Presence Of Metabolic Syndrome Research Articles

Liver steatosis in patients with rheumatoid arthritis treated with methotrexate is associated with body mass index.

Methotrexate (MTX) is the usual first-line treatment for rheumatoid arthritis (RA). Long-term use of MTX has been associated with liver steatosis (LS) and liver fibrosis (LF). To determine if LS in patients treated with MTX for RA is associated with MTX cumulative dose (MTX-CD), metabolic syndrome (MtS), body mass index (BMI), the male sex, or LF. A single-center, prospective study of patients receiving MTX for RA was performed from February 2019 to February 2020. The inclusion criteria were patients aged 18 years or older diagnosed with RA by a rheumatologist and being treated with MTX (without limitation on the duration of treatment). The exclusion criteria were previous diagnosis of liver disease (hepatitis B or C virus infection, known nonalcoholic fatty liver disease), alcohol consumption greater than 60 g/d in males or 40 g/d in females, human immunodeficiency virus infection on antiretroviral therapy, diabetes mellitus, chronic renal failure, congestive heart failure, or BMI greater than 30 kg/m². Patients receiving leflunomide in the 3 years prior to the study were also excluded. Transient elastography (FibroScan, Echosens®, Paris, France) was used for fibrosis determination (LF > 7 KpA) and computer attenuation parameter (CAP) for LS (CAP > 248 dB/m). Demographic variables, laboratory data, MTX-CD (> 4000 mg), MtS criteria, BMI (> 25), transient elastography, and CAP scores were collected from all patients. Fifty-nine patients were included. Forty-three were female (72.88%), and the mean age was 61.52 years (standard deviation: 11.73). When we compared MTX-CD ≤ 4000 mg (26 patients; 14 with LS and 12 without) with > 4000 mg (33 patients; 12 with LS and 21 without), no statistical differences were found (P = 0.179). We compared CAP scores stratified by MtS, BMI, sex, and LF. There were no significant differences in CAP scores based on the presence of MtS [CAP/MtS: 50 no MtS (84.75%); 9 MtS (15.25%); P = 0.138], the male sex (CAP/sex: 8 male/18 female LS; 8 male/25 female no LS; P = 0.576), or LF [CAP/fibrosis: 53 no LF (89.83%); 6 LF (10.17%); P = 0.239]. LS determined by CAP was significantly associated with BMI > 25 (CAP/BMI: 22 BMI ≤ 25 (37.29%); 37 BMI > 25 (62.71%); P = 0.002]. LS in patients with RA treated with MTX was not associated with MTX-CD, LF, the male sex, or MtS. However, BMI was significantly related to LS in these patients.

METABOLIC SYNDROME AND THYROID DYSFUNCTION IN PATIENTS WITH ACROMEGALY IN SULAIMANI

Background 
 Acromegaly is a chronic endocrinology disorder caused by the over-production of growth hormone (GH) predominantly by a pituitary adenoma. Acromegaly is associated with metabolic changes and thyroid dysfunction (ThD) in the body. However, the frequency of metabolic syndrome (MtS) in acromegaly patients is unknown, and studies assessing the frequency of different ThD types in acromegaly cases were few.
 Objectives 
 To analyze the frequencies of MtS and ThD in patients with acromegaly in comparison to controls in Sulaimani city, to find the frequencies of MtS and ThDs in active cases compared to inactive cases in acromegaly patients, and to assess the relationship between the cumulative exposure to Insulin-like Growth Factor 1 (IGF-1) with ThD and MtS in acromegaly.
 Patients and Methods
 In this case-control study, 82 subjects were enrolled, which included 22 patients with acromegaly who visited the Sulaimani endocrinology center from August 2021 to February 2022 and 60 control subjects. The mean age of cases was 47.55 [11.50] years, with 7 (31.8%) male and 15 (68.2%) female. Thyroid function test, clinical, and biochemical parameters of MtS were measured in both groups in addition to IGF1. Chi-square test, Student T-test, and ANOVA were used in data analysis. Correlation between quantitative variables determined by Pearson correlation, with a P-value ≤ 0.05, is significant
 Results
 Out of 22 patients with acromegaly, 68.2% were euthyroid, 9.1% had primary hypothyroidism, 18.2% had central hypothyroidism, and 4.5% had hyperthyroidism, which is significantly higher than the control group (p-value =0.002). MtS frequency is 68.18% in cases, significantly higher than control, p-value=0.011. Most MtS and ThD parameters were significantly higher in acromegaly patients than in controls, P-value < 0.001. No significant correlation between the last IGF1 and other parameters existed except free T3, which has a significant negative correlation with IGF1, P < 0.05. 
 Conclusion
 In acromegaly, the frequency of MtS is high (68.18%), and the frequency of ThD is 31.8%. Both MtS and ThDs are more common in patients compared to controls. No significant relationship exists between disease activity and the presence of MtS or ThD. Because both MtS and ThDs increase the metabolic markers, consequently increasing cardiovascular disease (CVD) morbidity and mortality in cases.

Examining the association between serum IgG of oral bacteria and metabolic syndrome.

AimThis investigation explored the relationship between oral bacteria and metabolic syndrome (METS).Materials and MethodsThere were 4,882 subjects enrolled in this cross-sectional study from the NHANES III database. The severity of periodontitis was classified into mild, moderate and severe. We measured oral bacterial antibodies. We examined the relationship between serum immunoglobulin G (IgG) antibodies of oral bacteria and METS via performing multivariate regression analysis. Mediation analysis of oral bacteria on the correlation between periodontitis and METS was also executed.ResultsAfter adjusting for covariates, the serum IgG antibodies of P. nigrescens, E. corrodens, and E. nodatum were associated with the presence of METS (p = 0.006, p = 0.014 and p = 0.018, respectively). Furthermore, serum IgG antibodies of P. intermedia, T. forsythia and V. parvula were positively associated with the presence of METS (p = 0.001, p = 0.011, and p = 0.002, respectively) and ≥4 features of METS (p = 0.019, p = 0.025, and p = 0.02, respectively). P. intermedia IgG mediated 11.2% of the relationship between periodontitis and METS.ConclusionSerological markers of oral pathogens were correlated with the presence and the number of METS features after multivariable adjustment. Oral bacteria acted as a mediator of the correlation between periodontitis and METS. Our study provided a biologically plausible explanation for the association between periodontitis and METS, which provides a comprehensive evaluation of periodontitis.

Impact of a high visceral adiposity index on female sexual dysfunction in sexually active women? Results of a cross-sectional study.

To our knowledge, this is the first study investigating the impact of high visceral adiposity index (VAI) on female sexual dysfunction (FSD). We aimed to show the impact of increased levels of VAI on FSD compared with body mass index (BMI) and waist circumference (WC) particularly in those with metabolic syndrome (MeTS). We included 158 participants in two groups: Group 1 (n=68 with normal sexual function) and Group 2 (n=90 with sexual dysfunction). Demographic, clinic data, presence of MeTS and comorbidities were recorded. The BMI, WC and the VAI were calculated. Sexual function was assessed using the female sexual function index. The mean age and all the anthropometric variables were similar between the groups (P>.05). MeTS was associated with lower arousal and lubrication scores than those without MeTS (P=.023). The higher VAI was associated with lower desire, lubrication and orgasm scores (P<.05). Each integer increase of the VAI weakly predicted decrease of desire (P=.015), arousal (P=.015), lubrication (P=.005) and satisfaction (P=.046). The WC and BMI were not a good predictor for FSD in women (OR=1.019, P=.318). The VAI was linked with lower scores in some female sexual function subdomains, but the correlation coefficient was low, indicating a weak association. Further studies with a higher number of participants are needed to conclude that the VAI may increase the risk of FSD, particularly in patients with MeTS.

Impact of high visceral adiposity index associated with metabolic syndrome on erectile function in sexually active men: Results of a cross-sectional study.

Erectile dysfunction (ED) is a common condition affected by many factors. We aimed to show the impact of the metabolic syndrome (MeTS) on male sexual function based on visceral adiposity index (VAI). Participants who met MeTS criteria (Group 1, n=96) and did not meet MeTS criteria (Group 2, n=189) were included in this cross-sectional study. The MeTS diagnosis was made in the presence of at least 3 of the following criteria: fasting serum glucose level higher than 100 mg/dL, HDL cholesterol level below 40 mg/dL, triglyceride level higher than 150 mg/dL, waist circumference higher than 102 cm and blood pressure higher than 130/85 mmHg. Demographic data were recorded; biochemical and hormonal tests were measured. Erectile and other sexual function scores were recorded. The VAI was calculated using the [(Waist Circumference/39.68) + (1.88 × body mass index)] × triglyceride/1.03 × 1.31/HDL formula. Mean age, smoking volume, testosterone (T) and testosterone/estradiol (T/E2 ) ratios of the groups were similar (P>.05). The mean VAI was two-fold higher in patients in Group 1 (P<.001) and erectile function score was lower in Group 1 than Group 2 (P=.001). Other sexual function scores were similar (P>.05). The METS was associated with an increased risk of ED (P=.001). Logistic regression analysis showed that each integer increase in the VAI was associated with a 1.4-fold increased risk of ED (P<.001). Higher T values were associated with a better erectile function (P=.03). For the VAI=4.33, receiver-operating characteristic analysis showed a sensitivity of 89.6% and specificity of 57.7%. Compared with non-MeTS, the presence of MeTS has emerged as a risk factor for patients with ED with high VAI levels while the other sexual functions are preserved. Management of ED patients with MeTS should cover a comprehensive metabolic and endocrinological evaluation in addition to andrological work up.

Differential Effect of the Metabolic Syndrome on the Incidence of Retinal Vein Occlusion in the Korean Population: A Nationwide Cohort Study.

PurposeTo investigate the impact of the metabolic syndrome (METS) on the incidence of retinal vein occlusion (RVO).MethodsThis is a retrospective cohort study using Korean National Health Insurance System data. 23,153,600 subjects without previous history of RVO underwent a National Health Screening Program examination between 2009 and 2012. They were monitored for RVO development (registration of diagnostic code for RVO) until 2015. Presence of METS was defined using the data from the National Health Screening Program examination according to the revised criteria of the National Cholesterol Education Program Adult Treatment Panel III. A multivariate adjusted Cox regression analysis was used to reveal hazard ratios and 95% confidence interval for RVO development in the presence of METS.ResultsThe age of the subjects was 47.64 ± 13.51 years. In this cohort, 11,747,439 (50.7%) were male, 11,406,161 (49.3%) were female, and 6,398,071 subjects (27.6%) were diagnosed with METS. The overall incidence of RVO was 0.947 per 1000 person-years. The adjusted hazard ratio of RVO in the presence of METS was 1.458 (95% confidence interval, 1.440–1.475; P < 0.001) after adjusting for age, sex, smoking status, alcohol consumption, physical activity, and income. Among all of the criteria for METS diagnosis, elevated blood pressure was the greatest risk for RVO development (adjusted hazard ratio, 1.610; 95% confidence interval, 1.589–1.631; P < 0.001).ConclusionsMETS and each of diagnostic criteria was associated with an increased risk of RVO development. Elevated blood pressure seems to be especially important factors for RVO development.Translational RelevanceOur results provide information about the link between METS and RVO.

P1024INFLUENCE OF NON-ALCOHOLIC FATTY LIVER DISEASE IN THE EVOLUTION OF RENAL FUNCTION IN DIABETIC PATIENTS

Abstract Background and Aims Nowadays, there is growing evidence that non-alcoholic fatty liver disease (NAFLD) may be associated with renal impairment and have an impact on the evolution of renal function in patients with type 2 diabetes mellitus (DM). Our aim was to compare the effect on renal function and proteinuria in patients with type 2 DM according to the presence of NAFLD. Method Retrospective and observational study, including patients with type 2 DM, &amp;lt; 70 years of age and with estimated glomerular filtration rate (eGFR) &amp;gt; 30 ml/min/1,73 m2. NAFLD was defined with the presence of compatible ultrasonography and/or presence of fibrosis using NAFLD score. Metabolic syndrome (MSd) was defined as: obesity (body mass index (BMI) &amp;gt; 30 kg/m2), hypertension and dyslipidaemia. Patients were classified according to the presence or absence of NAFLD. We analysed different clinical and analytical variables along the follow up. Results A total of 71 patients were included (66% males) with mean age of 57.4 ± 7.8 years. The median evolution of type 2 DM was 72.2 months (34.7 - 125.5 months) and 90.1% of the patients were treated with renin-angiotensin blockade. When comparing patients with (group 1, n=38) and without (group 2, n=33) NAFLD at the beginning of this study, we found no significant difference in eGFR (80.2 ± 40.4 ml/min vs 71.4 ± 31.8 ml/min), proteinuria (1.4 ± 2.7 g/24h vs 0.8 ± 1.0 g/24h) and glycated haemoglobin (6.8 ± 1.4% vs 7.2 ± 1.6%). On the other hand, we found significant difference in the presence of higher BMI (33.8 vs 29.3 kg/m2; .001) and presence of MSd (67.7 vs 32.3%; .03) in those patients with NAFLD. After a mean follow-up time of 74 months, we found significant differences in the loss of eFGR (-33.8 vs -13.9 ml/min; .003), but no difference in increase of proteinuria. We found an increase in incidence of chronic kidney disease in group 1 (50%) vs group 2 (10.5%). There were no differences in the need to initiate renal replacement therapy or all-cause mortality. Conclusion NAFLD in type 2 DM caused a mayor decline in renal function. We should, therefore, take into consideration the presence of NALFD and the presence of MSd to optimise treatment of associated risk factors.

Cardiometabolic risk profile and diet quality among internal migrants in Brazil: a population-based study.

Studies of migrants can improve understanding of the environmental influence on the risk of chronic diseases. In continental countries, internal migration has been associated with changes in diet and health status. The objective of this study is to assess differences in diet quality and the cardiometabolic risk profile between migrants and the host population. A cross-sectional, population-based study was conducted in the city of São Paulo. The study population included internal migrants, defined as individuals born outside São Paulo city who had lived in the city for ten years or longer. The final population (n = 537) was divided into three groups: natives of São Paulo (45.5%), migrants from the Southeast (26.9%) and migrants from the Northeast (27.5%). The joint interim statement consensus criteria were used for diagnosing MetSyn. Diet quality was estimated using the revised version of the Brazilian Healthy Eating Index (BHEI-R). Comparisons between the data of BHEI-R, cardiometabolic risk factors and MetSyn in migrants and natives were performed using generalized linear models adjusted for confounding factors, respectively. Southeastern and Northeastern migrants younger than 60years had a higher average of for whole fruit and oil components, respectively. Northeastern migrants older than 60years had higher systolic and diastolic blood pressure, atherogenic ratio concentrations, lower HDL-C and were more likely to present metabolic syndrome compared to those born in São Paulo of the same age group. Native and internal migrants from Brazil resident in São Paulo exhibited differences in diet quality and cardiometabolic risk factors.

Metabolic Syndrome in Adolescents with Polycystic Ovary Syndrome: Prevalence on the Basis of Different Diagnostic Criteria.

Existing literature on the prevalence of metabolic syndrome (MBS) in adolescents with polycystic ovary syndrome (PCOS) is inconsistent, likely because of the application of differing diagnostic criteria. The objective was to assess the prevalence of MBS in adolescents with PCOS depending on the PCOS diagnostic criteria used. A retrospective chart review of female patients (N=37), ages 11-22years, diagnosed with PCOS between January 2013 and December 2017. Patients were included only if they had received screening allowing comparison across all PCOS diagnostic criteria: National Institutes of Health, Rotterdam, Androgen Excess Society, Amsterdam, Endocrine Society, and the Pediatric Endocrine Society (PES). The presence of MBS was established using the International Diabetes Federation criteria. The proportion of patients having MBS was then calculated for each PCOS diagnostic criteria subgroup. For the entire study cohort, MBS was present in 17/37 patients (45.9%). The highest prevalence of MBS was among the subgroup of patients meeting the PES PCOS diagnostic criteria (13/25; 52.0%), whereas the lowest prevalence was in the subgroup meeting the Amsterdam PCOS criteria (6/15; 40.0%). Those diagnosed using the PES criteria also had the highest percentage of patients with 3 or more risk factors for MBS. The prevalence of MBS varied according to the specific PCOS diagnostic criteria and was highest when PES guidelines were used. The PES criteria are adolescent-specific and have thus refined the diagnosis of PCOS for this population. Our results highlight the importance of validated adolescent-specific PCOS diagnostic criteria.

251. The Prevalence of Metabolic Syndrome In Adolescents With Polycystic Ovary Syndrome Under Different Diagnostic Criteria

There is ample evidence that increased risk of metabolic dysfunction is present in women with polycystic ovary syndrome (PCOS). Existing literature on the prevalence of metabolic syndrome (MBS) in the adolescent population with PCOS is inconsistent. A recently conducted meta-analysis found that the prevalence of MBS ranged from 4.9% to 43.6% in adolescent girls with PCOS. The discrepancy in the prevalence of MBS in adolescents is likely due to application of differing diagnostic criteria for both PCOS and MBS. The impact of the specific PCOS diagnostic criteria used on the prevalence of MBS in adolescents has not yet been evaluated. As such, the objective of the current study was to assess the prevalence of MBS in adolescents with PCOS under different diagnostic criteria. A retrospective chart review was conducted on female patients (N=37), ages 11-22 years, with PCOS who were seen at Nationwide Children’s Hospital between January 2013 and December 2017. Patients were included in the study only if they had received screening that would allow comparison across all PCOS diagnostic criteria including the National Institute of Health (NIH), Rotterdam, Androgen Excess Society (AES), Amsterdam, Endocrine Society (ES) and the Pediatric Endocrine Society (PES). The presence of MBS was established using the International Diabetes Federation criteria. Patients were categorized according to the 6 different PCOS diagnostic criteria and then the presence of MBS and risk factors were evaluated. Mean age of the study population was 15.4 ±1.66 years (range: 11.5-20.4). All patients met the diagnosis of PCOS utilizing the Rotterdam criteria; whereas only 15/37 (40.5%) met the diagnosis using the Amsterdam criteria. The prevalence of a PCOS diagnosis among the other diagnostic guidelines was 30/37 (81.1%) NIH, 32/37 (86.5%) AES, 29/37 (78.4%) ES, and 25/37 (67.6%) with the PES criteria. For the entire study cohort, MBS was present in 17/37 (45.9%) patients. Arterial hypertension was evident in 10/37 (27.0%), and no patients were on antihypertensive medication. Low HDL was observed in 28/37 (75.7%), high triglyceride in 12/37 (32.4%) and no patients were on lipid lowering medication. Elevated blood glucose was found in 9/37 (24.3%), and no patients had Type 2 diabetes mellitus. The highest prevalence of MBS was found among the subgroup of patients meeting the PES diagnostic criteria (13/25, 52.0%), while the lowest prevalence of MBS was in the subgroup meeting the Amsterdam criteria (6/15, 40.0%). Those diagnosed using the PES criteria also had the highest percentage of patients with 3 or more risk factors for MBS. This study of adolescents evaluated for PCOS found that the prevalence of MBS varied according to the specific PCOS diagnostic criteria used and ranged from 40 % to 52 % in the same patient population. Prevalence of MBS was highest when PES guidelines were used. The PES criteria are adolescent-specific, and thus have refined the definition of clinical hyperandrogenism and ovulatory dysfunction for this population. These results highlight the importance of validated adolescent specific PCOS diagnostic criteria.

The Effects of Metformin on Thyroid Function among Patients with Subclinical Hypothyroidism and Coexisting Metabolic Syndrome

Background: The interference of metformin with thyroid function has been recently reported in several studies. In the present research, we assessed the effect of metformin on thyroid function tests in patients with subclinical hypothyroidism associated with metabolic syndrome. Method: In a double-blind clinical trial, 60 patients were selected among who referred to outpatient endocrine clinics and met the inclusion and exclusion criteria were considered for the study. Inclusion criteria were the presence of metabolic syndrome and subclinical hypothyroidism (2.5<TSH<10 mIU/l). Screened patients used no medications interfering with TSH level. Pregnancy, GFR less than 50 ml/min and intolerance of metformin were also considered as exclusion criteria. Patients were divided into case and a placebo groups. In the case group, patients received 1000 mg/day of metformin for 12 weeks. Anthropometry, liver and thyroid function tests, and lipid profile were evaluated before and after the intervention. Results: A total of 44 patients fully participated for the whole study period. The mean age was 44±14 years and 15 patients (34.1%) were male. The mean TSH and FT4 levels before and after intervention were 5.8±2.15, 4.8±2.7 and 1.10±0.19, 1.14±0.26, respectively. The positive TPO-ab was seen among 18 (40.9%) patients. TSH (4.12±2.07, p=0.013) and FT4 (1.18±0.23, p=0.007) levels were decreased and increased, respectively, compared to the placebo group. Furthermore, a reduction in metabolic element was observed. Conclusion: Our data showed that metformin reduced the TSH level in subclinical hypothyroid patients, especially in patients with TSH baseline level higher than 5mIU/l and TPO-ab positive patients.

Metabolic Syndrome and Genotype 1 Virus C Compensated Liver Cirrhosis in the Era of Directly Acting Antiviral Therapy

Objectives: The current study aimed at evaluating the association between metabolic syndrome (MeS) in patients with hepatitis C virus (HCV) liver cirrhosis (compensated, genotype, 1b) and changes after sustained viral response (SVR) following a 12-week therapy with paritaprevir, ritonavir, ombitasvir, dasabuvir, and ribavirin (PrOD+R). Methods: The current multicenter retrospective study included 809 patients diagnosed with compensated HCV cirrhosis (child class A), all 1b genotype treated for 12 weeks with direct acting antiviral agents - PrOD+R - regimen (according to the protocol practiced in Romania) and achieved SVR. The parameters of MeS (according to the definition of the International Diabetes Federation) were collected from medical records before and 12 weeks after the treatment. The results were collected in a central database and analyzed with SPSS 18.0. Statistical analysis used both descriptive and analytical methods with a significance level of 95% (CI 95%). Results: Out of the 809 patients, 105 (13%) demonstrated 3 out of the 5 criteria for MeS. Based on the MeS criteria, the commonest parameters were abnormal glycaemia (54.1%), followed by visceral obesity (38.6%), raised triglycerides (26.1%), high blood pressure (12.1%), and a low high-density lipoprotein (HDL)-cholesterol (4.6%). The re-assessment of MeS parameters after SVR showed favourable changes, which were statistically significant: a siginficanttly lower serum triglyeride level (182.32 vs. 153.50 mg/dL, P = 0.001), lower systolic arterial blood pressure (130.57 vs. 124.85 mmHg; P = 0.001), lower diastolic arterial blood pressure (80.26 vs. 78.42 mmHg; P = 0.001) and lower glyceamic levels (130.06 vs. 120.71 mg/dL; P = 0.001), as well as a significant rise in HDL-cholesterol levels (48.61 vs. 50.50 mg/dL; P = 0.003). Abdominal circumference was the only parameter, which did not change after SVR. Following the changes sustained after SVR, 26.7% of the patients no longer fulfilled the minimum 3 criteria for MeS. No correlation was observed between the presence of MeS and the risk of severe adverse events, but it was noted that 37.5% of the patients who decompensated, 66.7% of the ones who developed hepatocarcinoma and 100% of the ones that died of abnormal glycaemic levels. Conclusions: Hyperglycemia, and not MeS, is associated with HCV compensated liver cirrhosis genotype 1b, and is a risk factor for severe adverse events. The attainment of SVR through PrOD+R regimen results in short-term improvements in MeS parameters.

The effect of metabolic syndrome on structural anomalies, systolic and diastolic function of left ventricle determined using echocardiography of a patient with atrial fibrillation

Introduction: Atrial fibrillation (AF) is the most common atrial arrhythmia and has a growing trend worldwide. Change in lifestyle, cessation of alcohol abuse, smoking, physical inactivity and psychological stress reduces the risk of AF occurrence in people with genetic predisposition. We insist on CV risk, primarily obesity, metabolic syndrome (or cardiometabolic), hypertension, diabetes mellitus, dyslipidemia, obstructive sleep apnea. Metabolic syndrome (MSy) is a risk factor for stroke and thromboembolism. Aim of study: To determine the frequency of MSy in patients with AF who have systolic and/or diastolic dysfunction and structural anomalies of the left ventricle in a group of observed respondents. Determine which echocardiographic parameters characterize MSy in comparison to patients with AF without metabolic syndrome (NMSy). Material and methodology: This retrospective study includes a total of 102 patients with atrial fibrillation who are being treated and are regularly being checked in Internist Clinic ‘Dr Bastac’ in Zajecar. Systolic function of left ventricle is presented with ejection fraction of left ventricle (EF) and diastolic function is presented with ratio of Doppler velocity of early diastolic filling of left ventricle-E and average velocity of tissue Doppler of mitral annulus (E prim) - ratio E/e’. Structural anomalies which were in focus are a mass of left ventricle indexed on body surface (LVMI) and diameter of left atrium (LA). Results: In the target group with AF, MSy was present with 53/102 patients (50%) and absent (NMSy) with 49/102 (48%). In the MSy subgroup, gender structure was: men 40% and women 58% and vice versa with NMSy subgroup. Average value of ejection fraction of left ventricle is almost identical in both subgroups: MSy and NMSy (55,7±13,3% versus55,2±12,1%), NS, p=0,859. With individual distribution of MSy subgroup 7/53 (13%) have lower EF (32±5,0%) relative to 4/49 (8%) with NMSy but without statistically significant difference (X²=0.601). Normal E/e’ ratio is determined in 16/53 patients in MSy subgroup or 30%, with average value of 7.3±1.0, borderline in 22 (42%) with average value of 10.8±1.5 and increased in 15 (28%) with average value of 18.5±5.2. In NMSy subgroup E/e’ has similar distribution: 25% have normal E/e’ value, 47% have borderline value and 28% have increased value (insignificant difference, p=0.800). If we observe gender stratification, 81% of women and 64% of men with MSy have pathological E/e’ ratio, but there is no statistically relevant difference (Xi²=0.505). However, women with MSy have, statistically, more severe diastolic dysfunction both in individual distribution, and in average values, respectively: 10/31(33%)vs 5/22(23%), 19.7±5.8 versus 16.3±3.2 than men (t test, p=0.04). LVMI in men with MSy was increased in 16 (73%) with Xmean=139±23g/m², and in women in 25 (80%) with Xmean=127±38g/m² but without statistically significant difference (X²=0.356). Diameter of left atrium was increased in 95% men and 97% women with MetSy but without statistical difference relative to NMSy, both with average values and individual distribution. Conclusion: Metabolic syndrome (MSy) is present in more than half of patients with atrial fibrillation (AF), and patients are mostly women. Systolic function was not significantly different in AF with MSy presence and without it (NMSy). Pathological values of E/ e’ ratio are no different in patients with atrial fibrillation than with MSy and NMSy (70 vs 75%). However, women with MSY have statistically much severe diastolic dysfunction than men (T-test, p=0.04). Hypertrophy of left ventricle in 73-80% cases and dilatation of left atrium 95-97% regularly accompany metabolic syndrome.

Impact of metabolic syndrome and its components on kidney stone in aging Taiwanese males

Objectives: Metabolic syndrome (MtS) and kidney stone are two common aging diseases with male dominant. This is the first study regarding the potential impact of MtS and its components on kidney stone in aging Chinese population.Methods: A total of 694 males with a mean age of 55.6 years were enrolled. The definition of MtS was according to the modified criteria developed by the Bureau of Health Promotion in Taiwan. Subjects were classified as having a disease of kidney stones according to diagnosis by a physician with available medical records or evidence from ultrasonography judged by an investigator of urologist.Results: Using age-adjusted multivariate logistic regression analysis, our results showed that subjects with kidney stone had significantly higher prevalence of MtS (p = 0.04, OR = 1.74, 95% CI: 1.0 1–3.00). The presence of MtS had significant correlation with kidney stone (p = 0.01, OR = 1.83, 95% CI: 1.1 4–2.93), which were associated with the increment of MtS components (p < 0.01). After adjusting for age and testosterone level, abnormal blood pressure (BP) was the most significantly independent component of MtS for kidney stone among the MtS components (p < 0.01, OR = 2.81, 95% CI: 1.46–5.39).Conclusions: In aging Taiwanese males, the presence of MtS and its components are strongly associated with kidney stone. Abnormal BP is the most significant risk component of MtS for kidney stone.

Metabolic syndrome and cerebrovascular impairment in Alzheimer's disease.

Metabolic Syndrome (MeS) has inconstantly been associated with cognitive impairment. The aim of this study was to investigate the influence of MeS on cerebrovascular reactivity and the possible consequences on cognitive impairment in patients with Alzheimer's disease (AD). A total of 162 AD patients were enrolled and grouped depending on the presence/absence of MeS. An ultrasound assessment of the neck vessels was performed to evaluate common carotid artery intima-media thickness (IMT). Cerebral hemodynamics was assessed by the transcranial Doppler-based breath-holding index (BHI) test. The relationship between BHI and MeS was explored first with a nested binary logistic model and then with a general linear model/adjusted model. Both models were corrected for sex, age, education, BMI, smoking attitude, and IMT treated as covariates. Pathologic BHI values were significantly more frequent among patients with MeS (risk ratio (RR):1.477; 95% CI: 1.177-1.848). MeS significantly improved the prediction of a pathologic BHI in the binary logistic model (odds ratio (OR):11.64; 95% CI: 1.001-135.304; p < 0.05). Moreover, AD patients affected by MeS had significantly lower mean Mini-Mental State Evaluation values than the unaffected ones (16.06; 95% CI: 14.96-17.15 vs 17.79; 95% CI: 17.05-18.53; p < 0.0001). Our data show an association between the presence of MeS and cerebral hemodynamics. The possibility that a cluster of potentially treatable vascular risk factors may influence AD patients' prognosis deserves consideration.

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.

Associations among work‐related stress, cortisol, inflammation, and metabolic syndrome

This cross-sectional study examined the relationship between work-related stress, cortisol, and C-reactive protein (CRP) in predicting metabolic syndrome (MtS). Self-reported work stress measured by the effort reward imbalance ratio (ERI), anthropometric data, CRP, and saliva cortisol were collected from 204 healthy Jordanian male workers. ERI and cortisol were significantly associated with the presence of MtS (OR = 4.74, 95% CI: 2.13-10.55; OR = 3.03, 95% CI: 2.08-4.40; OR = 11.50, 95% CI: 2.16-59.14, respectively). The odds of MtS in men with high ERI and high cortisol were significantly higher than that of men with low ERI and low cortisol (OR = 11.50, 95% CI: 2.16-59.14). CRP was significantly associated with MtS (OR = 2.51, 95% CI: 1.50-4.20). The odds of MtS were significantly higher in centrally obese men with both high ERI and CRP level. Thus, high ERI along with high cortisol or high CRP increases the risk for MtS, especially among centrally obese men.

The impact of metabolic syndrome on the responsiveness to α1-blocker in men with BPH/LUTS

Increasing evidence has proposed the components of metabolic syndrome (MtS) as risk factors for the development of benign prostate hyperplasia (BPH); therefore, it is thought that MtS may play a role in lower urinary tract symptoms related to BPH (BPH/LUTS) aetiology. Considering the closed relationships between MtS and BPH/LUTS, it is possible that patients with MtS might have different drug responsiveness in men with BPH/LUTS. We prospectively investigated the impact of MtS on responsiveness to α1-blocker in men with BPH/LUTS. We enrolled a total of 109 patients with a mean (SD) age of 59.8 (9.0) years, having a prostate volume of 20 cm(3) or greater with moderate to severe LUTS. All patients received doxazosin GITS (gastrointestinal therapeutic system) 4 mg once daily for a 12-week period of treatment. The efficacy measurement was assessed by the changes from baseline in the total IPSS, maximum urinary flow rate and postvoid residual urine volume. The drug responders were defined as those who had a total IPSS decrease of more than 4 points from baseline after 12 weeks of treatment. Using multiple logistic regression analysis, our results showed that MtS was an independent factor for drug non-responder (OR = 4.26, p = 0.002). The rate of drug responder and total IPSS improvements in patients with MtS significantly decreased as the number of MtS components increased (p = 0.012 and p = 0.026). Among the MtS components, abnormal fasting blood glucose (FBG) was the most significantly independent factor for drug non-responder (OR = 3.17, p = 0.020). This study suggested that the presence of MtS had a significantly negative impact on the responsiveness to α1-blocker in men with BPH/LUTS. Our results are important for BPH/LUTS patients who did not initially respond to α1-blocker or who strive to reduce these metabolic risk factors.

The Potential Impact of Metabolic Syndrome on Erectile Dysfunction in Aging Taiwanese Males

Recently, metabolic syndrome (MtS) has received increasing attention. However, investigations regarding the potential impact of MtS and its components on erectile dysfunction (ED) have not been completely clarified. To determine the potential impact of MtS on ED in aging Taiwanese males. The definition of MtS was according to the modified criteria developed by the Bureau of Health Promotion in Taiwan. The presence and severity of ED were evaluated by International Index of Erectile Function 5 (IIEF-5) scores. A total of 639 subjects with a mean age of 60.2 years (range 40-83) were enrolled during a free health screening. All the men had complete clinical data and questionnaires taken. Clinical variables were compared according to MtS and ED prevalence. Multiple logistic regression analysis was used to determine the independent predictors of ED and MtS. Using age-adjusted multivariate logistic regression analysis, our results showed that subjects with ED had significantly higher prevalence of MtS (P<0.01, OR=2.30, 95% CI: 1.44-3.69). The presence of MtS had significant correlation with lower IIEF-5 scores (P<0.01), which were associated with the increment of MtS components number (P<0.01). Among the MtS components, abnormal fasting blood glucose (FBG) was the most significantly independent factor of MtS for ED (P=0.01, OR=1.60, 95% CI: 1.09-2.35). Testosterone levels were significantly lower in subjects with MtS (P=0.05), while inversely correlated with number of MtS components (P<0.01). In aging Taiwanese males, the presence of MtS is strongly associated with ED and abnormal FBG is the most independent predictor for ED. Low testosterone level might be viewed as another possible common denominator for various pathologies linking MtS to ED.

The Interactive Effects of Metabolic Syndrome, Blood Pressure, and Mental Health in Worksite Employees

Background: Cardiovascular disease (CVD), CVD-related conditions, and mental health disorders are prevalent in the US workforce. We examined associations between metabolic syndrome (METS), blood pressure (BP), and mental health indicators in 1813 employees (25.4% women; 74.6% men) from a large manufacturing firm. Methods: Employees participated in a health screen. Biometric measures were body mass index, waist circumference, BP, and fingerstick determinations of blood lipid-lipoproteins and glucose. Mental health was assessed with 5 self-reported questions regarding anger, depression, anxiety, and family and work stress. Multivariate analysis of covariance tested for differences in BP and mental health indicators in employees (370 employees with METS, and 1443 employees without). Results: Participants were primarily middle-aged (44.8 ± 0.3 years), overweight (27.9 ± 0.1 kg/m2) men (n = 1352) and women (n = 461) with a resting BP of 122.5 ± 0.3 mm Hg and 79.8 ± 0.2 mm Hg, respectively. Diastolic BP (DBP) was found to be 5 mm Hg higher in men with METS compared with men who did not have METS. When questioned, men with higher DBP stated that they often experienced anxiety (n = 39; 91.0 ± 2 mm Hg) compared with men who reported they rarely experienced anxiety (n = 112; 86.2 ± 1.9 mm Hg) (P = 0.020). Similarly, systolic BP (SBP) tended to be 4 mm Hg higher in men with METS who stated they often experienced anxiety (n = 39; 138.9 ± 2 mm Hg) compared with men who reported they rarely experienced anxiety (n = 112; 134.5 ± 1.2 mm Hg) (P = 0.119). Diastolic BP tended to be 2 mm Hg higher among men with METS who stated they often experienced anger (n = 117; 89.4 ± 0.9 mm Hg) compared with those who indicated they rarely experienced anger (n = 157; 87.3 ± 0.8 mm Hg) (P = 0.086), and DBP was 3 mm Hg higher in men with METS who reported overwhelming work stress (n = 83; 89.7 ± 1.1 mm Hg) compared with those reporting little work stress (n = 79; 86.6 ± 1.2 mm Hg) (P = 0.176). In contrast, no associations were found between BP and mental health in men without METS, and in women, regardless of the presence or absence of METS (P > 0.05). Conclusions: Men with METS who reported higher levels of anxiety, anger, and work stress had higher BP than men without METS, who also reported lower levels of these mental health indicators. The METS appeared to adversely interact with BP and mental health in men at this worksite. Our findings suggest worksite health promotion programs can improve the cardiometabolic and mental health profile of US employees.