Syndrome In Middle-aged Men Research Articles

Comparative analysis of energy intake and physical activity according to household type and presence of metabolic syndrome in middle-aged men based on data from the 7th Korea national health and nutrition examination survey (KNHANES) (2016-2018).

[Purpose] This study analyzed data from the 7th Korean National Health and Nutrition Examination Survey (2016‒2018) to compare the differences in energy intake and physical activity (PA) levels in middle-aged Korean men aged 40-59 years according to household type and the presence of metabolic syndrome (MetS).[Methods] Data from 2,266 young adults (aged >39 years and <60 years) were obtained from the KNHANES. We analyzed the differences in energy intake and PA levels according to household type and MetS. The presence or absence of MetS was determined by measuring waist circumference, blood pressure, fasting blood glucose, triglyceride, and HDL-C levels.[Results] Regarding total nutritional intake, no relationship with MetS was observed regardless of household type (interaction between MetS and household type: p = 0.875). No differences in total PA were observed between multiple- and single-person households (interaction between MetS and household type: p = 0.122). The relationship between MetS and MetS components according to nutritional intake showed that participants with a higher energy intake had a 27% lower prevalence of low high-density lipoprotein cholesterol (HDL-C) (p < 0.05) and a 36% higher prevalence of high blood pressure (p < 0.01). The relationship between MetS and MetS components according to the PA level showed significantly reduced prevalence of MetS by approximately 39%, 35%, and 43% (p < 0.01, 0.01, and 0.001) in subjects who were somewhat active, active, and very active, respectively, compared to inactivity.[Conclusion] Middle-aged men showed no difference in nutritional intake and PA between multiple- and single-person households. However, the risk of MetS was significantly higher in participants with approximately 1.5 times the energy intake compared to the group with the lowest energy intake. Moreover, higher levels of PA had a marked positive effect on the risk factors and prevalence of MetS. Therefore, we suggest that reducing the total energy intake and increasing total PA are important for preventing MetS in middle-aged men regardless of household type.

Examining the Research Criteria for Traumatic Encephalopathy Syndrome in Middle-Aged Men From the General Population Who Played Contact Sports in High School.

Objective: There are no validated or agreed upon diagnostic clinical criteria for chronic traumatic encephalopathy or traumatic encephalopathy syndrome. This study examines the leading research criteria for traumatic encephalopathy syndrome (TES) in middle-aged men in the general population.Method: Participants were 409 men between the ages of 35 and 55 recruited through an online crowdsourcing platform. Participants provided demographic information, medication history, concussion history, contact sport history, current medication use, and current symptoms. Research criteria for TES were applied to the sample.Results: Over half of the total sample met TES symptom criteria (56.2%), without applying the neurotrauma exposure criteria. Those with 4+ prior concussions had higher rates of meeting TES criteria compared to those with 0–3 prior concussions, but the results were not statistically significant (69.8 vs. 54.6%; χ2 = 3.58, p = 0.06). Exposure to contact sports was not related to higher rates of TES (ps ≥ 0.55). In a binary logistic regression predicting the presence of mild or greater TES, significant predictors were sleep difficulties [Odds ratio (OR) = 6.68], chronic pain (OR = 3.29), and age (OR = 1.04). Neurotrauma exposure was not a significant predictor (p = 0.66). When analyzing those with no prior concussions or contact sport histories (n = 126), 45.2% met symptom criteria for mild or greater TES; chronic pain and sleep difficulties were associated with a higher prevalence of meeting criteria for TES in this subgroup (ps < 0.001).Conclusions: Men who participated in contact sports in high school or college were not more likely to meet criteria for TES than men who participated in non-contact sports or no sports. In a multivariable model, sleep problems and chronic pain were predictive of meeting the symptom criteria for TES, but the repetitive neurotrauma exposure criterion was not a significant predictor of meeting the TES symptom criteria.

Aerobic Capacity, Physical Activity and Metabolic Risk Factors in Firefighters Compared with Police Officers and Sedentary Clerks.

BackgroundThis study examined the association between the physical work environment and physiological performance measures, physical activity levels and metabolic parameters among German civil servants. A main focus in this study was to examine the group differences rather than measuring the absolute values in an occupational group.MethodsWe prospectively examined 198 male German civil servants (97 firefighters [FFs], 55 police officers [POs] and 46 sedentary clerks [SCs]). For each parameter, the groups were compared using a linear regression adjusted for age.ResultsThe 97 FFs showed a similar maximal aerobic power (VO2max l/min) of 3.17±0.44 l/min compared with the POs, who had a maximal aerobic power of 3.13±0.62 l/min (estimated difference, POs vs. FFs: 0.05, CI: -0.12-0.23, p=0.553). The maximal aerobic power of the FFs was slightly higher than that of the SCs, who had a maximal aerobic power of 2.85±0.52 l/min (-0.21, CI: -0.39-0.04, p=0.018 vs. FFs). The average physical activity (in metabolic equivalents [METS]/week) of the FFs was 3818.8±2843.5, whereas those of the POs and SCs were 2838.2±2871.9 (-808.2, CI: 1757.6-141.2, p=0.095) and 2212.2±2292.8 (vs. FFs: -1417.1, CI: -2302-531.88, p=0.002; vs. POs: -2974.4, CI: -1611.2-393.5, p=0.232), respectively. For the FFs, the average body fat percentage was 17.7%±6.2, whereas it was 21.4%±5.6 for the POs (vs. FFs: 2.75, CI: 0.92-4.59, p=0.004) and 20.8%±6.5 for the SCs (vs. FFs: 1.98, CI: -0.28-4.25, p=0.086; vs. POs: -0.77, CI: 3.15-1.61, p=0.523). The average waist circumference was 89.8 cm±10.0 for the FFs, 97.8 cm±12.4 (5.63, CI: 2.10-9.15, p=0.002) for the POs, and 97.3±11.7 (vs. FFs: -4.89, CI: 1.24-8.55, p=0.009; vs. POs: -0.73, CI: -5.21-3.74, p=0.747) for the SCs.ConclusionsThe FFs showed significantly higher physical activity levels compared with the SCs. The PO group had the highest cardiovascular risk of all of the groups because it included more participants with metabolic syndrome; furthermore, the POs had an average of 2.75% higher body fat, lower HDL cholesterol values and higher waist circumferences compared with the FFs and higher LDL cholesterol values compared with the SCs. Our data indicate that sedentary occupations appear to be linked to obesity and metabolic syndrome in middle-aged men.

Frequency of Obstructive Sleep Apnea Syndrome in Dental Patients with Tooth Wear

To estimate the frequency of obstructive sleep apnea syndrome (OSAS) in dental patients with tooth wear, and to assess the role of dentists in the identification of patients at risk of OSAS. Dental patients with tooth wear and treated with occlusal splint were prospectively recruited to perform sleep study. The severity of tooth wear was established by the treating dentist before patient referral to sleep disorders unit. Sleep questionnaires, anthropometric measurements, and validated respiratory polygraphy were performed. All patients with dental wear were offered a sleepiness analysis. Of 31 recruited patients, 30 (77% males) participated in this study. Patients' mean age was 58.5 ± 10.7 years (range: 35-90 years) and the body mass index was 27.9 ± 3.4 kg/m(2). Tooth wear was mild in 13 patients, moderate in 8 and severe in 9. The mean apnea-hypopnea index (AHI) was 32.4 ± 24.9. AHI < 5 was reported in 2 patients, AHI of 5-29 in 17, and AHI ≥ 30 in 11. A statistically significant association was found between AHI severity and tooth wear severity (Spearman R = 0.505; p = 0.004). Tooth wear could be a tool to identify those patients at risk of having OSAS. This highlights the importance of dental professionals to identify and refer patients with OSAS.

Abstract T P161: Asymmetric Dimethylarginine, C-reactive Protein, and the Risk of Developing Metabolic Syndrome in Middle-Aged Men

BACKGROUND: The metabolic syndrome has known as an independent risk factor of stroke. We have recently shown that the measurement of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, may be useful for identifying individuals with a high risk of stroke among Japanese population. We aimed to examine whether serum levels of ADMA and a high-sensitivity C-reactive protein (hs-CRP) are associated with the risk of developing metabolic syndrome in middle-aged men. METHODS: In this longitudinal study, serum ADMA and hs-CRP levels were measured in Japanese men without metabolic syndrome, which was diagnosed according to the currently accepted unified criteria. The subjects were followed-up for a maximum of four years to determine new-onset metabolic syndrome. A Cox proportional hazards model with adjusting for potential confounders was applied to determine the hazard ratio (HR) for developing metabolic syndrome according to serum levels of ADMA and hs-CRP, considered either alone or in combination. RESULTS: Of the 848 subjects (mean age, 43 ± 6 years), 100 subjects developed metabolic syndrome. High ADMA levels (≥ 0.45μmol/L) alone did not show a significant HR for developing metabolic syndrome, while high hs-CRP levels (≥ 0.3 mg/L) did (HR 1.82, 95% CI 1.17-2.83). The combination of high levels of both hs-CRP and ADMA had a high HR (2.32, 95% CI 1.30-4.14) as compared to low levels of both markers. In contrast, the HR was not significant in the combination of high hs-CRP and low ADMA levels, as well as low hs-CRP and high ADMA levels. CONCLUSIONS: Serum hs-CRP, but not ADMA, levels were associated with the risk of metabolic syndrome. Furthermore, the combination of high ADMA and high CRP levels increased the risk of metabolic syndrome. Hence, further studies are needed, but measuring the new combination of two markers may potentiate the predictive value for developing cardiovascular diseases including stroke.

Predictive value of asymmetric dimethylarginine and C-reactive protein for the risk of developing metabolic syndrome in middle-aged men

BackgroundWe aimed to examine whether serum levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, and C-reactive protein (CRP) are associated with the risk of developing metabolic syndrome in middle-aged men. MethodsIn this longitudinal study, serum ADMA and CRP levels were measured in Japanese men without metabolic syndrome, which was diagnosed according to the currently accepted unified criteria. The subjects were followed-up for a maximum of four years to determine new-onset metabolic syndrome. A Cox proportional hazards model with adjusting for potential confounders was applied to determine the hazard ratio (HR) for developing metabolic syndrome according to serum levels of ADMA and CRP, considered either alone or in combination. ResultsOf the 848 subjects (mean age, 43 ± 6 years), 100 subjects developed metabolic syndrome. High ADMA levels (≥ 0.45 μmol/L) alone did not show a significant HR for developing metabolic syndrome, while high CRP levels (≥ 0.3 mg/L) did (HR 1.75, 95% CI 1.12–2.74). The combination of high levels of both CRP and ADMA had a high HR (2.09, 95% CI 1.12–3.76) as compared to low levels of both markers. In contrast, the HR was not significant in the combination of high CRP and low ADMA levels, as well as low CRP and high ADMA levels. ConclusionsSerum CRP, but not ADMA, levels were associated with the risk of metabolic syndrome. Nevertheless, the risk of metabolic syndrome could be predicted more reliably by considering these two markers together rather than CRP alone.

Frequency of heavy alcohol drinking and risk of metabolic syndrome in middle-aged men.

Frequency of alcohol drinking is known to influence cardiovascular risk. However, little is known regarding the relationship between frequency of drinking and metabolic syndrome (MetS). The aim of this study was to determine how frequency of heavy drinking modifies the prevalence of MetS. The subjects were middle-aged male nondrinkers and occasional or regular heavy drinkers (ethanol intake: ≥66 g per drinking day). Odds ratios (ORs) for MetS and each component comprising MetS were calculated with adjustment for age and histories of smoking and regular exercise. ORs versus nondrinkers for MetS defined by the criteria of the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) or the International Diabetes Federation (IDF) were significantly higher than the reference level of 1.00 in occasional heavy drinkers (NCEP-ATP III, 1.94 [confidence interval (CI): 1.54 to 2.45]; IDF, 1.97 [CI: 1.56 to 2.49]) and regular heavy drinkers (NCEP-ATP III, 1.48 [CI: 1.19 to 1.84]; IDF, 1.50 [CI: 1.20 to 1.86]). When compared with the reference level, OR versus nondrinkers for large waist circumference was significantly higher in occasional heavy drinkers (1.96 [CI: 1.63 to 2.35]), but not in regular heavy drinkers (1.12 [CI: 0.96 to 1.32]), while OR versus nondrinkers for hyperglycemia was significantly lower in regular heavy drinkers (0.66 [CI: 0.46 to 0.95]), but not in occasional heavy drinkers (0.86 [CI: 0.60 to 1.24]). There is a positive association between heavy drinking and MetS, which is stronger in occasional drinkers than in regular drinkers. This difference may be explained by a positive association between occasional heavy drinking and central obesity and an inverse association between regular heavy drinking and hyperglycemia. The results suggest that heavy drinking, even if occasionally, is a cardiovascular risk factor.

The influence of sex and age on the relationship between sleep duration and metabolic syndrome in Korean adults

AimsTo investigate the influence of sex and age on the relationship between sleep duration and metabolic syndrome in a nationally representative population. MethodsWe used data from the Korea National Health and Nutrition Examination Survey (2001–2010) and enrolled 24,511 participants aged 20–79 years. Sleep duration was categorized into five groups: ≤5, 6, 7 (referent), 8, and ≥9h/day. Age was categorized into three groups: younger (20–39y), middle-aged (40–59y), and older (60–79y). The association between sleep duration and metabolic syndrome was assessed in the total, separately in men and women, then in six groups based on sex and age. ResultsThe prevalence of metabolic syndrome by sleep category demonstrated a U-shaped pattern in the total population. However, after adjusting for age, education, occupation, exercise, smoking, alcohol, and body mass index, the prevalence of metabolic syndrome increased in long sleepers (OR 1.31; 95% CI 1.14–1.51) but not in short sleepers (OR 1.00; 95% CI 0.89–1.11). The relationship between sleep duration and metabolic syndrome varied by sex and age–long sleep (≥9h/day) was positively associated with metabolic syndrome only in younger (OR 2.13; 95% CI 1.38–3.28) and middle-aged (OR 1.63; 95% CI 1.21–2.21) women. Short sleep (≤5h/day) was not associated with metabolic syndrome in any sex and age groups. However, extremely short sleep (≤4h/day) was associated with metabolic syndrome in middle-aged men (OR 1.76, 95% CI 1.05–2.96). ConclusionThese data suggest that sex and age significantly modify the relationship between sleep duration and metabolic syndrome.

Waist circumference a good indicator of future risk for type 2 diabetes and cardiovascular disease

BackgroundAbdominal obesity is a more important risk factor than overall obesity in predicting the development of type 2 diabetes and cardiovascular disease. From a preventive and public health point of view it is crucial that risk factors are identified at an early stage, in order to change and modify behaviour and lifestyle in high risk individuals.MethodsData from a community based study was used to assess the risk for type 2 diabetes, cardiovascular disease and prevalence of metabolic syndrome in middle-aged men. In order to identify those with increased risk for type 2 diabetes and/or cardiovascular disease sensitivity and specificity analysis were performed, including calculation of positive and negative predictive values, and corresponding 95% CI for eleven different cut-off points, with 1 cm intervals (92 to 102 cm), for waist circumference.ResultsA waist circumference ≥94 cm in middle-aged men, identified those with increased risk for type 2 diabetes and/or for cardiovascular disease with a sensitivity of 84.4% (95% CI 76.4% to 90.0%), and a specificity of 78.2% (95% CI 68.4% to 85.5%). The positive predictive value was 82.9% (95% CI 74.8% to 88.8%), and negative predictive value 80.0%, respectively (95% CI 70.3% to 87.1%).ConclusionsMeasurement of waist circumference in middle-aged men is a reliable test to identify individuals at increased risk for type 2 diabetes and cardiovascular disease. This measurement should be used more frequently in daily practice in primary care in order to identify individuals at risk and when planning health counselling and interventions.

Cardiac Arrhythmias in Obstructive Sleep Apnea (from the Akershus Sleep Apnea Project)

Increased prevalence of cardiac arrhythmias has been reported in patients with severe obstructive sleep apnea (OSA), but this may not be generalizable to patients from the general population with a milder form of the condition. The aim of this study was to assess the association between cardiac arrhythmias and OSA of mainly mild and moderate severity. In total, 486 subjects (mean age 49 years, 55% men) recruited from a population-based study in Norway underwent polysomnography for OSA assessment and Holter recordings for arrhythmia assessment. Of these, 271 patients were diagnosed with OSA (apnea-hypopnea index [AHI] ≥5, median AHI 16.8, quartiles 1 to 3 8.9 to 32.6). Mean nadir oxygen saturations were 82% and 89% in patients with and without OSA, respectively. Ventricular premature complexes (≥5/hour) were more prevalent in subjects with OSA compared to subjects without OSA (median AHI 1.4, quartiles 1 to 3 0.5 to 3.0) during the night (12.2% vs 4.7%, p = 0.005) and day (14% vs 5.1%, p = 0.002). In multivariate analysis after adjusting for relevant confounders, AHI was independently associated with an increased prevalence of ventricular premature complexes at night (odds ratio per 1-U increase of log-transformed AHI 1.5, 95% confidence interval 1.1 to 2.0, p = 0.008) and during the day (odds ratio 1.37, 95% confidence interval 1.0 to 1.8, p = 0.035). In conclusion, the prevalence of ventricular premature complexes is increased in middle-aged patients with mainly mild or moderate OSA, suggesting an association between OSA and ventricular arrhythmias even in mild OSA.

중년 남성에서 대사증후군과 식이요인과의 관련성

Objectives: This study aims to identify dietary factors related to metabolic syndrome in middle aged Korean men who were participants in the Fourth Korea National Health and Nutrition Examination Survey(KNHANES IV) in 2007. Methods: The study targeted 361 of the 709 men aged between 40 and 64 years for a final analysis; the other 348 surveys had incomplete data which did not allow for the determination of metabolic syndrome. The definition of metabolic syndrome was based on the National Cholesterol Education Program Adult Treatment Panel III(NCEP ATP III). Results: There were significant differences in the metabolic syndrome of middle-aged men according to age, smoking pack-years, and number of resturant meals per week. Dietary factors such as vitamins, riboflavin, natrium, carbohydrate, protein and lipid intakes were not significant. Conclusions: It was verified that metabolic syndrome in middle-aged men is related to age, smoking pack-years and number of resturant meals per week. Dietary factors were not significantly related. However, further detailed studies in this area are needed.

Obstructive sleep apnea may increase the risk of stroke in AF patients: Refining the CHADS2 score

The significance of stroke as a burdensome cardiovascular outcome has long been recognized. In the United States, it is the third ranking cause of all-cause mortality [ [1] Lloyd-Jones D. Adams R. Carnethon M. et al. Heart disease and stroke statistics–2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009; 119: e21-e181 Crossref PubMed Scopus (2096) Google Scholar ]. While there are classical risk factors for stroke that have been recognized, there is a more recent acknowledgement of the significance of sleep apnea (SA). SA involves repeated cessations of breathing during sleep, which has many detrimental effects. The gold standard for diagnosis is overnight polysomnography. There are two types of SA: central sleep apnea (CSA) and obstructive sleep apnea (OSA). CSA, involves an absence of breathing effort stemming from central dysregulation, while in OSA, efforts are made to breathe but are perturbed by upper airway obstruction [ [2] Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999; 22:667–89. Google Scholar ]. OSA is more common and its severity is usually defined by the apnea–hypopnea index (AHI), the number of obstructive apnea and hypopnea episodes per hour of sleep (severe=AHI≥30) [ [2] Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep. 1999; 22:667–89. Google Scholar ]. The reported prevalence of OSA in adults can be as high as 1 in 5 in Western nations [ [3] Young T. Peppard P.E. Gottlieb D.J. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Resp Crit Care. 2002; 165: 1217-1239 Crossref PubMed Scopus (3282) Google Scholar ]. In addition, an estimated 80% of Americans have undiagnosed SA [ [4] Young T. Evans L. Finn L. Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997; 20: 705-706 Crossref PubMed Scopus (1277) Google Scholar ].

Relationship between Metabolic Syndrome and Aging Male Symptoms in Middle-Aged Males in Korea

Background: Metabolic syndrome is regarded as a risk factor of cardiovascular disease. We observed and compared aging males symptoms (AMS) between healthy and metabolic syndrome patients in middle-aged Korean men to evaluate clinical significance of AMS. Methods: From May 2009 to July 2009, 171 middle-aged men (over 40 years-old) who visited a health promotion center of a university hospital in Gyeonggi Province were enrolled in study. The subjects were divided into two groups; metabolic syndrome (N = 87) vs. control (N = 84) and measured the aging male symptoms (AMS) scale. AMS were also grouped according to its severity. Results: There were no significant differences except, weight, body mass index between two groups. In AMS severity, 'severe' group show higher prevalence of metabolic syndrome. And the group of metabolic syndrome gets higher AMS score than control. Among the five constitutive factors of metabolic syndrome, the prevalence of fasting blood sugar (≥ 100 mg/dL) and triglyceride (≥ 150 mg/dL) level is higher 'moderates' and 'severe' groups in AMS severity. In the subscale analysis of AMS, there are significant differences between two groups in sexual and somato-vegitative axis, but are not in psychological axis. With age-adjusted analysis, the results still show same trend. Conclusion: It might be necessary to approach aging males symptoms comprehensively during the management of metabolic syndrome in middle-aged men. And it could be helpful in treatment to recognize and control metabolic syndrome factors for the patients with severe aging males symptoms.

Prevalence of cardiovascular risk factors and the metabolic syndrome in middle-aged men and women in Gothenburg, Sweden

BackgroundRandom samples of 50-year-old men living in Gothenburg have been examined every 10th year since 1963 with a focus on cardiovascular risk factors. The aims of the study were to acquire up-to-date information about risk factors in the fifth cohort of 50-year-old men and women, to re-examine those who were 50 years of age in 1993, and to analyse the prevalence of the metabolic syndrome (MetSyn) using different definitions.MethodsA random sample of men and women born in 1953 were examined in 2003–2004 for cardiovascular risk factors. Men born in 1943 and that participated in the examination in 1993 were also invited. Descriptive statistics were calculated.ResultsThe participation rate among men and women born in 1953 was 60 and 67% respectively. Among men born in 1943, the participation rate was 87%. The prevalence of obesity was from 15 to 17% (body mass index, BMI ≥ 30) in the three samples. The prevalence of known diabetes was 4% among the 50-year-old men and 6% among the 60-year-old men, and 2% among the women. Increased fasting plasma glucose varied substantially from 4 to 33% depending on cut-off level and gender. Mean cholesterol was 5.4 to 5.5 mmol/l. Smoking was more common among women aged 50 (26%) than among men aged 50 (22%) and 60 years (15%). The prevalence of the MetSyn varied with the definition used: from 10 to 15.8% among the women, from 16.1 to 26% among 50-year-old men, and from 19.9 to 35% among the 60-year-old men. Only 5% of the men and women had no risk factors.ConclusionThis study provides up-to-date information about the prevalence of cardiovascular risk factors and the MetSyn in middle-aged Swedish men and women. Different definitions of the MetSyn create confusion regarding which definition to use.

Testosterone Making an Entry Into the Cardiometabolic World

Testosterone, the predominant sex hormone in men, is produced by the testes under stimulation by the gonadotrophs in the pituitary, which in turn are controlled by gonadotropin-releasing hormone neurons in the hypothalamus. A young adult man generally produces 3 to 10 mg of testosterone daily, which translates into serum values of 300 to 1000 ng/dL. The consequences of classical male hypogonadism (primary or secondary) have been long known to physicians and patients alike and include decreased libido, erectile dysfunction, osteoporosis, reduced sexual hair, and changes in body habitus. Recently, we have come to appreciate that reductions in serum testosterone resulting from aging or chronic disease have signs and symptoms similar to those seen in classical male hypogonadism, along with increased fat mass, decreased lean body mass, decreased muscle strength, and diminished quality of life.1 During the past decade, reports have been trickling in, mainly from laboratory and epidemiological studies (and a few clinical studies), linking differences in serum testosterone levels to various cardiovascular risk factors and also directly to cardiovascular disease and death. The article by Khaw et al2 in this issue of Circulation is another link to this growing chain. Article p 2694 Thirteen years ago, Phillips et al3 reported that low total and free testosterone levels were inversely linked to coronary artery disease, even after adjusting for age and adiposity. This observation still holds true, as was recently supported by a study showing that men with angiographically proven coronary artery disease had lower levels of testosterone than those of controls.4 Furthermore, testosterone levels were negatively correlated to the degree of coronary involvement. A few population-based studies have been published that relate low serum testosterone level with risk of death. A study of male veterans showed that low testosterone was associated with increased risk of …

Circulating leptin levels predict the development of metabolic syndrome in middle-aged men: an 8-year follow-up study

Because high circulating plasma leptin is associated with many features of the metabolic syndrome (MS), such as abdominal obesity, insulin resistance and high blood pressure (BP), we analysed the ability of plasma leptin concentration to predict the risk of developing MS in a prospective investigation of adult male participants of the Olivetti Heart Study (OHS). Three hundred and sixty out of 907 men participating in the 1994-95 and 2002-04 OHS examinations (mean age at baseline 50.4 years, range 25-73 years) were free of MS at first visit according to NCEP-ATP III criteria (modified for the lack of high-density lipoprotein cholesterol measurement at baseline). During an average follow-up period of 8 years, there were 52 incident cases of MS (14.5%) due, in particular, to a rise in the prevalence of high BP (+42.4%), abdominal obesity (+16.4%) and impaired fasting glucose (IFG, +6.1%). In multivariate analyses, a one standard deviation difference in baseline plasma leptin concentration was associated with a 1.58-fold greater risk of developing MS (95% confidence interval = 1.10-2.30, P = 0.016) accounting for age, waist circumference, homeostatic assessment model index, smoking, alcohol consumption and physical activity. In particular, plasma leptin was positively associated with the risk of developing high BP (0.006) and IFG (0.014), after adjustment for confounders. In this sample of an adult male population free of MS at baseline, circulating plasma leptin was a significant predictor of the risk of MS and, in particular, of its high BP and IFG components, independently of potential confounders.

Long-term effects of various physical activity levels in preventing obesity and metabolic syndrome in middle-aged men

Long-term effects of various physical activity levels in preventing obesity and metabolic syndrome in middle-aged men

The N363S Polymorphism of the Glucocorticoid Receptor and Metabolic Syndrome Factors in Men

To test the associations between the N363S polymorphism of the glucocorticoid receptor gene (NR3C1) and factors related to the metabolic syndrome in middle-aged men with and without juvenile-onset obesity. This study included two groups of middle-aged men, who were originally identified at 20 years of age at the draft boards. One group (n = 208; age, 48 +/- 6 years) was selected on the basis of juvenile-onset obesity (BMI > or = 31 kg/m(2)). The other group consisted of mainly nonobese men randomly sampled from the same population in parallel with the obese men (n = 299; age, 50 +/- 7 years). The subjects were genotyped for the N363S polymorphism by polymerase chain reaction-restriction fragment length polymorphism. Body composition was measured by DXA. Glucose metabolism was evaluated by an oral glucose tolerance test, and the Matsudas index was calculated as a proxy for insulin sensitivity. Serum triglycerides and total and high-density lipoprotein-cholesterol were measured in the fasting state. Among the men with juvenile-onset obesity, carriers (n = 17) of the 363S allele had a lower whole body fat percentage, after accounting for differences in BMI and higher Matsudas index, compared with the noncarriers. The difference in Matsudas index lost statistical significance after the difference in body fat was accounted for. In the randomly sampled men, these variables did not relate to genotype. No relationship between carriers and noncarriers was found in body fat distribution or serum lipids. This study suggests that, in men developing obesity early in life, the 363S allele is associated with less adiposity at a given BMI, leading to higher insulin sensitivity.

Association of lymphocyte sub-populations with clustered features of metabolic syndrome in middle-aged Japanese men

To examine the relationship between altered cellular immune status and clustered features of the metabolic syndrome, we measured body mass index (BMI), serum concentrations of high-density lipoprotein–cholesterol, triglycerides, fasting plasma glucose, and blood pressure levels as well as differential leukocyte counts and lymphocyte sub-populations among 439 apparently healthy Japanese men aged 35–60 years. The components of the metabolic syndrome were defined based on the following criteria: BMI ≥25.0 kg/m 2, fasting plasma glucose ≥6.11 mmol/l, systolic blood pressure ≥130 mmHg and/or diastolic blood pressure ≥85 mmHg, high-density lipoprotein (HDL)–cholesterol <1.03 mmol/l, and fasting triglyceride ≥1.69 mmol/l. Counts of total leukocyte, total lymphocyte, CD3+T cell, CD4+T cell, and CD4+CD45RO+T cell significantly correlated with the number of components of the metabolic syndrome (0, 1, 2, and 3+) after adjustment for age and smoking status. These findings were more evident among smokers than among non-smokers. The counts of total leukocytes, total lymphocytes and more specifically memory (CD4+CD45RO+T) cells were elevated with clustered features of the metabolic syndrome in middle-aged men, which suggest the involvement of altered cellular immune status in the pathogenesis of atherosclerosis.

Cardiorespiratory fitness and vigorous leisure-time physical activity modify the association of small size at birth with the metabolic syndrome.

Small size at birth has been associated with components of the metabolic syndrome, but little is known about the association with the metabolic syndrome itself or whether leisure-time physical activity (LTPA) and cardiorespiratory fitness modify that association. We studied the association of size at birth with the metabolic syndrome. Birth weight and length, the metabolic syndrome (World Health Organization criteria), LTPA over the previous 12 months, and VO(2max) were assessed in 462 nondiabetic middle-aged Finnish men who were part of a population-based cohort study. Men with a ponderal index (kg/m(3)) at birth in the lower third had higher fasting insulin and glucose levels than men in the upper third in age-adjusted analyses and were at least twofold more likely to have the metabolic syndrome, even in men without cardiovascular disease. Adjustment for childhood or adult socioeconomic status or adult BMI did not attenuate the association. Thinness at birth was even more clearly associated with hyperinsulinemia and the metabolic syndrome in men engaging in <25 min/wk of vigorous LTPA and in men with a VO(2max) <28.6 ml x kg(-1) x min(-1) or <2.44 l/min. In active and fit men, however, the association was absent. Small size at birth was associated with the metabolic syndrome in middle-aged men already before development of diabetes or cardiovascular disease. Thinness at birth may carry with it lifelong metabolic consequences, but regular strenuous physical activity and maintenance of cardiorespiratory fitness may alleviate or eliminate those consequences.