cholesterol, 48.3%; and abdominal obesity, 41.3%. During the study, the CHD was more frequent in patients with MeS (27.8%) than was in those without MeS (14.1%) (P = 0.004). In addition, stroke happened more frequently in the MeS group than in those without MeS (30.5% vs. 17.4%; P = 0.008). The mean number of criteria for MeS was not significantly associated with mortality causes (CHD, 2.7 ± 1.3; stroke, 2.8 ± 0.9; other causes, 2.9 ± 1.3 P = 0.78). However, hypertension (89.3%) and diabetes mellitus (53.8%) were associated with increased risk for mortality. In the group of MeS, CHD were not significantly associated with serum albumin, calcium, phosphate, blood urea nitrogen, creatinine, ferritin, C-reactive protein, and KT/V; but there was significant association with white blood cells count (P < 0.0002).Conclusions:These findings suggested MeS might be an important risk factor for CHD, but not for mortality due to CHD in patients on HD.

Effect of Statin Therapy on Incident Type 2 Diabetes Mellitus in Patients With Clinically Manifest Vascular Disease

Several trials and cohort studies have shown an increased incidence of type 2 diabetes mellitus (T2DM) in patients using statins. Whether this only applies to patients at already high risk for the development of T2DM or for all patients is still a matter of debate. In the present prospective cohort study of 4,645 patients with established vascular disease without DM at baseline, 3,057 patients used statins at baseline, of whom 1,608 used intensive statin therapy, defined as statin therapy theoretically lowering low-density lipoprotein cholesterol with ≥40%. Cox proportional hazards models were used to estimate the risk of incident T2DM with (intensive) statin therapy. Statin therapy was associated with increased risk of incident T2DM (hazard ratio 1.63; 95% confidence interval 1.15 to 2.32) when adjusted for age, gender, body mass index, plasma high-density lipoprotein cholesterol, and plasma triglyceride levels. Intensive statin therapy tended to be related to a higher risk of T2DM compared with moderate statin therapy (hazard ratio 1.22; 95% confidence interval 0.92 to 1.61, adjusted for age, gender, body mass index, plasma high-density lipoprotein cholesterol, and plasma triglyceride levels). The increase in risk was regardless of the number of metabolic syndrome characteristics or insulin resistance but was particularly present in patients with low baseline glucose levels (<5.6 mmol/L; p for interaction 2.9 × 10(-7)). In conclusion, statin use increases the risk of incident T2DM in patients with clinically manifest vascular disease. The increase in risk was independent of the number of metabolic syndrome criteria and was even more pronounced in patients with low baseline glucose levels.