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The investigations of genetic determinants of the metabolic syndrome. Fathi Dizaji Behdokht Diabetes & metabolic syndrome Metabolic syndrome is the aggregation of cardiovascular risk factors that increases the risk of type 2 diabetes and cardiovascular diseases. Family and twin studies, heritability spectrum for its components and different prevalence among ethnicities, have provided genetic susceptibility to the metabolic syndrome. The investigations of genetic base for the disorder have recognized numerous chromosomes, various DNA polymorphisms in candidate genes and many gene variants, that are associated with metabolic syndrome as an entity or its traits, which mostly are related to lipid metabolism. In addition, recent finding of the role of rare variants, epigenetic mechanisms, non-coding RNAs and evaluating the function of genes in molecular networks have improved our knowledge. However, a common genetic basis explaining the co-occurrence of its components has not been identified and more researches are essential. 10.1016/j.dsx.2018.04.009
Effectiveness of Mobile Health Interventions Promoting Physical Activity and Lifestyle Interventions to Reduce Cardiovascular Risk Among Individuals With Metabolic Syndrome: Systematic Review and Meta-Analysis. Sequi-Dominguez Irene,Alvarez-Bueno Celia,Martinez-Vizcaino Vicente,Fernandez-Rodriguez Rubén,Del Saz Lara Alicia,Cavero-Redondo Iván Journal of medical Internet research BACKGROUND:Physical activity and lifestyle interventions, such as a healthy diet, have been proven to be effective approaches to manage metabolic syndrome. However, these interventions require great commitment from patients and clinicians owing to their economic costs, time consumption, and lack of immediate results. OBJECTIVE:The aim of this systematic review and meta-analysis was to analyze the effect of mobile-based health interventions for reducing cardiometabolic risk through the promotion of physical activity and healthy lifestyle behaviors. METHODS:PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, and SPORTdiscus databases were searched for experimental studies evaluating cardiometabolic risk indicators among individuals with metabolic syndrome who were included in technology-assisted physical activity and lifestyle interventions. Effect sizes, pooled mean changes, and their respective 95% CIs were calculated using the DerSimonian and Laird method. Outcomes included the following clinical and biochemical parameters: body composition (waist circumference [WC] and BMI), blood pressure (systolic blood pressure [SBP] and diastolic blood pressure [DBP]), glucose tolerance (fasting plasma glucose [FPG] and glycated hemoglobin A1c [HbA]), and lipid profile (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol [HDL-C], and triglycerides). RESULTS:A total of nine studies were included in the meta-analysis. Owing to the scarcity of studies, only pooled mean pre-post changes in the intervention groups were estimated. Significant mean changes were observed for BMI (-1.70 kg/m2, 95% CI -3.20 to -0.20; effect size: -0.46; P=.03), WC (-5.77 cm, 95% CI -9.76 to -1.77; effect size: -0.54; P=.005), SBP (-7.33 mmHg, 95% CI -13.25 to -1.42; effect size: -0.43; P=.02), DBP (-3.90 mmHg, 95% CI -7.70 to -0.11; effect size: -0.44; P=.04), FPG (-3.65 mg/dL, 95% CI -4.79 to -2.51; effect size: -0.39; P<.001), and HDL-C (4.19 mg/dL, 95% CI 2.43-5.95; effect size: 0.23; P<.001). CONCLUSIONS:Overall, mobile-based health interventions aimed at promoting physical activity and healthy lifestyle changes had a strong positive effect on cardiometabolic risk indicators among individuals with metabolic syndrome. Nevertheless, further research is required to compare this approach with usual care in order to support the incorporation of these technologies in health systems. TRIAL REGISTRATION:PROSPERO CRD42019125461; https://tinyurl.com/y3t4wog4. 10.2196/17790
Improvement of Lipoprotein Profile and Metabolic Endotoxemia by a Lifestyle Intervention That Modifies the Gut Microbiota in Subjects With Metabolic Syndrome. Guevara-Cruz Martha,Flores-López Adriana G,Aguilar-López Miriam,Sánchez-Tapia Mónica,Medina-Vera Isabel,Díaz Daniel,Tovar Armando R,Torres Nimbe Journal of the American Heart Association Background Metabolic syndrome (MetS) is a serious health problem over the world; thus, the aim of the present work was to develop a lifestyle intervention to decrease the dysbiosis of gut microbiota and reduce the biochemical abnormalities of MetS. Methods and Results The prevalence of MetS was evaluated in 1065 subjects of Mexico City, Mexico, and the gut microbiota in a subsample. Subjects with MetS were selected for a pragmatic study based on a lifestyle intervention with a low-saturated-fat diet, reduced-energy intake, with functional foods and physical activity, and a second group was selected for a randomized control-placebo study to assess the gut microbiota after the dietary intervention. Prevalence of MetS was 53%, and the higher the body mass index, the higher the gut microbiota dysbiosis. The higher the Homeostatic Model Assessment for Insulin Resistance, the lower the high-density lipoprotein cholesterol concentration. The pragmatic study revealed that after 15 days on a low-saturated-fat diet, there was a 24% reduction in serum triglycerides; and after a 75-day lifestyle intervention, MetS was reduced by 44.8%, with a reduction in low-density lipoprotein cholesterol, small low-density lipoprotein particles, glucose intolerance, lipopolysaccharide, and branched-chain amino acid. The randomized control-placebo study showed that after the lifestyle intervention, there was a decrease in the dysbiosis of the gut microbiota associated with a reduction in the Prevotella/ Bacteroides ratio and an increase in the abundance of Akkermansia muciniphila and Faecalibacterium prausnitzii. Conclusions A lifestyle intervention significantly decreased MetS components, small low-density lipoprotein particle concentration, gut microbiota dysbiosis, and metabolic endotoxemia, reducing the risk of atherosclerosis. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT03611140. 10.1161/JAHA.119.012401
Effect of a Six-Month Lifestyle Intervention on the Physical Activity and Fitness Status of Adults with NAFLD and Metabolic Syndrome. Nutrients (1) Background: Physical inactivity has been linked to NAFLD, and exercise has been reported as useful to reduce intrahepatic fat content in NAFLD. (2) Objectives: To assess the physical activity (PA) and fitness status after a six-month lifestyle intervention (diet and PA) in adults with NAFLD and metabolic syndrome (MetS). (3) Design: Prospective cohort analysis of data obtained between baseline and six-year parallel-group randomized trial (n = 155, aged 40-60 years old, with MetS and NAFLD). Participants were randomized into three nutritional and PA intervention groups: Conventional diet (CD); MedDiet-high meal frequency (MD-HMF); MedDiet-physical activity (MD-PA). (4) Methods: PA and fitness status were assessed using a validated Minnesota questionnaire, ALPHA-FIT test battery, accelerometers, and functional fitness score. Information related to age, gender, education level, marital status, socioeconomic status, smoking habit, and alcohol consumption were also obtained. (5) Results: The CD group had higher improvement in standing handgrip than the MD-HMF group. The MD-PA group did more modified push-up repetitions than the CD group. The MD-PA and CD groups showed higher sitting handgrip than the MD-HMF group. The MD-HMF group showed the highest decrease in aerobic capacity. The MD-PA group showed lower light intensity PA/day than the CD and MD-HMF groups. The MD-PA group showed higher moderate intensity PA than the CD and MD-HMF groups. The CD group reported more METs per day than the MD-HMF group. (6) Conclusions: Lifestyle six-month intervention with diet and regular PA improved functional fitness in middle-aged patients with NAFLD and MetS. Aerobic capacity improved in patients who followed a Mediterranean diet and regular training sessions at six months. 10.3390/nu14091813
The Effect of Exercise Intensity and Volume on Metabolic Phenotype in Patients with Metabolic Syndrome: A Randomized Controlled Trial. von Korn Pia,Keating Shelley,Mueller Stephan,Haller Bernhard,Kraenkel Nicolle,Dinges Sophia,Duvinage André,Scherr Johannes,Wisløff Ulrik,Tjønna Arnt Erik,Halle Martin,Lechner Katharina Metabolic syndrome and related disorders Moderate intensity continuous training (MICT) ameliorates dysmetabolism in patients with metabolic syndrome (MetS). The impact of low- (1HIIT) versus high-volume high-intensity interval training (4HIIT) versus MICT on central adiposity, insulin resistance, and atherogenic dyslipidemia in patients with MetS has not yet been reported. Twenty-nine patients with MetS according to International Diabetes Federation criteria (nine females, age 61 ± 5 years, body mass index 31.1 ± 3.7 kg/m, waist circumference (WC) ♀ 102.2 ± 10.6 cm, ♂ 108.5 ± 8.6 cm) were randomized (1:1:1) to 16 weeks of (1) MICT (5 × 30 min/week, 35%-50% heart rate reserve (HRR), (2) 1HIIT (3 × 17 min/week incl. 4 min @80%-90% HRR), and (3) 4HIIT (3 × 38 min/week incl. 4 × 4 min @80%-90% HRR). Peak oxygen uptake (O), WC and anthropometric/metabolic indices indicative of MetS, fasting glucose/insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), dyslipidemia, and respiratory exchange ratio (RER) at warm-up were quantified at baseline and study completion. Analysis of variance and paired t tests were used for statistical analysis. Analyses were performed after checking for parametric distribution. There were no significant differences between groups in waist-to-height ratio (♀: Δ -0.10 ± -0.05, ♂: Δ -0.08 ± -0.06,  = 0.916), WC (♀: Δ -1.4 ± -0.1 cm, ♂: Δ 0.1 ± 0.9 cm,  = 0.590), fasting glucose (Δ -1.18 ± 16.7 μU/mL,  = 0.773), fasting insulin (Δ 0.76 ± 13.4 μU/mL,  = 0.509), HOMA-IR (Δ 0.55 ± 4.1,  = 0.158), atherogenic dyslipidemia [triglycerides (TAG) Δ -10.1 ± 46.9 mg/dL,  = 0.468, high-density lipoprotein cholesterol (HDL-C) Δ 1.5 ± 5.4,  = 0.665, TAG/HDL-C -0.19 ± 1.3,  = 0.502], O ( = 0.999), or RER ( = 0.842). In the entire group, waist-to-height-ratio and O significantly improved by a clinically meaningful amount (Δ 2.7 ± 0.9 mL/min/kg;  < 0.001) and RER at warm-up significantly decreased (Δ -0.03 ± 0.06,  = 0.039). In patients with MetS, there was no significant difference between HIIT, irrespective of volume, to MICT for improving exercise capacity or metabolic health. 10.1089/met.2020.0105
Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial. Salas-Salvadó Jordi,Díaz-López Andrés,Ruiz-Canela Miguel,Basora Josep,Fitó Montse,Corella Dolores,Serra-Majem Luís,Wärnberg Julia,Romaguera Dora,Estruch Ramon,Vidal Josep,Martínez J Alfredo,Arós Fernando,Vázquez Clotilde,Ros Emilio,Vioque Jesús,López-Miranda José,Bueno-Cavanillas Aurora,Tur Josep A,Tinahones Francisco J,Martín Vicente,Lapetra José,Pintó Xavier,Daimiel Lidia,Delgado-Rodríguez Miguel,Matía Pilar,Gómez-Gracia Enrique,Díez-Espino Javier,Babio Nancy,Castañer Olga,Sorlí José V,Fiol Miquel,Zulet María Ángeles,Bulló Mònica,Goday Albert,Martínez-González Miguel Á, Diabetes care OBJECTIVE:The long-term impact of intentional weight loss on cardiovascular events remains unknown. We describe 12-month changes in body weight and cardiovascular risk factors in PREvención con DIeta MEDiterránea (PREDIMED)-Plus, a trial designed to evaluate the long-term effectiveness of an intensive weight loss lifestyle intervention on primary cardiovascular prevention. RESEARCH DESIGN AND METHODS:Overweight/obese adults with metabolic syndrome aged 55-75 years ( = 626) were randomized to an intensive weight loss lifestyle intervention based on an energy-restricted Mediterranean diet, physical activity promotion, and behavioral support (IG) or a control group (CG). The primary and secondary outcomes were changes in weight and cardiovascular risk markers, respectively. RESULTS:Diet and physical activity changes were in the expected direction, with significant improvements in IG versus CG. After 12 months, IG participants lost an average of 3.2 kg vs. 0.7 kg in the CG ( < 0.001), a mean difference of -2.5 kg (95% CI -3.1 to -1.9). Weight loss ≥5% occurred in 33.7% of IG participants compared with 11.9% in the CG ( < 0.001). Compared with the CG, cardiovascular risk factors, including waist circumference, fasting glucose, triglycerides, and HDL cholesterol, significantly improved in IG participants ( < 0.002). Reductions in insulin resistance, HbA, and circulating levels of leptin, interleukin-18, and MCP-1 were greater in IG than CG participants ( < 0.05). IG participants with prediabetes/diabetes significantly improved glycemic control and insulin sensitivity, along with triglycerides and HDL cholesterol levels compared with their CG counterparts. CONCLUSIONS:PREDIMED-Plus intensive lifestyle intervention for 12 months was effective in decreasing adiposity and improving cardiovascular risk factors in overweight/obese older adults with metabolic syndrome, as well as in individuals with or at risk for diabetes. 10.2337/dc18-0836
Management of common clinical problems experienced by survivors of cancer. Lancet (London, England) Improvements in early detection and treatment have led to a growing prevalence of survivors of cancer worldwide. Models of care fail to address adequately the breadth of physical, psychosocial, and supportive care needs of those who survive cancer. In this Series paper, we summarise the evidence around the management of common clinical problems experienced by survivors of adult cancers and how to cover these issues in a consultation. Reviewing the patient's history of cancer and treatments highlights potential long-term or late effects to consider, and recommended surveillance for recurrence. Physical consequences of specific treatments to identify include cardiac dysfunction, metabolic syndrome, lymphoedema, peripheral neuropathy, and osteoporosis. Immunotherapies can cause specific immune-related effects most commonly in the gastrointestinal tract, endocrine system, skin, and liver. Pain should be screened for and requires assessment of potential causes and non-pharmacological and pharmacological approaches to management. Common psychosocial issues, for which there are effective psychological therapies, include fear of recurrence, fatigue, altered sleep and cognition, and effects on sex and intimacy, finances, and employment. Review of lifestyle factors including smoking, obesity, and alcohol is necessary to reduce the risk of recurrence and second cancers. Exercise can improve quality of life and might improve cancer survival; it can also contribute to the management of fatigue, pain, metabolic syndrome, osteoporosis, and cognitive impairment. Using a supportive care screening tool, such as the Distress Thermometer, can identify specific areas of concern and help prioritise areas to cover in a consultation. 10.1016/S0140-6736(22)00242-2
Nonalcoholic steatohepatitis (NASH) - current treatment recommendations and future developments. Roeb Elke,Geier Andreas Zeitschrift fur Gastroenterologie Nonalcoholic fatty liver disease (NAFLD) includes nonalcoholic fatty liver (NAFL), nonalcoholic steato hepatitis (NASH) and NASH cirrhosis. NAFLD is the leading cause of liver diseases in the Western world (Central Europe, United States). The NAFLD incidence increases because of increasing type 2 diabetes and obesity. This article reviews the scientific findings of epidemiology, diagnostic, and therapeutic management of NAFLD. Lifestyle modifications (low-caloric Mediterranean diet and exercise training) to reduce weight are a major factor in the treatment of NAFLD.Pharmacological therapies may be useful in patients with NASH and fibrosis as well as nonresponders to lifestyle modifications. Currently, however, no pharmacological substances are approved for the indication NASH. 10.1055/a-0784-8827
The metabolic syndrome - What is it and how should it be managed? Nilsson Peter M,Tuomilehto Jaakko,Rydén Lars European journal of preventive cardiology A cluster of metabolic factors have been merged into an entity named the metabolic syndrome. Although the characteristics of this syndrome have varied over time the presently used definition was established in 2009. The presence of three abnormal findings out of five components qualifies a person for the metabolic syndrome: elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting plasma glucose. Cut points have been defined for all components apart from waist circumference, for which national or regional values are used. The metabolic syndrome predicts cardiovascular disease and type 2 diabetes. This associated risk does not exceed its components whereof elevated blood pressure is the most frequent. A successful management should, however, address all factors involved. The management is always based on healthy lifestyle choices but has not infrequently to be supported by pharmacological treatment, especially blood pressure lowering drugs. The metabolic syndrome is a useful example of the importance of multiple targets for preventive interventions. To be successful management has to be individualized not the least when it comes to pharmacological therapy. Frail elderly people should not be over-treated. Knowledge transfer of how risk factors act should be accompanied by continuous trust building and motivation. In complex situations with a mix of biological risk factors, adverse social conditions and unhealthy lifestyle, everything cannot be changed at once. It is better to aim for small steps that are lasting than large, unsustainable steps with relapses to unhealthy behaviours. A person with the metabolic syndrome will always be afflicted by its components, which is the reason that management has to be sustained over a very long time. This review summarizes the knowledge on the metabolic syndrome and its management according to present state of the art. 10.1177/2047487319886404
Assessing and Managing the Metabolic Syndrome in Children and Adolescents. DeBoer Mark D Nutrients The metabolic syndrome (MetS) is a group of cardiovascular risk factors that are associated with insulin resistance and are driven by underlying factors, including visceral obesity, systemic inflammation, and cellular dysfunction. These risks increasingly begin in childhood and adolescence and are associated with a high likelihood of future chronic disease in adulthood. Efforts should be made at both recognition of this metabolic risk, screening for potential associated Type 2 diabetes, and targeting affected individuals for appropriate treatment with an emphasis on lifestyle modification. Effective interventions have been linked to reductions in MetS-and in adults, reductions in the severity of MetS have been linked to reduced diabetes and cardiovascular disease. 10.3390/nu11081788
Membrane and soluble endoglin role in cardiovascular and metabolic disorders related to metabolic syndrome. Cellular and molecular life sciences : CMLS Membrane endoglin (Eng, CD105) is a transmembrane glycoprotein essential for the proper function of vascular endothelium. It might be cleaved by matrix metalloproteinases to form soluble endoglin (sEng), which is released into the circulation. Metabolic syndrome comprises conditions/symptoms that usually coincide (endothelial dysfunction, arterial hypertension, hyperglycemia, obesity-related insulin resistance, and hypercholesterolemia), and are considered risk factors for cardiometabolic disorders such as atherosclerosis, type II diabetes mellitus, and liver disorders. The purpose of this review is to highlight current knowledge about the role of Eng and sEng in the disorders mentioned above, in vivo and in vitro extent, where we can find a wide range of contradictory results. We propose that reduced Eng expression is a hallmark of endothelial dysfunction development in chronic pathologies related to metabolic syndrome. Eng expression is also essential for leukocyte transmigration and acute inflammation, suggesting that Eng is crucial for the regulation of endothelial function during the acute phase of vascular defense reaction to harmful conditions. sEng was shown to be a circulating biomarker of preeclampsia, and we propose that it might be a biomarker of metabolic syndrome-related symptoms and pathologies, including hypercholesterolemia, hyperglycemia, arterial hypertension, and diabetes mellitus as well, despite the fact that some contradictory findings have been reported. Besides, sEng can participate in the development of endothelial dysfunction and promote the development of arterial hypertension, suggesting that high levels of sEng promote metabolic syndrome symptoms and complications. Therefore, we suggest that the treatment of metabolic syndrome should take into account the importance of Eng in the endothelial function and levels of sEng as a biomarker and risk factor of related pathologies. 10.1007/s00018-020-03701-w
Pancreatogenic Diabetes, 2 Onset Forms and Lack of Metabolic Syndrome Components Differentiate It From Type 2 Diabetes. Valdez-Hernández Pedro,Pérez-Díaz Ivan,Soriano-Rios Andrea,Gómez-Islas Valeria,García-Fong Kevin,Hernández-Calleros Jorge,Uscanga-Dominguez Luis,Pelaez-Luna Mario Pancreas OBJECTIVES:We compared pancreatogenic (DM3c) and type 2 diabetes mellitus. METHODS:We compared age-, sex-, and diabetes mellitus duration-matched DM3c cases (n = 142) and type 2 diabetes mellitus (n = 142). Pancreatogenic diabetes was considered when it appeared after the diagnosis of pancreatitis or after pancreatic surgery. RESULTS:Pancreatogenic diabetes presented lower body mass index (BMI) [odds ratio (OR), 1.2; 95% confidence interval (CI), 1.13-1.28; P < 0.001], worse glycemic control (OR, 1.196; 95% CI, 1.058-1.35; P = 0.004), required insulin more frequently (OR, 4.21; 95% CI, 2.57-6.93; P = 0.0001), had more hypoglycemic episodes (OR, 3.65; 95% CI, 1.64-8.16; P = 0.001) but lower frequency of dyslipidemia (OR, 0.42; 95% CI, 0.26-0.68; P = 0.001) and arterial hypertension (OR, 0.52; 95% CI, 0.32-0.86; P = 0.01). Pancreatogenic diabetes cases on pancreatic enzyme replacement therapy had lower glycosylated hemoglobin (8.52% vs 9.44%; P = 0.026), serum carotenes (79.1 vs 116.1; P = 0.03), and BMI (23.4 vs 26.1; P = 0.0005) than those not on pancreatic enzyme replacement therapy. Pancreatogenic diabetes onset occurred earlier in necrotizing pancreatitis and after pancreatic surgery. CONCLUSIONS:Pancreatogenic diabetes presents with low BMI and lacks metabolic syndrome components. The type of pancreatic disease or surgery defines its onset time. 10.1097/MPA.0000000000001930
Prevalence of Metabolic Syndrome in Relation to Cardiovascular Biomarkers and Dietary Factors among Adolescents with Type 1 Diabetes Mellitus. Nutrients The occurrence of metabolic syndrome (MetS) significantly affects the course of diabetes mellitus (DM), resulting in deterioration of insulin sensitivity and metabolic control, as well as many cardiometabolic complications. The aim of the study was to investigate the relationships between cardiovascular biomarkers, nutritional status, dietary factors and the occurrence of MetS among 120 participants from northeast Poland (adolescents with type 1 DM and healthy peers). MetS was assessed using several criteria: nutritional status by anthropometric measurements, body composition analysis by bioelectrical impedance, and diet using a food diary and questionnaire. MetS was diagnosed in every third diabetic. Compared to healthy peers, MetS patients had higher total body fat (26% vs. 14%, p < 0.001) and visceral fat (77 cm2 vs. 35 cm2, p < 0.001), and lower total antioxidant status (1.249 mmol/L vs. 1.579 mmol/L, p < 0.001). Additionally, their diet was rich in saturated fatty acids, but low in dietary fiber as well as mono- and polyunsaturated fatty acids. The group of diabetics reported many inappropriate eating behaviors. The combination of those with the presence of an excessive content of visceral fat tissue and abnormal values of MetS components may negatively affect metabolic control, thus accelerating the development of cardiometabolic complications. 10.3390/nu14122435
Prevalence and Associations of Metabolic Syndrome in an Urban High Diabetes Risk Population in a Low/Middle-Income Country. Ahmed Asma,Akhter Jaweed,Iqbal Romaina,Jabbar Abdul,Mawani Minaz,Awan Safia,Samad Zainab,Shaikh Preet Ayoub,Salik Muammad,Tuomilehto Jaakko Metabolic syndrome and related disorders We aimed to assess the burden of metabolic syndrome (MetS), and evaluate the phenotypic variation of MetS in a population at high risk for diabetes in urban Karachi, Pakistan. This study was embedded in a lifestyle intervention trial for the prevention of type 2 diabetes mellitus. The study population comprised participants who belonged to urban households in Karachi, Pakistan. Among 15,590 individuals who were screened through diabetes risk score (DRS), 3945 individuals met the criteria for a high DRS (≥60). After excluding 1780 participants due to refusals and ineligibility, 2165 were enrolled, a total of 1188 subjects (54.9%) met the International Diabetes Federation criteria for MetS, and a total of 1199 subjects (55.4%) participants met the US National Cholesterol Education Program. Raised serum triglycerides (TGs) and low high-density lipoprotein (HDL) cholesterol were significantly associated with MetS. On multivariate logistic regression, higher body mass index levels (obese category: odds ratio [OR] = 2.14, 95% confidence interval [CI] 1.56-2.95), age >44 years (OR = 2.64, 95% CI 1.93-3.60), and family history of diabetes in both parents (OR = 1.71, 95% CI 1.15-2.54) were found to be independently associated with MetS, whereas higher education (OR = 0.78, 95% CI 0.57-1.06) and physical activity levels (OR = 0.74, 95% CI 0.57-0.96) had lower odds of MetS. One in two individuals with a high DRS in an urban low/middle-income country setting met the criteria for MetS. Patients with atherogenic dyslipidemia defined as low HDL and high TGs represent unique subphenotypes of MetS in this population. 10.1089/met.2019.0098
Root Cause for Metabolic Syndrome and Type 2 Diabetes: Can Lifestyle and Nutrition Be the Answer for Remission. Endocrinology and metabolism clinics of North America Obesity and its association with metabolic syndrome are implicated in many disease states. Research has focused on the role of diet and lifestyle modifications in the evolution of prediabetes to diabetes seeking ways to intervene and improve outcomes. Proven nutritional include leaner proteins, an abundance of vegetables, extra-virgin olive oil, and controlled portioning of carbs and starches. The transition from a sedentary state to an exercise routine of moderate intensity has shown efficacy in lowering metabolic risks. The synergy of dietary and physical activity modifications are the building blocks for lifestyle modifications examined in this review as a means of preventing obesity-related diabetes. 10.1016/j.ecl.2022.10.007
The Effects of Different Types of Exercise on Circulating Irisin Levels in Healthy Individuals and in People With Overweight, Metabolic Syndrome and Type 2 Diabetes. Physiological research Irisin is a myokine secreted during exercise. It has drawn the attention of researchers as it regulates several effects of exercise that are considered beneficial. It has also been proposed as a therapeutic tool to treat metabolic disorders. In recent years, the effect of different types of training on circulating irisin has been studied in large populations. An overall beneficial result has been shown, however, the outcome of the investigations has raised some controversy. Herein we evaluated the existing literature on the effects of different types of training on the circulating irisin levels in healthy subjects and in those displaying different metabolic condition. We conducted queries in the PubMed and Web of Science databases for literature published between January 2010 and January 2021. Thirty-seven original articles were retrieved and they were included in this review. Any letter to the editor, meta-analyses, reviews, and systematic review articles were excluded. From these 37 articles, 19 of them reported increased levels of circulating irisin. The interventions encompassed aerobic, resistance, combined, circuit, and interval training types. Such increase of circulating irisin was reported for healthy subjects and for those displaying different metabolic condition. A training that is steadily kept with a moderate to high intensity, including that characterized by brief highly intense intervals, were distinguishable from the rest. Nevertheless, the training effectiveness as evaluated by the increased circulating irisin levels depends on the subject's metabolic condition and age.
Exercise training to reduce cardiovascular risk in patients with metabolic syndrome and type 2 diabetes mellitus: How does it work? Kränkel Nicolle,Bahls Martin,Van Craenenbroeck Emeline M,Adams Volker,Serratosa Luis,Solberg Erik Ekker,Hansen Dominique,Dörr Marcus,Kemps Hareld European journal of preventive cardiology Metabolic syndrome (MetS) - a clustering of pathological conditions, including abdominal obesity, hypertension, dyslipidemia and hyperglycaemia - is closely associated with the development of type 2 diabetes mellitus (T2DM) and a high risk of cardiovascular disease. A combination of multigenetic predisposition and lifestyle choices accounts for the varying inter-individual risk to develop MetS and T2DM, as well as for the individual amount of the increase in cardiovascular risk in those patients. A physically active lifestyle can offset about half of the genetically mediated cardiovascular risk. Yet, the extent to which standardized exercise programmes can reduce cardiovascular risk differs between patients. Exercise parameters, such as frequency, intensity, type and duration or number of repetitions, differentially target metabolic function, vascular health and physical fitness. In addition, exercise-induced molecular mechanisms are modulated by other patient-specific variables, such as age, diet and medication. This review discusses the molecular and cellular mechanisms underlying the effects of exercise training on cardiovascular risk specifically in patients with MetS and T2DM. 10.1177/2047487318805158
Metabolic syndrome and lifestyle factors among type 2 diabetes mellitus patients in Dessie Referral Hospital, Amhara region, Ethiopia. Zerga Aregash Abebayehu,Bezabih Afework Mulugeta PloS one BACKGROUND:The prevalence of metabolic syndrome is rising at an alarming rate and more common among Type 2 Diabetes Mellitus patients in the world. The risk for cardiovascular disease is greater among individuals who have a combination of Type 2 Diabetes Mellitus and metabolic syndrome compared to those who have either alone. OBJECTIVE:To assess the proportion of metabolic syndrome and lifestyle factors among Type 2 Diabetes Mellitus Patients in Dessie Referral Hospital, Amhara Region, Ethiopia. METHODS:A hospital-based cross-sectional study was conducted from February to March 2017 among 343 randomly selected Type 2 Diabetes Mellitus patients. Three definitions of Metabolic syndrome were considered. Multivariable logistic regression analysis was conducted to identify factors associated with metabolic syndrome. Adjusted odds ratio (AOR) with 95% confidence intervals (CI) were reported to show the strength of association. Statistical significance was declared at P-value < 0.05. RESULT:The proportion of metabolic syndrome was 50.3%, 59.4% and 64.5% according to 2005 International Diabetes Federation, revised ATP III and 2009 harmonized criteria, respectively. Being female (AOR = 2.43; 95% CI = 1.40, 4.21), consumption of red meat (AOR = 2.61; 95% CI = 1.28, 5.33), sedentary leisure time activity (AOR = 2.65; 95% CI = 1.47, 4.78), coffee intake (AOR = 0.43; 95% CI = 0.21, 0.86), BMI ≥ 25 kg/m2 (AOR = 9.59; 95% CI = 4.98, 18.47), 40-49 years of age (AOR = 2.74, 95% CI = (1.02, 7.37), 50-59 years of age (AOR = 4.22; 95% CI = 1.60, 11.11) and ≥70 years of age (AOR = 4.51, 95% CI = 1.44, 14.15) were significantly associated with metabolic syndrome. CONCLUSION AND RECOMMENDATION:The proportion of metabolic syndrome was high among Type 2 Diabetes Mellitus patients. Overweight and obesity, being female, age of respondent, intake of coffee, regular red meat consumption, and sedentary leisure-time activity were factors associated with metabolic syndrome. Counseling of Type 2 Diabetes Mellitus patients on the need for spending leisure time with activities, intake of coffee, control of body weight, and avoidance of regular red meat consumption is recommended. 10.1371/journal.pone.0241432
Exercise as Treatment for Neuropathy in the Setting of Diabetes and Prediabetic Metabolic Syndrome: A Review of Animal Models and Human Trials. Current diabetes reviews BACKGROUND:Peripheral neuropathy is among the most common complications of diabetes, but a phenotypically identical distal sensory predominant, painful axonopathy afflicts patients with prediabetic metabolic syndrome, exemplifying a spectrum of risk and continuity of pathogenesis. No pharmacological treatment convincingly improves neuropathy in the setting of metabolic syndrome, but evolving data suggest that exercise may be a promising alternative. OBJECTIVE:The aim of the study was to review in depth the current literature regarding exercise treatment of metabolic syndrome neuropathy in humans and animal models, highlight the diverse mechanisms by which exercise exerts beneficial effects, and examine adherence limitations, safety aspects, modes and dose of exercise. RESULTS:Rodent models that recapitulate the organismal milieu of prediabetic metabolic syndrome and the phenotype of its neuropathy provide a strong platform to dissect exercise effects on neuropathy pathogenesis. In these models, exercise reverses hyperglycemia and consequent oxidative and nitrosative stress, improves microvascular vasoreactivity, enhances axonal transport, ameliorates the lipotoxicity and inflammatory effects of hyperlipidemia and obesity, supports neuronal survival and regeneration following injury, and enhances mitochondrial bioenergetics at the distal axon. Prospective human studies are limited in scale but suggest exercise to improve cutaneous nerve regenerative capacity, neuropathic pain, and task-specific functional performance measures of gait and balance. Like other heath behavioral interventions, the benefits of exercise are limited by patient adherence. CONCLUSION:Exercise is an integrative therapy that potently reduces cellular inflammatory state and improves distal axonal oxidative metabolism to ameliorate features of neuropathy in metabolic syndrome. The intensity of exercise need not improve cardinal features of metabolic syndrome, including weight, glucose control, to exert beneficial effects. 10.2174/1573399817666210923125832
The interaction between metabolic syndrome and physical activity, and risk for gestational diabetes mellitus. Schneider Ashleigh K,Leemaqz Shalem Y,Dalton Julia,Verburg Petra E,Mol Ben W,Dekker Gus A,Roberts Claire T,Grieger Jessica A Acta diabetologica AIMS:Metabolic syndrome (MetS) is a cluster of risk factors which increases risk of cardiometabolic diseases in the adult population and increases risk for pregnancy complications such as gestational diabetes mellitus (GDM). Epidemiological data indicate that moderate-to-high levels of physical activity reduces the risk for GDM. The study aims to determine whether the association between MetS and GDM is affected by physical activity. METHODS:We performed a prospective cohort study among 1373 pregnant nulliparous women in Adelaide, South Australia. At 9-16 weeks' gestation, demographic, lifestyle and self-reported frequencies of physical activity were obtained, and a non-fasting blood sample was taken for assessment of MetS, defined using the International Diabetes Federation criteria. GDM was diagnosed at 24-28 weeks' gestation using the World Health Organization classification. RESULTS:1158 pregnant women were included: 107 (9%) women had MetS in early pregnancy, and 184 (16%) developed GDM. Having MetS increased the risk of developing GDM (37.4% vs. 13.7%, adjusted RR 2.5; 95% CI 1.7, 3.6). The interaction effect (RR; (95% CI) between MetS and physical activity was not significant (vigorous physical activity: 2.60; 0.46, 14.71) for ≥ 4 times per week; less vigorous activity; 0.77; 0.15, 4.02 for ≥ 4 times per week; stair climbing ≥ once day (1.16; 0.54, 2.51), all compared to no physical activity). CONCLUSIONS:Physical activity was not an effect modifier in the association between GDM and MetS. Information collected about the nature and extent of physical activity needs to be more detailed and granular to determine whether physical activity really has an effect. 10.1007/s00592-021-01696-9
Impact of the metabolic syndrome on peripheral nerve structure and function in type 2 diabetes. Issar Tushar,Tummanapalli Shyam S,Borire Adeniyi A,Kwai Natalie C G,Poynten Ann M,Arnold Ria,Markoulli Maria,Krishnan Arun V European journal of neurology BACKGROUND AND PURPOSE:There is a strong association between the metabolic syndrome in diabetes and the development of peripheral neuropathy; however, the pathophysiological mechanisms remain unknown. METHODS:Participants with type 2 diabetes and metabolic syndrome (T2DM/MetS, n = 89) and type 2 diabetes alone (T2DM; n = 59) underwent median nerve ultrasound and excitability studies to assess peripheral nerve structure and function. A subset of T2DM/MetS (n = 24) and T2DM (n = 22) participants underwent confocal microscopy to assess central and inferior whorl corneal nerve structure. Neuropathy severity was assessed using the modified Toronto Clinical Neuropathy Score (mTCNS). Diabetes groups were similar for age, sex distribution, diabetes duration, hemoglobin A , insulin treatment, and renal function. Sixty healthy controls similar for age and sex distribution were recruited for comparison. RESULTS:Participants with T2DM/MetS manifested with a greater mTCNS compared to T2DM (p < 0.05). Median nerve cross-sectional area was larger in the T2DM/MetS group compared to the T2DM cohort (p < 0.05). Participants with T2DM/MetS had reductions in central (all p < 0.01) and inferior whorl (all p < 0.05) nerve measures. Compared to T2DM, the T2DM/MetS group demonstrated more severe changes in nerve excitability measures, which was due to reduced sodium channel permeability and sodium-potassium pump function. In comparison, only sodium channel permeability was reduced in the T2DM group. CONCLUSIONS:Compared to participants with type 2 diabetes alone, those with diabetes and metabolic syndrome manifested greater alterations in peripheral nerve structure and function, which may be due to reduced function of the sodium-potassium pump. 10.1111/ene.14805
METABOLIC SYNDROME. ETIOLOGY AND PATHOGENESIS. Diemieszczyk Inna,Głuszyńska Paulina,Wojciak Pawel Andrzej,Ładny Jerzy Robert,Razak Hady Hady Wiadomosci lekarskie (Warsaw, Poland : 1960) The aim of the study was to assess the impact of individual components of the metabolic syndrome on the human body, taking into account their etiology and pathogenesis. This article is analytical analysis of scientific and medical literature basing on aspects of the etiology and pathogenesis of the metabolic syndrome. The key role in the pathogenesis of the metabolic syndrome is played by insulin resistance, which may be a result of lifestyle conditions (low physical activity, overweight or obesity) or genetic background. A certain role in the pathogenesis of the metabolic syndrome is also attributed to disorders of the hypothalamic-pituitary-adrenal axis in the form of increased cortisol control, which may initiate the development of abdominal obesity, insulin resistance, hypertension and dyslipidemia. Aforementioned factors (environmental, hormonal and genetic) lead to excessive fat tissue gathering. The excess of abdominal fat tissue - abdominal obesity - leads to insulin resistance, the concentration of which causes body mass gain. Such mechanism is dangerous for our health and may lead to the occurrence of type 2 diabetes and premature development of atherosclerosis with all its consequences such as atherosclerotic cardiovascular diseases including coronary artery disease.
Latin American Consensus on the management of hypertension in the patient with diabetes and the metabolic syndrome. López-Jaramillo Patricio,Barbosa Eduardo,Molina Dora I,Sanchez Ramiro,Diaz Margarita,Camacho Paul A,Lanas Fernando,Pasquel Miguel,Accini José L,Ponte-Negretti Carlos I,Alcocer Luis,Cobos Leonardo,Wyss Fernando,Sebba-Barroso Weimar,Coca Antonio,Zanchetti Alberto, Journal of hypertension : The prevalence of hypertension, type 2 diabetes mellitus (DM2) and the metabolic syndrome continues to increase in Latin America, while the rates of diagnosis, treatment and control of these disorders remain low. The frequency of the risk factors that constitute the metabolic syndrome and are associated with an increased risk of cardiovascular disease has not diminished since the publication of the previous consensus. This document discusses the socioeconomic, demographic, environmental and cultural characteristics of most associated Latin American countries and partially explains the lack of better results in improving clinical and public health actions that allow high morbidity and mortality rates caused by cardiovascular diseases and DM2 to be reduced through programs aligned with the so-called precision medicine, which should be predictive, preventive, personalized and participatory. The Consensus ratifies the diagnostic criteria expressed in the previous consensus to define hypertension and DM2 but, for the metabolic syndrome, and in the absence of evidence, the recommendation is to implement a cohort study that determines the abdominal perimeter value associated with hard outcomes, such as DM2 and CVD. Meanwhile, we recommend modifying the criterion to more than 94 cm in men and more than 84 cm in women according to WHO recommendations. We also recommend the carrying out of a study that identifies the situation of hypertension and DM2 in people of African ancestry who, in Latin America, exceed 75 million and whose epidemiology does not include solid studies. With respect to the proposed therapeutic targets, we recommended maintaining those defined in the previous consensus, but insisting that early pharmacological management of prediabetes with metformin should be introduced, as should the treatment of diabetic hypertensive patients with a combination therapy of two fixed-dose antihypertensive drugs and management with statins. To increase adherence, the use of different drugs combined in a single pill (polypill) is recommended. The simplification of the therapeutic regimen is accompanied by greater control of cardiovascular risk factors, both in primary and secondary prevention, and has been shown to be cost-effective. The consensus recommends the use of the currently available polypill combining an angiotensin-converting enzyme inhibitor, a statin and aspirin for secondary cardiovascular prevention and in patients with a high cardiovascular risk, such as hypertension patients with DM2. 10.1097/HJH.0000000000002072
HOMA-IR as a predictor of Health Outcomes in Patients with Metabolic Risk Factors: A Systematic Review and Meta-analysis. High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension INTRODUCTION:There exists clinical interest in the following question: Is there an association between HOMA-IR and the risk of developing metabolic diseases? AIMS:Assessing the association between high values of HOMA-IR with the incidence of T2DM, MACE, essential hypertension, dyslipidemia, NASH, and cancer in healthy participants and participants with a component of metabolic syndrome. METHODS:Databases were searched by an experienced librarian to find eligible studies. Observational cohort studies enrolling healthy adults and adults with metabolic syndrome components that evaluated HOMA as a marker of IR were considered for inclusion. Eligibility assessment, data extraction and risk of bias assessment were performed independently and in duplicate. Baseline characteristics of patients, cutoff values of HOMA-IR to predict metabolic events were extracted independently and in duplicate. RESULTS:38 studies (215,878 participants) proved eligible. A higher HOMA-IR value had a significant effect on the risk of developing T2DM (HR 1.87; CI 1.40-2.49), presenting non-fatal MACE (HR 1.46; CI 1.08-1.97) and hypertension (HR 1.35; CI 1.15-1.59). No association was found regarding cancer mortality and fatal MACE with higher HOMA-IR values, there was not enough information to carry out a meta-analysis to establish an association between higher values of HOMA with cancer incidence, dyslipidemia, and NASH. CONCLUSIONS:High values of HOMA were associated with an increased risk of diabetes, hypertension, and non-fatal MACE; yet, not for cardiovascular or cancer mortality. More research is needed to determine the value of the HOMA index in metabolic and cardiovascular outcomes. PROSPERO REGISTRATION NUMBER:CRD42020187645. 10.1007/s40292-022-00542-5
The metabolic syndrome and diabetes are not synonymous. Chedraui Peter,Pérez-López Faustino R Climacteric : the journal of the International Menopause Society 10.1080/13697137.2019.1605758
The Interplay between Insulin Resistance, Inflammation, Oxidative Stress, Base Excision Repair and Metabolic Syndrome in Nonalcoholic Fatty Liver Disease. Ziolkowska Sylwia,Binienda Agata,Jabłkowski Maciej,Szemraj Janusz,Czarny Piotr International journal of molecular sciences One of the most common chronic liver disorders, affecting mainly people in Western countries, is nonalcoholic fatty liver disease (NAFLD). Unfortunately, its pathophysiological mechanism is not fully understood, and no dedicated treatment is available. Simple steatosis can lead to nonalcoholic steatohepatitis and even to fibrosis, cancer, and cirrhosis of the liver. NAFLD very often occurs in parallel with type 2 diabetes mellitus and in obese people. Furthermore, it is much more likely to develop in patients with metabolic syndrome (MS), whose criteria include abdominal obesity, elevated blood triacylglycerol level, reduced high-density lipoprotein cholesterol level, increased blood pressure, and high fasting glucose. An important phenomenon in MS is also insulin resistance (IR), which is very common in NAFLD. Liver IR and NAFLD development are linked through an interaction between the accumulation of free fatty acids, hepatic inflammation, and increased oxidative stress. The liver is particularly exposed to elevated levels of reactive oxygen species due to a large number of mitochondria in hepatocytes. In these organelles, the main DNA repair pathway is base excision repair (BER). The present article will illustrate how impairment of BER may be related to the development of NAFLD. 10.3390/ijms222011128
Health-Promoting Properties of Selected Cyclitols for Metabolic Syndrome and Diabetes. Nutrients Cyclitols play a particularly important role in cell functioning because they are involved in ion channel physiology, phosphate storage, signal transduction, cell wall formation, membrane biogenesis, osmoregulation and they have antioxidant activity. They are involved in the cell membranes as a phosphatidyl inositol, an inositol triphosphate precursor, which acts as a transmitter that regulates the activity of several hormones, such as follicle-stimulating hormone, thyrotropin, and insulin. The aim of this paper is to characterize the selected cyclitols: -inositol, D--inositol, and D-pinitol in type-2 metabolic syndrome and diabetes treatment. Results and discussion: Cyclitols have certain clinical applications in the treatment of metabolic syndromes and are considered to be an option as a dietary supplement for the treatment or prevention of gestational diabetes mellitus and type-2 diabetes. Improved metabolic parameters observed after using cyclitols, like -inositol, in the treatment of polycystic ovary syndrome and type-2 diabetes suggest that they may have a protective effect on the cardiovascular system. Pinitol, together with inositol,maybe responsible for improving lipid profiles by reducing serum triglyceride and total cholesterol. Pinitol is also well-researched and documented for insulin-like effects. inositol, D-inositol, and D-pinitol indicate a number of therapeutic and health-promoting properties. 10.3390/nu11102314
Obesity, Metabolic Syndrome and the Risk of Microvascular Complications in Patients with Diabetes mellitus. Katsiki Niki,Anagnostis Panagiotis,Kotsa Kalliopi,Goulis Dimitrios G,Mikhailidis Dimitri P Current pharmaceutical design BACKGROUND:Obesity frequently co-exists with type 2 diabetes mellitus (T2DM), leading to the socalled "diabesity epidemic". The metabolic syndrome (MetS), a cluster of central obesity, hypertension, dysglycemia, insulin resistance and/or atherogenic dyslipidemia, as well as non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of MetS, has been associated with increased cardiovascular disease (CVD), T2DM and chronic kidney disease (CKD) incidence. However, the association between obesity, MetS (including NAFLD) and diabetic microvascular complications is less evident. METHODS:The present narrative review discusses the associations of obesity, MetS and NAFLD with diabetic kidney disease (DKD), diabetic retinopathy (DR) and diabetic peripheral neuropathy (DPN) as well as cardiac autonomic neuropathy (CAN). The available data on the effects of lifestyle measures and bariatric surgery on these diabetic complications are also briefly discussed. RESULTS:Overall, both obesity and MetS have been related to DKD, DR and DPN, although conflicting results exist. Links between NAFLD and diabetic microvascular complications have also been reported but data are still limited. Lifestyle intervention and bariatric surgery may prevent the development and/or progression of these microvascular complications but more evidence is needed. CONCLUSION:Clinicians should be aware of the frequent co-existence of MetS and/or NAFLD in T2DM patients to prevent or treat these metabolic disorders, thus potentially minimizing the risk for both CVD and diabetic microvascular complications. 10.2174/1381612825666190708192134
The role of diet and intestinal microbiota in the development of metabolic syndrome. Santos-Marcos Jose A,Perez-Jimenez Francisco,Camargo Antonio The Journal of nutritional biochemistry Metabolic syndrome (MetS) is a cluster of metabolic factors that increase the risk of cardiovascular disease and type 2 diabetes mellitus (T2DM), which is in itself a major cardiovascular disease risk factor. The aim of this review is to summarize the data related to the influence of the gut microbiota on the development of obesity and the MetS, highlighting the role of diet in controlling the MetS by modifying the gut microbiota. The main alterations in the gut microbiota of individuals with MetS consist of an increased Firmicutes/Bacteriodetes ratio and a reduced capacity to degrade carbohydrates to short-chain fatty acids, which in turn is related with the metabolic dysfunction of the host organism rather than with obesity itself. In addition to a low-fat, high-carbohydrate diet, with its high fiber intake, a diet with 30% fat content but with a high content in fruit and vegetables, such as the Mediterranean diet, is beneficial and partially restores the dysbiosis found in individuals with MetS. Overall, the shaping of the gut microbiota through the administration of prebiotics or probiotics increases the short-chain fatty acid production and is therefore a valid alternative in MetS treatment. 10.1016/j.jnutbio.2019.03.017
Glucagon-Like Peptide-1 Receptor Agonists and Dual Glucose-Dependent Insulinotropic Polypeptide/Glucagon-Like Peptide-1 Receptor Agonists in the Treatment of Obesity/Metabolic Syndrome, Prediabetes/Diabetes and Non-Alcoholic Fatty Liver Disease-Current Evidence. Journal of cardiovascular pharmacology and therapeutics The obesity pandemic is accompanied by increased risk of developing metabolic syndrome (MetS) and related conditions: non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH), type 2 diabetes mellitus (T2DM) and cardiovascular (CV) disease (CVD). Lifestyle, as well as an imbalance of energy intake/expenditure, genetic predisposition, and epigenetics could lead to a dysmetabolic milieu, which is the cornerstone for the development of cardiometabolic complications. Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs promote positive effects on most components of the "" and consequently help reduce the need for polypharmacy. In this review, we highlight the main pathophysiological mechanisms and risk factors (RFs), that could be controlled by GLP-1 and dual GIP/GLP-1 RAs independently or through synergism or differences in their mode of action. We also address the evidence on the use of GLP-1 and dual GIP/GLP-1 RAs in the treatment of obesity, MetS and its related conditions (prediabetes, T2DM and NAFLD/NASH). In conclusion, GLP-1 RAs have already been established for the treatment of T2DM, obesity and cardioprotection in T2DM patients, while dual GIP/GLP-1 RAs appear to have the potential to possibly surpass them for the same indications. However, their use in the prevention of T2DM and the treatment of complex cardiometabolic metabolic diseases, such as NAFLD/NASH or other metabolic disorders, would benefit from more evidence and a thorough clinical patient-centered approach. There is a need to identify those patients in whom the metabolic component predominates, and whether the benefits outweigh any potential harm. 10.1177/10742484221146371
Metabolic syndrome and peripheral neuropathy. Kazamel Mohamed,Stino Amro Maher,Smith Albert Gordon Muscle & nerve Diabetic peripheral neuropathy and metabolic syndrome (MetS) are both global health challenges with well-established diagnostic criteria and significant impacts on quality of life. Clinical observations, epidemiologic evidence, and animal models of disease have strongly suggested MetS is associated with an elevated risk for cryptogenic sensory peripheral neuropathy (CSPN). MetS neuropathy preferentially affects small unmyelinated axons early in its course, and it may also affect autonomic and large fibers. CSPN risk is linked to MetS and several of its components including obesity, dyslipidemia, and prediabetes. MetS also increases neuropathy risk in patients with established type 1 and type 2 diabetes. In this review we present animal data regarding the role of inflammation and dyslipidemia in MetS neuropathy pathogenesis. Several studies suggest exercise-based lifestyle modification is a promising treatment approach for MetS neuropathy. 10.1002/mus.27086
Magnesium in Obesity, Metabolic Syndrome, and Type 2 Diabetes. Piuri Gabriele,Zocchi Monica,Della Porta Matteo,Ficara Valentina,Manoni Michele,Zuccotti Gian Vincenzo,Pinotti Luciano,Maier Jeanette A,Cazzola Roberta Nutrients Magnesium (Mg) deficiency is probably the most underestimated electrolyte imbalance in Western countries. It is frequent in obese patients, subjects with type-2 diabetes and metabolic syndrome, both in adulthood and in childhood. This narrative review aims to offer insights into the pathophysiological mechanisms linking Mg deficiency with obesity and the risk of developing metabolic syndrome and type 2 diabetes. Literature highlights critical issues about the treatment of Mg deficiency, such as the lack of a clear definition of Mg nutritional status, the use of different Mg salts and dosage and the different duration of the Mg supplementation. Despite the lack of agreement, an appropriate dietary pattern, including the right intake of Mg, improves metabolic syndrome by reducing blood pressure, hyperglycemia, and hypertriglyceridemia. This occurs through the modulation of gene expression and proteomic profile as well as through a positive influence on the composition of the intestinal microbiota and the metabolism of vitamins B1 and D. 10.3390/nu13020320
Lifestyle associated with risk of metabolic syndrome in adults and the elderly. Nutrition (Burbank, Los Angeles County, Calif.) OBJECTIVES:The aim of this study was to analyze the association between at least one of the risk factors for metabolic syndrome and the lifestyle of adults and elderly individuals in Teresina, Piauí. METHODS:This was a cross-sectional, population-based study, with adults and elderly of both both sexes, living in Teresina, Piauí.. Data were collected using Epicollect 5 software (Imperial College London) in a mobile application (mobile). Pearson's χ test was used to assess the association between variables. The prevalence ratio (PR) was calculated, with a 95% confidence interval (95% CI), estimated by Poisson regression, to measure the strength of association between the study variables with the presence of at least one factor of risk for disease. The level of significance adopted was P < 0.05. RESULTS:The main habit as a protective factor for at least one risk factor for metabolic syndrome was the consumption of natural fruit juice once to three times a week (0.93), in addition to the current daily use of tobacco (raw and adjusted; 0.80) and irregularly active and active/very active physical activity level (0.86), which when adjusted increased to 0.89 in the latter activity level. The habit of drinking alcohol frequently/occasionally was 1.08 times more likely and when adjusted increased (1.10). CONCLUSIONS:The presence of at least one risk factor for this disease, according to lifestyle, deserves a warning for the population, as it is capable of harming health, especially at the level of cardiovascular impairment. 10.1016/j.nut.2022.111647
Inflammatory Biomarkers and Components of Metabolic Syndrome in Adolescents: a Systematic Review. de F Rocha Ariane R,de S Morais Núbia,Priore Silvia E,do C C Franceschini Sylvia Inflammation Metabolic syndrome (MetS) has been prevalent among adolescents. The association between the concentration of inflammatory markers and the individual components of the metabolic syndrome indicates that inflammation, when there is no recent or ongoing disease, mediated by an inflammatory process, is an event that may precede the development of metabolic disorders in teenagers. The objective of this study is to verify the association of inflammatory biomarkers with the components of metabolic syndrome in adolescents. From a search of 3 databases, 13 articles met the study inclusion criteria. Two investigators independently extracted data from included studies. The evaluated inflammatory biomarkers are related to the components of MetS (insulin resistance, central and visceral obesity, arterial hypertension, dyslipidemia), which may increase the risk of developing the syndrome in adolescents. The results of this review are of clinical relevance, since the evaluation of inflammatory biomarkers in the presence of metabolic alterations can help to identify the risk factors that lead to the progression of MetS in adolescents. 10.1007/s10753-021-01549-1
Genetic and Epigenetic Biomarkers for Diagnosis, Prognosis and Treatment of Metabolic Syndrome. Giglio Rosaria V,Stoian Anca P,Patti Angelo M,Rizvi Ali A,Sukhorukov Vasily,Ciaccio Marcello,Orekhov Alexander,Rizzo Manfredi Current pharmaceutical design BACKGROUND:Metabolic syndrome is a clinical condition that deserves special attention because it puts the individual at high cardiovascular risk, especially heart attack and stroke. Considering precision medicine, it would be advisable to evaluate the individual cardio-metabolic risk by estimating the coexistence of risk factors (abdominal obesity, low level of High-Density Lipoprotein Cholesterol, High Triglycerides, and small dense Low-Density Lipoproteins sub-classes, hypertension, and elevated fasting glycemia), which could engrave on metabolism increasing cardiovascular mortality. OBJECTIVE:To identify genetic and epigenetic biomarkers may assist in the possibility of helping follow-up strategies and other measures of prevention and in metabolic risk. METHODS:We searched for studies that valued the combination between epigenetic biomarkers and all factors of cardio-metabolic risk. RESULTS:Numerous researches have investigated the molecular start of metabolic alterations, focusing on the epigenetic mark, as methylation of DNA, histone modifications and non.coding RNAs. It has been found that DNA methylation is the most searched epigenetic sign in the human genome concerning the control of gene expression. CONCLUSION:For the screening, diagnosis, and prognosis of metabolic syndrome and the prescription of personalized medicine, the DNA methylation biomarkers specify for subjects have been recognized as an ensuring tool. While these results are promising, further investigations are needed to unravel the complicated synergic association of the genome, epigenome and the situations related to metabolic pathology. 10.2174/1381612827666210412145915
Acculturation, Physical Activity, and Metabolic Syndrome in Asian American Adults. Journal of transcultural nursing : official journal of the Transcultural Nursing Society INTRODUCTION:Asian Americans (AsAms) have a high prevalence of metabolic syndrome (MetS) and are one of the least physically active racial groups in America. The purpose of this study was to examine the relationship between MetS and moderate-to-vigorous physical activity (MVPA) among AsAm adults and whether acculturation modifies this relationship. METHOD:Data were from 2,259 AsAms participating in the 2011-2016 National Health and Nutrition Examination Survey. Physical activity (PA) was self-reported as minutes of weekly MVPA. Acculturation included nativity, length of residency in America, and language preference. The International Diabetes Federation criteria was used to determine the presence of MetS. RESULTS:About 64.4% of AsAms did not meet the PA recommendation (MVPA ≥150 min/week). The prevalence of MetS was 39.2%. The odds of having MetS were greater among AsAms who did not meet MVPA recommendations compared with those who did meet MVPA recommendations (odds ratio [OR] = 1.5, 95% confidence interval [CI] = [1.11, 2.07]). When stratified by acculturation, this association remained statistically significant in the groups who immigrated to America more than 15 years ago and who spoke English only. CONCLUSION:MVPA reduces MetS risk in AsAm adults, especially among more acculturated AsAms. Culturally adapted programs are warranted to promote PA and adequate knowledge of disease prevention in this population. 10.1177/10436596221114150
An update on metabolic syndrome: Metabolic risk markers and adipokines in the development of metabolic syndrome. Kumari Reena,Kumar Sandeep,Kant Ravi Diabetes & metabolic syndrome BACKGROUND:Metabolic syndrome is a collection of physiological and biochemical abnormalities about 20-25% of adult population in developing countries is suffering from metabolic syndrome. Previous research demonstrated that adipose tissue plays an important role in energy regulation via endocrine, paracrine and autocrine signals as results of obesity due to accumulation of adipose tissue to excess that by time affects negatively both physical and psychological health and well being, it has been found that adipose tissues produces a variety of factors known as "adipokines" which play a key role in the development and progression of the disease and also hypothesized that adipokines are a possible link between obesity and the other risk components of the Metabolic syndrome. Many of the adipokines exert multiple actions in a variety of cellular processes leading to a complex array of abnormal characteristic of Metabolic syndrome. Abnormal production of these adipokines by expanded visceral fat during Adiposity contributes to a pro-inflammatory state. Increasing evidence suggests that aberrant production/release of adipokine from adipocyte i.e. adiponectin, leptin and resistin etc, may contribute to the health problems associated with Adiposity such as dyslipidemia, insulin resistance and atherosclerosis. This study conclusively have shown a significant role of adipokines secreted by adipose tissue and various metabolic risk markers play a important role in the development of Metabolic syndrome. 10.1016/j.dsx.2019.06.005
Socio-economics status and metabolic syndrome: A meta-analysis. Blanquet M,Legrand A,Pélissier A,Mourgues C Diabetes & metabolic syndrome OBJECTIVE:The metabolic syndrome (MetS) is responsible for an increased risk of type 2 diabetes, cardiovascular diseases and is associated with all-cause and cardiovascular mortality. Economic and social vulnerability is not an easy concept to grasp, but some studies investigate the association between MetS and socioeconomic and demographic factors, deprivation (more often correlations rather than causal one due to data). This work aims to assess the association between MetS and socio-economic gradient (SEG) in the literature by performing a meta-analysis. DESIGN:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for systematic reviews were followed. SETTING:The raw list of studies extracted from PubMed as regard to the inclusion/exclusion criteria was imported in Word. Studies were filed with regard to our three definitions of SEG and their title. PARTICIPANTS:Subgroup analysis were performed considering several definitions of Mets: NCEP-ATPIII and IDF2006. RESULTS:The overall multivariable-adjusted OR showed that the risk of MetS was significantly increased in association with SEG The results of the subgroup analysis showed an increased risk of MetS in association with SEG when IDF definition was considered. CONCLUSIONS:Targeted interventions must be implemented in a specific way as prevention campaigns aimed at the general population are generally not adapted to this particular vulnerable population. 10.1016/j.dsx.2019.04.003
Evaluation of metabolic syndrome and sleep quality in shift workers. Demiralp N,Özel F Occupational medicine (Oxford, England) BACKGROUND:Shift workers have risks associated with metabolic syndrome and low sleep quality. AIMS:This study aimed to examine metabolic syndrome and sleep quality in firefighters and mine workers working shifts and daytime hours. METHODS:A comparative descriptive study was conducted in two institutions on firefighters and mine workers (n = 120) who were working shifts (n = 84) and working daytime hours (n = 36). The data were obtained using a questionnaire including socio-demographic information, anthropometric measurements and the Pittsburgh Sleep Quality Index. RESULTS:When risk of metabolic syndrome was compared with sleep quality, it was found that according to International Diabetes Federation criteria, 11% of those diagnosed with metabolic syndrome among shift-working firefighters and 5% of those diagnosed with metabolic syndrome among shift-working miners had low sleep quality. It was found that according to the National Cholesterol Education Program-Adult Treatment Panel III criteria, 9% of those diagnosed with metabolic syndrome among shift firefighters and 2% of those diagnosed with metabolic syndrome among shift miners had low sleep quality. CONCLUSIONS:Preventive measures should be taken to reduce the risk of metabolic syndrome in shift workers. 10.1093/occmed/kqab140
Useful Biomarkers of Metabolic Syndrome. International journal of environmental research and public health The Special Issue call for papers on "Metabolic syndrome and its association with biomarkers" was proposed to present research on various markers for pathophysiology and the early detection of metabolic syndrome (MetS) [...]. 10.3390/ijerph192215003
Long-term metabolic fate and mortality in obesity without metabolic syndrome. Annals of medicine BACKGROUND:Obesity and metabolic syndrome (MetS) are known to expose to atrial fibrillation (AF), cardiovascular diseases (CVD) and mortality. Metabolically healthy obesity refers to obesity without MetS. This study aimed to investigate how obesity and MetS modify the risk of CVD, AF and mortality in very long-time follow-up. METHODS:Finnish middle-aged subjects ( = 1045) were grouped into four subgroups according to the presence of obesity and MetS. CVD events and AF were followed for 24 years and total mortality for 30 years. Moreover, 600 available patients had a follow-up visit for metabolic examinations after approximately 22 years. RESULTS:One-hundred and sixty-two (30%) subjects without obesity or MetS died during the follow-up. Ninety-two (17%) of the patients in this group had a CVD event and 58 (11%) were diagnosed with AF. As compared to them, obese subjects without MetS had similar metabolic fate and mortality (mortality 26 (38%),  = .143; CVD event 12 (18%),  = .858 and AF 7 (10%),  = .912, respectively), whereas subjects with obesity and MetS had greater mortality (102 (49%),  < .001), more CVD (71 (34%),  < .001) and AF (49 (23%),  < .001). Non-obese individuals with MetS had greater rates of mortality (96 (44%),  < .001) and CVD (80 (37%),  < .001), but not of AF (26 (12%),  = .606). Of the 40 subjects with obesity but without MetS at baseline and available for the follow-up visit, 15 (38%) were metabolically healthy at the follow-up visit. CONCLUSIONS:In the present long-term follow-up study, the presence of MetS, but not obesity only, implies a greater risk of mortality and CVD. The risk of AF is increased only in subjects with both obesity and MetS. However, obesity without MetS tends to progress eventually to obesity with MetS. Key messagesThe presence of metabolic syndrome (MetS), but not obesity only, entails a greater risk of mortality and cardiovascular diseases.The risk of atrial fibrillation is increased only in subjects with both obesity and MetS.Obesity without MetS tends to progress eventually to obesity with MetS. 10.1080/07853890.2022.2075915
Dietary Assessment Tools and Metabolic Syndrome: Is It Time to Change the Focus? Nutrients Metabolic syndrome (MS) is associated with a range of chronic diseases, for which lifestyle interventions are considered the cornerstone of treatment. Dietary interventions have primarily focused on weight reduction, usually via energy restricted diets. While this strategy can improve insulin sensitivity and other health markers, weight loss alone is not always effective in addressing all risk factors associated with MS. Previous studies have identified diet quality as a key factor in reducing the risk of MS independent of weight loss. Additionally, supporting evidence for the use of novel strategies such as carbohydrate restriction and modifying the frequency and timing of meals is growing. It is well established that dietary assessment tools capable of identifying dietary patterns known to increase the risk of MS are essential for the development of personalised, targeted diet and lifestyle advice. The American Heart Association (AHA) recently evaluated the latest in a variety of assessment tools, recommending three that demonstrate the highest evidence-based and clinical relevance. However, such tools may not assess and thus identify all dietary and eating patterns associated with MS development and treatment, especially those which are new and emerging. This paper offers a review of current dietary assessment tools recommended for use by the AHA to assess dietary and eating patterns associated with MS development. We discuss how these recommendations align with recent and novel evidence on the benefits of restricting ultra-processed food and refined carbohydrates and modifying timing and frequency of meals. Finally, we provide recommendations for future redevelopment of these tools to be deployed in health care settings. 10.3390/nu14081557
The role of bioactives in energy metabolism and metabolic syndrome. Bordoni A,Boesch C,Malpuech-Brugère C,Orfila C,Tomás-Cobos L The Proceedings of the Nutrition Society Some food bioactives potentially exert anti-obesity effects. Anthocyanins (ACN), catechins, β-glucan (BG) and n-3 long chain PUFA (LCPUFA) are among the most promising candidates and have been considered as a strategy for the development of functional foods counteracting body weight gain. At present, clinical trials, reviews and meta-analyses addressing anti-obesity effects of various bioactives or bioactive-rich foods show contradictory results. Abdominal obesity is an important criterion for metabolic syndrome (MetS) diagnosis along with glucose intolerance, dyslipidaemia and hypertension. Food bioactives are supposed to exert beneficial effects on these parameters, therefore representing alternative therapy approaches for the treatment of MetS. This review summarises outcomes on MetS biomarkers in recent clinical trials supplementing ACN, catechins, BG and n-3 LCPUFA, focusing mainly on anti-obesity effects. Overall, it is clear that the level of evidence for the effectiveness varies not only among the different bioactives but also among the different putative health benefits suggested for the same bioactive. Limited evidence may be due to the low number of controlled intervention trials or to inconsistencies in trial design, i.e. duration, dose and/or the method of bioactive supplementation (extracts, supplements, rich or enriched food). At present, the question 'Are bioactives effective in weight management and prevention of metabolic syndrome?' remains inconclusive. Thus, a common effort to harmonise the study design of intervention trials focusing on the most promising bioactive molecules is urgently needed to strengthen the evidence of their potential in the treatment of obesity, MetS and related diseases. 10.1017/S0029665119000545
Ethnicity and Metabolic Syndrome: Implications for Assessment, Management and Prevention. Lear Scott A,Gasevic Danijela Nutrients The metabolic syndrome (MetS) is a constellation of cardiometabolic risk factors that identifies people at increased risk for type 2 diabetes and cardiovascular disease. While the global prevalence is 20%-25% of the adult population, the prevalence varies across different racial/ethnic populations. In this narrative review, evidence is reviewed regarding the assessment, management and prevention of MetS among people of different racial/ethnic groups. The most popular definition of MetS considers race/ethnicity for assessing waist circumference given differences in visceral adipose tissue and cardiometabolic risk. However, defining race/ethnicity may pose challenges in the clinical setting. Despite 80% of the world's population being of non-European descent, the majority of research on management and prevention has focused on European-derived populations. In these studies, lifestyle management has proven an effective therapy for reversal of MetS, and randomised studies are underway in specific racial/ethnic groups. Given the large number of people at risk for MetS, prevention efforts need to focus at community and population levels. Community-based interventions have begun to show promise, and efforts to improve lifestyle behaviours through alterations in the built environment may be another avenue. However, careful consideration needs to be given to take into account the unique cultural context of the target race/ethnic group. 10.3390/nu12010015
Metabolic Syndrome and Viral Pathogenesis: Lessons from Influenza and Coronaviruses. Journal of virology Metabolic syndrome increases the risk of severe disease due to viral infection. Yet few studies have assessed the pathogenesis of respiratory viruses in high-risk populations. Here, we summarize how metabolic dysregulation impairs immune responses, and we define the role of metabolism during influenza virus and coronavirus infections. We also discuss the use of various , , and models to elucidate the contributions of host factors to viral susceptibility, immunity, and disease severity. 10.1128/JVI.00665-20
The association between metabolic syndrome and presence of frailty: a systematic review and meta-analysis. European geriatric medicine BACKGROUND:Frailty represents a progressive deterioration in multi-system of the body and could increase vulnerability to stressors. Recently, several studies found that metabolic syndrome was significantly associated with frailty and emphasized its role in assessing and preventing frailty. However, these conclusions are controversial. We conducted this systematic review and meta-analysis to evaluate the association between metabolic syndrome and frailty. METHODS:Databases including Pubmed, Embase, Web of Science, CINAHL Complete, China National Knowledge Infrastructure (CNKI) and Wanfang Data Knowledge Service Platform were searched for studies on the association between metabolic syndrome and frailty, from inception to 17th June 2022. Two researchers independently screened the literature, extracted the data and evaluated the quality. Stata/SE 15.0 software was used to perform the statistical analysis. RESULTS:Eleven studies were included in this review and eight studies were included in the meta-analysis, involving one prospective cohort studies and ten cross-sectional studies with 12,640 participants. The pooled results indicated that metabolic syndrome was significantly associated with frailty (OR = 1.82, 95% CI = 1.46-2.27) with a low heterogeneity (I = 32.1%), and there were significant associations between MetS and weakness (OR = 1.35, 95% CI = 1.15-1.58, I = 0.0%), slow gait speed (OR = 1.80, 95% CI = 1.51-2.14, I = 93.4%), weight loss (OR = 1.77, 95% CI = 1.36-2.29, I = 0.0%) and decreased physical activity (OR = 1.87, 95% CI = 1.49-2.35, I = 39.7%). CONCLUSIONS:The findings of this systematic review and meta-analysis suggested that metabolic syndrome could be significantly associated with the presence of frailly. Future studies need to further consider the effects of measurement tools, age and specific disease status in this association. Furthermore, the casual relationship between them is to be determined. 10.1007/s41999-022-00688-4
Metabolic syndrome and osteoarthritis pain: common molecular mechanisms and potential therapeutic implications. Valdes A M Osteoarthritis and cartilage There is no clear evidence from epidemiological and animal studies of a direct link between metabolic syndrome (MetS) and cartilage degeneration in osteoarthritis (OA) once body mass index (BMI) has been considered. However, recent epidemiological studies indicate a significant role for MetS in predicting increased knee pain after adjustment for BMI. This implies there are mechanisms that underlie both MetS and OA pain. In addition to the common systemic inflammatory and pro-inflammatory components of the two disorders, there are other molecular mechanisms that may link MetS and OA pain. These include regulation of the endocannabinoid system, activation of the transient receptor potential cation channel vanilloid subfamily member 1 (TRPV1) channel and gut dysbiosis. These three mechanisms are interlinked and are the target of therapeutic dietary or pharmacological interventions. Exploring and understanding these mechanisms may help improve outcomes for both pain and metabolic comorbidities affecting individuals with OA. 10.1016/j.joca.2019.06.015
Adipokines and Metabolic Syndrome: Pluripotent Markers for a Complex Relationship? American journal of hypertension 10.1093/ajh/hpab184
Improving prevention strategies for cardiometabolic disease. Sattar Naveed,Gill Jason M R,Alazawi William Nature medicine There is a growing burden of cardiometabolic disease in many parts of the world. Despite some progress in its prevention, more can be done to tackle risks of its development in the community and in different specialty clinics. Currently, the identification and management of those at elevated risk of developing cardiovascular disease or diabetes or with conditions such as fatty liver disease remains fragmented and is not linked to constructive lifestyle advice. In this Perspective, we argue for a more consistent weight-management approach, alongside a holistic assessment of the risk for developing cardiometabolic diseases, offering patients a range of simple or more-intensive evidence-based lifestyle options in an empathetic manner, with encouragement for repeated attempts and a willingness to embrace failure. 10.1038/s41591-020-0786-7
Metabolic syndrome, LDL-hypercholesterolaemia, and cerebrocardiovascular risk: sex matters. Tsaban Gal European journal of preventive cardiology 10.1093/eurjpc/zwaa132
Can Fasting Curb the Metabolic Syndrome Epidemic? Vrdoljak Josip,Kumric Marko,Vilovic Marino,Martinovic Dinko,Rogosic Veljko,Borovac Josip A,Ticinovic Kurir Tina,Bozic Josko Nutrients Metabolic syndrome (MetS) represents a cluster of metabolic abnormalities that includes hypertension, central obesity, insulin resistance, and atherogenic dyslipidemia. Due to the high prevalence (around 1/3 of the world population) economic burden of MetS, there is a need for new dietary, lifestyle, and therapeutic options. Recently, fasting emerged as a dietary method proposed for controlling metabolic risk factors. Intermittent fasting (IF), or time-restricted feeding (TRF), describes an array of feeding patterns in which calorie intake is restricted to a specific time period. Hence, this review aimed to elucidate the latest data on MetS and explore the viability of simple management options, such as IF and TRF. Preclinical studies have shown how IF/TRF exerts beneficial effects on the gut microbiota, glucose and insulin metabolism, weight and visceral fat, and lipid metabolism. However, the results obtained from human studies are somewhat conflicting, as weight loss was achieved in all studies, whereas in some studies, there was no significant effect on insulin resistance, cholesterol/lipid metabolism, or blood pressure. Nevertheless, as only very few human studies were performed, there is a need for more randomized control trials on larger cohorts of patients with MetS to gather higher-yield evidence to clarify whether IF/TRF are suitable dietary patterns for this population. 10.3390/nu14030456
Metabolic syndrome and pre-eclampsia. Hooijschuur M C E,Ghossein-Doha C,Kroon A A,De Leeuw P W,Zandbergen A A M,Van Kuijk S M J,Spaanderman M E A Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology OBJECTIVE:To evaluate the association between different pre-eclampsia (PE) phenotypes and the development of metabolic syndrome postpartum, in order to identify the subgroup of formerly pre-eclamptic women with a worse cardiovascular risk profile requiring tailored postpartum follow-up. METHODS:This was a cohort study of 1102 formerly pre-eclamptic women in whom cardiovascular and cardiometabolic evaluation was performed at least 3 months postpartum. Women were divided into four subgroups based on PE resulting in delivery before 34 weeks (early-onset (EO)) or at or after 34 weeks (late onset (LO)) of gestation and whether they delivered a small-for-gestational-age (SGA) neonate. Metabolic syndrome was diagnosed as the presence of hyperinsulinemia along with two or more of: body mass index ≥ 30 kg/m ; dyslipidemia; hypertension; and microalbuminuria or proteinuria. Data were compared between groups using ANOVA after Bonferroni correction. Odds ratios (OR) were calculated using logistic regression to determine the association between metabolic syndrome and the four subgroups. We constructed receiver-operating characteristics curves and computed the area under the curve (AUC) to quantify the ability of different obstetric variables to distinguish between women who developed metabolic syndrome and those who did not. RESULTS:The prevalence of metabolic syndrome was higher in women with EO-PE and SGA (25.8%) than in those with EO-PE without SGA (14.7%) (OR 2.01 (95% CI, 1.34-3.03)) and approximately five-fold higher than in women with LO-PE with SGA (5.6%) (OR 5.85 (95% CI, 2.60-13.10)). In women with LO-PE, the prevalence of metabolic syndrome did not differ significantly between women with and those without SGA. Multivariate analysis revealed that a history of SGA, a history of EO-PE and systolic blood pressure at the time of screening are the best predictors of developing metabolic syndrome postpartum. The AUC of the model combining these three variables was 74.6% (95% CI, 70.7-78.5%). The probability of the presence of metabolic syndrome was calculated as: P = 1/(1 + e ), where LP is linear predictor = -8.693 + (0.312 × SGA (yes = 1)) + (0.507 × EO-PE (yes = 1)) + (0.053 × systolic blood pressure). CONCLUSIONS:The incidence of metabolic syndrome postpartum was associated more strongly with EO-PE in combination with SGA as compared with LO-PE or EO-PE without SGA. Both time of onset of PE and fetal growth affect the risk of metabolic syndrome after a pre-eclamptic pregnancy. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd. 10.1002/uog.20126
Metabolic syndrome and bladder cancer. Panminerva medica Metabolic syndrome (MetS) is a widely diffused dysmetabolism, well known to be associated with an increased cardiovascular risk. However, a growing burden of evidence links MetS with several malignancies, potentially influencing the onset, progression, and therapeutic response. In this work, we critically explored the relationship between MetS and bladder cancer through a narrative review, researching the most recent literature on the topic using PubMed, MEDLINE, and EMBASE. We found that the current evidence on the subject is heterogeneous and inconsistent, making it difficult to draw definitive conclusions. Furthermore, since MetS would be a modifiable oncological risk factor, more high-quality data is needed for tailored treatment of bladder cancer. 10.23736/S0031-0808.22.04641-9
Autonomic dysfunction, diabetes and metabolic syndrome. Yu Tae Yang,Lee Moon-Kyu Journal of diabetes investigation Relationships among autonomic nervous system, diabetes and metabolic syndrome. 10.1111/jdi.13691
Metabolic syndrome and pesticides: A systematic review and meta-analysis. Environmental pollution (Barking, Essex : 1987) The relation between pesticides exposure and metabolic syndrome (MetS) has not been clearly identified. Performing a systematic review and meta-analysis, PubMed, Cochrane Library, Embase, and ScienceDirect were searched for studies reporting the risk of MetS following pesticides exposure and their contaminants. We included 12 studies for a total of 6789 participants, in which 1981 (29.1%) had a MetS. Overall exposure to pesticides and their contaminants increased the risk of MetS by 30% (95CI 22%-37%). Overall organochlorine increased the risk of MetS by 23% (14-32%), as well as for most types of organochlorines: hexachlorocyclohexane increased the risk by 53% (28-78%), hexachlorobenzene by 40% (0.01-80%), dichlorodiphenyldichloroethylene by 22% (9-34%), dichlorodiphenyltrichloroethane by 28% (5-50%), oxychlordane by 24% (1-47%), and transnonchlor by 35% (19-52%). Sensitivity analyses confirmed that overall exposure to pesticides and their contaminants increased the risk by 46% (35-56%) using crude data or by 19% (10-29%) using fully-adjusted model. The risk for overall pesticides and types of pesticides was also significant with crude data but only for hexachlorocyclohexane (36% risk increase, 17-55%) and transnonchlor (25% risk increase, 3-48%) with fully-adjusted models. Metaregressions demonstrated that hexachlorocyclohexane increased the risk of MetS in comparison to most other pesticides. The risk increased for more recent periods (Coefficient = 0.28, 95CI 0.20 to 0.37, by year). We demonstrated an inverse relationship with body mass index and male gender. In conclusion, pesticides exposure is a major risk factor for MetS. Besides organochlorine exposure, data are lacking for other types of pesticides. The risk increased with time, reflecting a probable increase of the use of pesticides worldwide. The inverse relationship with body mass index may signify a stockage of pesticides and contaminants in fat tissue. 10.1016/j.envpol.2022.119288
Trace Elements, PPARs, and Metabolic Syndrome. International journal of molecular sciences Metabolic syndrome (MetS) is a constellation of metabolic derangements, including central obesity, insulin resistance, hypertension, glucose intolerance, and dyslipidemia. The pathogenesis of MetS has been intensively studied, and now many factors are recognized to contribute to the development of MetS. Among these, trace elements influence the structure of proteins, enzymes, and complex carbohydrates, and thus an imbalance in trace elements is an independent risk factor for MetS. The molecular link between trace elements and metabolic homeostasis has been established, and peroxisome proliferator-activated receptors (PPARs) have appeared as key regulators bridging these two elements. This is because on one hand, PPARs are actively involved in various metabolic processes, such as abdominal adiposity and insulin sensitivity, and on the other hand, PPARs sensitively respond to changes in trace elements. For example, an iron overload attenuates hepatic mRNA expression of ; zinc supplementation is considered to recover the DNA-binding activity of PPAR-α, which is impaired in steatotic mouse liver; selenium administration downregulates mRNA expression of , thereby improving lipid metabolism and oxidative status in the liver of high-fat diet (HFD)-fed mice. More importantly, PPARs' expression and activity are under the control of the circadian clock and show a robust 24 h rhythmicity, which might be the reasons for the side effects and the clinical limitations of trace elements targeting PPARs. Taken together, understanding the casual relationships among trace elements, PPARs' actions, and the pathogenesis of MetS is of great importance. Further studies are required to explore the chronopharmacological effects of trace elements on the diurnal oscillation of PPARs and the consequent development of MetS. 10.3390/ijms21072612
Sleep and Metabolic Syndrome. The Nursing clinics of North America Metabolic syndrome (MetS) refers to the clustering of risk factors for cardiovascular disease and diabetes, including central adiposity, hypertension, dyslipidemia, and hyperglycemia. During the past 20 years, there have been parallel and epidemic increases in MetS and impaired sleep. This article describes evidence on the association between MetS and short sleep duration, circadian misalignment, insomnia, and sleep apnea. Potential mechanisms where impaired sleep desynchronizes and worsens metabolic control and interventions to improve sleep and potentially improve MetS are presented. 10.1016/j.cnur.2020.10.012
Molecular Biological and Clinical Understanding of the Pathophysiology and Treatments of Hyperuricemia and Its Association with Metabolic Syndrome, Cardiovascular Diseases and Chronic Kidney Disease. Yanai Hidekatsu,Adachi Hiroki,Hakoshima Mariko,Katsuyama Hisayuki International journal of molecular sciences Uric acid (UA) is synthesized mainly in the liver, intestines, and vascular endothelium as the end product of an exogenous purine from food and endogenously from damaged, dying, and dead cells. The kidney plays a dominant role in UA excretion, and the kidney excretes approximately 70% of daily produced UA; the remaining 30% of UA is excreted from the intestine. When UA production exceeds UA excretion, hyperuricemia occurs. Hyperuricemia is significantly associated with the development and severity of the metabolic syndrome. The increased urate transporter 1 (URAT1) and glucose transporter 9 (GLUT9) expression, and glycolytic disturbances due to insulin resistance may be associated with the development of hyperuricemia in metabolic syndrome. Hyperuricemia was previously thought to be simply the cause of gout and gouty arthritis. Further, the hyperuricemia observed in patients with renal diseases was considered to be caused by UA underexcretion due to renal failure, and was not considered as an aggressive treatment target. The evidences obtained by basic science suggests a pathogenic role of hyperuricemia in the development of chronic kidney disease (CKD) and cardiovascular diseases (CVD), by inducing inflammation, endothelial dysfunction, proliferation of vascular smooth muscle cells, and activation of the renin-angiotensin system. Further, clinical evidences suggest that hyperuricemia is associated with the development of CVD and CKD. Further, accumulated data suggested that the UA-lowering treatments slower the progression of such diseases. 10.3390/ijms22179221
Physical Activity, Cardiorespiratory Fitness, and the Metabolic Syndrome. Nutrients Both observational and interventional studies suggest an important role for physical activity and higher fitness in mitigating the metabolic syndrome. Each component of the metabolic syndrome is, to a certain extent, favorably influenced by interventions that include physical activity. Given that the prevalence of the metabolic syndrome and its individual components (particularly obesity and insulin resistance) has increased significantly in recent decades, guidelines from various professional organizations have called for greater efforts to reduce the incidence of this condition and its components. While physical activity interventions that lead to improved fitness cannot be expected to normalize insulin resistance, lipid disorders, or obesity, the combined effect of increasing activity on these risk markers, an improvement in fitness, or both, has been shown to have a major impact on health outcomes related to the metabolic syndrome. Exercise therapy is a cost-effective intervention to both prevent and mitigate the impact of the metabolic syndrome, but it remains underutilized. In the current article, an overview of the effects of physical activity and higher fitness on the metabolic syndrome is provided, along with a discussion of the mechanisms underlying the benefits of being more fit or more physically active in the prevention and treatment of the metabolic syndrome. 10.3390/nu11071652
Metabolic Syndrome: Updates on Pathophysiology and Management in 2021. Fahed Gracia,Aoun Laurence,Bou Zerdan Morgan,Allam Sabine,Bou Zerdan Maroun,Bouferraa Youssef,Assi Hazem I International journal of molecular sciences Metabolic syndrome (MetS) forms a cluster of metabolic dysregulations including insulin resistance, atherogenic dyslipidemia, central obesity, and hypertension. The pathogenesis of MetS encompasses multiple genetic and acquired entities that fall under the umbrella of insulin resistance and chronic low-grade inflammation. If left untreated, MetS is significantly associated with an increased risk of developing diabetes and cardiovascular diseases (CVDs). Given that CVDs constitute by far the leading cause of morbidity and mortality worldwide, it has become essential to investigate the role played by MetS in this context to reduce the heavy burden of the disease. As such, and while MetS relatively constitutes a novel clinical entity, the extent of research about the disease has been exponentially growing in the past few decades. However, many aspects of this clinical entity are still not completely understood, and many questions remain unanswered to date. In this review, we provide a historical background and highlight the epidemiology of MetS. We also discuss the current and latest knowledge about the histopathology and pathophysiology of the disease. Finally, we summarize the most recent updates about the management and the prevention of this clinical syndrome. 10.3390/ijms23020786
Associations of dietary inflammatory index with metabolic syndrome and its components: a systematic review and meta-analysis. Public health nutrition OBJECTIVE:Inflammation has been suggested to play an important role in the development and progression of metabolic syndrome (MetS). Dietary inflammatory index (DII), a measurement of inflammatory potential in diets, was suggested to be associated with MetS. The aim of this systematic review and meta-analysis was to establish the associations of DII with MetS and its components based on available observational studies. DESIGN:Systematic review and meta-analysis. SETTING:A comprehensive literature search of studies that assessed the associations between DII and MetS was conducted in PubMed, Medline and Embase, using a combination of search terms relating to DII and MetS. PARTICIPANTS:Eighteen articles were eligible, of which fourteen were cross-sectional and four were cohort in design. RESULTS:Results from the random effects meta-analysis showed significantly positive associations of higher DII (top v. bottom quartiles) with MetS (OR: 1·23 (95 % CI 1·10, 1·37)), abdominal obesity (OR: 1·15 (95 % CI 1·02, 1·29)), high blood pressure (OR: 1·17 (95 % CI 1·07, 1·29)), hyperglycaemia (OR: 1·18 (95 % CI 1·05, 1·33)) and hypertriacylglycerolaemia (OR: 1·17 (95 % CI 1·07, 1·28)). The effects of summary OR became stronger when analyses were restricted to cohorts, studies that adjudged for covariates (including BMI, physical activity and total energy intake). CONCLUSIONS:Higher DII, representing pro-inflammatory diet, is associated with higher odds of MetS and its components, except for low HDL-cholesterol. The findings prompt dietary interventions for preventing MetS from the aspect of inflammation. 10.1017/S1368980021000288
Pathobiological mechanisms underlying metabolic syndrome (MetS) in chronic obstructive pulmonary disease (COPD): clinical significance and therapeutic strategies. Pharmacology & therapeutics Chronic obstructive pulmonary disease (COPD) is a major incurable global health burden and is currently the 4th largest cause of death in the world. Importantly, much of the disease burden and health care utilisation in COPD is associated with the management of its comorbidities (e.g. skeletal muscle wasting, ischemic heart disease, cognitive dysfunction) and infective viral and bacterial acute exacerbations (AECOPD). Current pharmacological treatments for COPD are relatively ineffective and the development of effective therapies has been severely hampered by the lack of understanding of the mechanisms and mediators underlying COPD. Since comorbidities have a tremendous impact on the prognosis and severity of COPD, the 2015 American Thoracic Society/European Respiratory Society (ATS/ERS) Research Statement on COPD urgently called for studies to elucidate the pathobiological mechanisms linking COPD to its comorbidities. It is now emerging that up to 50% of COPD patients have metabolic syndrome (MetS) as a comorbidity. It is currently not clear whether metabolic syndrome is an independent co-existing condition or a direct consequence of the progressive lung pathology in COPD patients. As MetS has important clinical implications on COPD outcomes, identification of disease mechanisms linking COPD to MetS is the key to effective therapy. In this comprehensive review, we discuss the potential mechanisms linking MetS to COPD and hence plausible therapeutic strategies to treat this debilitating comorbidity of COPD. 10.1016/j.pharmthera.2019.02.013
Butyrate generated by gut microbiota and its therapeutic role in metabolic syndrome. Bridgeman Stephanie C,Northrop Wendy,Melton Phillip E,Ellison Gaewyn C,Newsholme Philip,Mamotte Cyril D S Pharmacological research Metabolic syndrome (MetS) and the associated incidence of cardiovascular disease and type 2 diabetes represents a significant contributor to morbidity and mortality worldwide. Butyrate, a short-chain fatty acid produced by the gut microbiome, has long been known to promote growth in farmed animals and more recently has been reported to improve body weight and composition, lipid profile, insulin sensitivity and glycaemia in animal models of MetS. In vitro studies have examined the influence of butyrate on intestinal cells, adipose tissue, skeletal muscle, hepatocytes, pancreatic islets and blood vessels, highlighting genes and pathways that may contribute to its beneficial effects. Butyrate's influences in these cells have been attributed primarily to its epigenetic effects as a histone deacetylase inhibitor, as well as its role as an agonist of free fatty acid receptors, but clear mechanistic evidence is lacking. There is also uncertainty whether results from animal studies can translate to human trials due to butyrate's poor systemic availability and rapid clearance. Hitherto, several small-scale human clinical trials have failed to show significant benefits in MetS patients. Further trials are clearly needed, including with formulations designed to improve butyrate's availability. Regardless, dietary intervention to increase the rate of butyrate production may be a beneficial addition to current treatment. This review outlines the current body of evidence on the suitability of butyrate supplementation for MetS, looking at mechanistic effects on the various components of MetS and highlighting gaps in the knowledge and roadblocks to its use in humans. 10.1016/j.phrs.2020.105174
Effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors: a systematic review and network meta-analysis. Reviews in cardiovascular medicine This study examines the effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors, to identify the most effective way of improving metabolic syndrome and preventing cardiovascular disease. We searched EMBASE, the Cochrane Library, PubMed, MEDLINE, Ovid, the Chinese Biological Medicine Database (CBM), the Wanfang Database, the China National Knowledge Infrastructure (CNKI) database, and the Chinese Scientific Journal Database (VIP), for randomized controlled trials (RCTs), identifying 15 comparing the effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors (e.g., glucose, triglyceride, blood pressure, body mass index, etc.). We assessed the quality of the articles and performed a network meta-analysis with a Bayesian random effects model to synthesize direct and indirect evidence. Combined exercise was most effective at controlling glucose and total triglyceride (TG) levels. Aerobic, resistance, and combined exercise groups achieved significant effects regarding body fat. Aerobic exercise was superior to resistance exercise regarding body mass index (BMI). There was no statistically significant difference in weight, waist circumference (WC), levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), insulin, systolic blood pressure (SBP), and diastolic blood pressure (DBP) among the exercise groups. Combined exercise was the best exercise scheme for improving weight, WC, DBP, TG, TC, glucose, and insulin levels. Resistance exercise was most effective at ameliorating body fat, LDL-C levels, and SBP. Aerobic exercise was the optimal way of improving BMI and HDL-C levels. This network meta-analysis suggests combined exercise is the most effective choice in improving the metabolic syndrome and cardiovascular risk parameters, whereas aerobic exercise reveals the minimum effect. Further studies should certify the role resistance exercises play in metabolic syndrome and cardiac rehabilitation. 10.31083/j.rcm2204156
Sedentary time and the risk of metabolic syndrome: A systematic review and dose-response meta-analysis. Obesity reviews : an official journal of the International Association for the Study of Obesity The dose-response association between sedentary time and the risk of metabolic syndrome is unclear, which indicates an important knowledge gap in public health. The objective of this study was to determine the categorical and continuous dose-response associations between sedentary time and the risk of metabolic syndrome. A systematic literature search of English articles published in PubMed, CINHAL, Embase, and Web of Science Core Collection prior to June 2022 was conducted. All cohort and cross-sectional studies that examined the association between sedentary time and the risk of metabolic syndrome were considered, and duplicate and non-related studies were excluded. Data extraction using a standardized chart and quality assessment using two appraisal tools were also performed. Two independent reviewers were involved in these processes. In categorical meta-analyses, the pooled effect sizes for metabolic syndrome associated with different categories of sedentary time were calculated by comparing the highest and intermediate with the lowest categories. In continuous meta-analyses, the linear and nonlinear dose-response associations were estimated using generalized least squares and restricted cubic spline models, respectively. Data were collected and analyzed from March to June 2022. Four prospective cohort studies and 22 cross-sectional studies with 105,239 participants and 16,185 MetS cases were included in this study. In categorical analyses, both intermediate (median duration: 4.11 h/day; pooled OR: 1.17, 95% CI: 1.08-1.26, P &lt; 0.001) and high levels (median duration: 7.26 h/day; pooled OR: 1.71, 95% CI: 1.43-2.04, P &lt; 0.001) of total sedentary time were significantly associated with an increased risk of metabolic syndrome. Similarly, a significant association between screen time and the risk of metabolic syndrome was also found in intermediate (median duration: 2.22 h/day; pooled OR: 1.20, 95% CI: 1.10-1.32, P &lt; 0.001) and high levels (median duration: 3.40 h/day; pooled OR: 1.63, 95% CI: 1.44-1.86, P &lt; 0.001) of exposure. Of note, these associations were significantly stronger in women. Different patterns of the behavior-disease association were not observed in children, adolescents, and adults. The findings of continuous meta-analyses could not provide solid evidence for the linearity and nonlinearity of the behavior-disease association. This study demonstrated that long-time sedentary behavior was associated with a higher risk of MetS independent of physical activity and the patterns of association varied by gender instead of age. These findings have implications for future guideline recommendations on physical activity, sedentary behavior, and prevention of metabolic syndrome. 10.1111/obr.13510
Hypertension in Metabolic Syndrome: Novel Insights. Katsimardou Alexandra,Imprialos Konstantinos,Stavropoulos Konstantinos,Sachinidis Alexandros,Doumas Michalis,Athyros Vasilios Current hypertension reviews BACKGROUND:Metabolic syndrome (MetS) is characterized by the simultaneous presence of obesity, hypertension, dyslipidemia and hyperglycemia in an individual, leading to increased cardiovascular disease (CVD) risk. It affects almost 35% of the US adult population, while its prevalence increases with age. Elevated blood pressure is the most frequent component of the syndrome; however, until now, the optimal antihypertensive regiment has not been defined. OBJECTIVE:The purpose of this review is to present the proposed definitions for the metabolic syndrome, as well as the prevalence of hypertension in this condition. Moreover, evidence regarding the metabolic properties of the different antihypertensive drug classes and their effect on MetS will be displayed. METHODS:A comprehensive review of the literature was performed to identify data from clinical studies for the prevalence, pathophysiology and treatment of hypertension in the metabolic syndrome. RESULTS:Hypertension is present in almost 80% of patients with metabolic syndrome. The use of thiazide diuretics and b-blockers has been discouraged in this population; however, new evidence suggests their use under specific conditions. Calcium channel blockers seem to exert a neutral effect on MetS, while renin-angiotensin system inhibitors are believed to be of the most benefit, although differences exist between the different agents of this category. CONCLUSION:Controversy still exists regarding the optimal antihypertensive treatment for hypertension in MetS. Due to the high prevalence of hypertension in this population, more data from clinical trials are needed in the future. 10.2174/1573402115666190415161813
The Roles and Associated Mechanisms of Adipokines in Development of Metabolic Syndrome. Kim Ji-Eun,Kim Jin-Sun,Jo Min-Jee,Cho Eunjung,Ahn Shin-Young,Kwon Young-Joo,Ko Gang-Jee Molecules (Basel, Switzerland) Metabolic syndrome is a cluster of metabolic indicators that increase the risk of diabetes and cardiovascular diseases. Visceral obesity and factors derived from altered adipose tissue, adipokines, play critical roles in the development of metabolic syndrome. Although the adipokines leptin and adiponectin improve insulin sensitivity, others contribute to the development of glucose intolerance, including visfatin, fetuin-A, resistin, and plasminogen activator inhibitor-1 (PAI-1). Leptin and adiponectin increase fatty acid oxidation, prevent foam cell formation, and improve lipid metabolism, while visfatin, fetuin-A, PAI-1, and resistin have pro-atherogenic properties. In this review, we briefly summarize the role of various adipokines in the development of metabolic syndrome, focusing on glucose homeostasis and lipid metabolism. 10.3390/molecules27020334
Adipose tissue inflammation and metabolic syndrome. The proactive role of probiotics. Torres Sebastian,Fabersani Emanuel,Marquez Antonela,Gauffin-Cano Paola European journal of nutrition PURPOSE:The first part of this review focuses on the role of cells and molecules of adipose tissue involved in metabolic syndrome-induced inflammation and in the maintenance of this pathology. In the second part of the review, the potential role of probiotics-modulating metabolic syndrome-related inflammatory components is summarized and discussed. METHODS:The search for the current scientific literature was carried out using ScienceDirect, PubMed, and Google Scholar search engines. The keywords used were: metabolic syndrome, obesity, insulin resistant, adipose tissue, adipose tissue inflammation, chronic low-grade inflammation, immune cells, adipokines, cytokines, probiotics, and gut microbiota. RESULTS AND CONCLUSIONS:Chronic low-grade inflammation that characterized metabolic syndrome can contribute to the development of the metabolic dysfunctions involved in the pathogenesis of its comorbidities. Adipose tissue is a complex organ that performs metabolic and immune functions. During metabolic syndrome, an imbalance in the inflammatory components of adipose tissue (immune cells, cytokines, and adipocytokines), which shift from an anti-inflammatory to a pro-inflammatory profile, can provoke metabolic syndrome linked complications. Further knowledge concerning the immune function of adipose tissue may contribute to finding better alternatives for the treatment or prevention of such disorders. The control of inflammation could result in the management of many of the pathologies related to metabolic syndrome. Due to the strong evidence that gut microbiota composition plays a role modulating the body weight, adipose tissue, and the prevalence of a low-grade inflammatory status, probiotics emerge as valuable tools for the prevention of metabolic syndrome and health recovery. 10.1007/s00394-018-1790-2
Lifestyle and Metabolic Syndrome: Contribution of the Endocannabinoidome. Di Marzo Vincenzo,Silvestri Cristoforo Nutrients Lifestyle is a well-known environmental factor that plays a major role in facilitating the development of metabolic syndrome or eventually exacerbating its consequences. Various lifestyle factors, especially changes in dietary habits, extreme temperatures, unusual light-dark cycles, substance abuse, and other stressful factors, are also established modifiers of the endocannabinoid system and its extended version, the endocannabinoidome. The endocannabinoidome is a complex lipid signaling system composed of a plethora (>100) of fatty acid-derived mediators and their receptors and anabolic and catabolic enzymes (>50 proteins) which are deeply involved in the control of energy metabolism and its pathological deviations. A strong link between the endocannabinoidome and another major player in metabolism and dysmetabolism, the gut microbiome, is also emerging. Here, we review several examples of how lifestyle modifications (westernized diets, lack or presence of certain nutritional factors, physical exercise, and the use of cannabis) can modulate the propensity to develop metabolic syndrome by modifying the crosstalk between the endocannabinoidome and the gut microbiome and, hence, how lifestyle interventions can provide new therapies against cardiometabolic risk by ensuring correct functioning of both these systems. 10.3390/nu11081956
Metabolic syndrome and cancer risk: The role of xanthine oxidoreductase. Battelli Maria Giulia,Bortolotti Massimo,Polito Letizia,Bolognesi Andrea Redox biology Obesity and related pathologies such as diabetes and metabolic syndrome are associated with chronic inflammation and cancer. The serum level of xanthine oxidoreductase (XOR) is correlated to obesity-associated metabolic disorders. XOR can play a role in the pathogenesis of both metabolic syndrome and cancer through the inflammatory response and the oxidative stress elicited by the products of its activity. The reactive oxygen and nitrogen species and the uric acid derived from XOR concur to the development of hypertension, dyslipidemia and insulin resistance and participate in both cell transformation and proliferation, as well as in the progression and metastasis process. Despite the availability of different drugs to inhibit in vivo XOR activity, the complexity of XOR inhibition effects should be carefully considered before clinical application, save in the case of symptomatic hyperuricemia. 10.1016/j.redox.2018.101070
Leisure-Time Physical Activity, Sedentary Behaviour and Diet Quality are Associated with Metabolic Syndrome Severity: The PREDIMED-Plus Study. Gallardo-Alfaro Laura,Bibiloni Maria Del Mar,Mascaró Catalina M,Montemayor Sofía,Ruiz-Canela Miguel,Salas-Salvadó Jordi,Corella Dolores,Fitó Montserrat,Romaguera Dora,Vioque Jesús,Alonso-Gómez Ángel M,Wärnberg Julia,Martínez J Alfredo,Serra-Majem Lluís,Estruch Ramon,Fernández-García José Carlos,Lapetra José,Pintó Xavier,García Ríos Antonio,Bueno-Cavanillas Aurora,Gaforio José J,Matía-Martín Pilar,Daimiel Lidia,Micó-Pérez Rafael M,Vidal Josep,Vázquez Clotilde,Ros Emilio,Fernandez-Lázaro Cesar Ignacio,Becerra-Tomás Nerea,Gimenez-Alba Ignacio Manuel,Zomeño María Dolors,Konieczna Jadwiga,Compañ-Gabucio Laura,Tojal-Sierra Lucas,Pérez-López Jéssica,Zulet M Ángeles,Casañas-Quintana Tamara,Castro-Barquero Sara,Gómez-Pérez Ana María,Santos-Lozano José Manuel,Galera Ana,Basterra-Gortari F Javier,Basora Josep,Saiz Carmen,Pérez-Vega Karla Alejandra,Galmés-Panadés Aina M,Tercero-Maciá Cristina,Sorto-Sánchez Carolina,Sayón-Orea Carmen,García-Gavilán Jesús,Muñoz-Martínez Júlia,Tur Josep A Nutrients Healthy lifestyle factors, such as physical activity (PA) and Mediterranean diet (MD), decrease the likelihood of developing metabolic syndrome (MetS). The aim of this study was to report main lifestyle components and related factors according to the MetS severity. Cross-sectional analysis was done of baseline lifestyle factors from 5739 participants with overweight/obesity and MetS features (aged 55-75 years) included in the PREDIMED-PLUS primary cardiovascular prevention randomized trial. Participants were categorized in tertiles according to a validated MetS severity score (MetSSS). Anthropometrics, visceral adiposity index, dietary nutrient intake, biochemical marker levels, as well as a Dietary Inflammatory Index and depression symptoms (Beck Depression Inventory-II) were measured. Diet quality was assessed using a 17-item energy-restricted MD questionnaire. Duration and intensity of PA was self-reported using the Minnesota-REGICOR Short Physical Activity Questionnaire. Sedentary behaviours were measured using the Spanish version of the Nurses' Health Study questionnaire. The 30 s chair stand test was also assessed. Participants with highest MetSSS showed higher values of cardiovascular risk factors (except for total cholesterol and LDL cholesterol), depression risk, sedentary and TV viewing time, and lower moderate and vigorous leisure-time physical activity (LTPA). Highest MetSSS participants tended to a pro-inflammatory dietary pattern and tended to lower MD adherence. In addition, they showed lower carbohydrate and nut intake and higher intake of protein, saturated and trans fatty acids, cholesterol, iodine, sodium, red and processed meat products, other oils different from olive oil and spirit alcoholic drinks. The highest MetS severity score was associated with lower moderate and vigorous LTPA and higher sedentary time and depression risk, as they tended to a pro-inflammatory dietary pattern and lower MD adherence. 10.3390/nu12041013
Metabolic Syndrome and Cognitive Function. Tahmi Mouna,Palta Priya,Luchsinger José A Current cardiology reports PURPOSE OF REVIEW:Metabolic syndrome (MetS) is a cluster of cardiovascular disease risk factors that are related to several adverse health outcomes, including poor cognitive function. This review seeks to summarize and critically review select recent findings on the association between MetS and cognition. RECENT FINDINGS:MetS was associated with lower domain-specific and global cognitive function in most cross-sectional studies, but findings from longitudinal studies are not consistent. The associations varied depending on age, sex, cognitive test, genetic susceptibility, and the duration of follow-up in prospective studies. MetS was associated with a higher risk of mild cognitive impairment (MCI) and progression from MCI to dementia, particularly vascular dementia. Among MetS components, high blood pressure, high waist circumference, and hyperglycemia were the strongest predictors of cognitive function. MetS is associated with higher risk of cognitive impairment. Research is needed on how preventing or treating MetS affects cognition. 10.1007/s11886-021-01615-y
Early-Life Origins of Metabolic Syndrome: Mechanisms and Preventive Aspects. International journal of molecular sciences One of the leading global public-health burdens is metabolic syndrome (MetS), despite the many advances in pharmacotherapies. MetS, now known as "developmental origins of health and disease" (DOHaD), can have its origins in early life. Offspring MetS can be programmed by various adverse early-life conditions, such as nutrition imbalance, maternal conditions or diseases, maternal chemical exposure, and medication use. Conversely, early interventions have shown potential to revoke programming processes to prevent MetS of developmental origins, namely reprogramming. In this review, we summarize what is currently known about adverse environmental insults implicated in MetS of developmental origins, including the fundamental underlying mechanisms. We also describe animal models that have been developed to study the developmental programming of MetS. This review extends previous research reviews by addressing implementation of reprogramming strategies to prevent the programming of MetS. These mechanism-targeted strategies include antioxidants, melatonin, resveratrol, probiotics/prebiotics, and amino acids. Much work remains to be accomplished to determine the insults that could induce MetS, to identify the mechanisms behind MetS programming, and to develop potential reprogramming strategies for clinical translation. 10.3390/ijms222111872
Metabolic Syndrome and Reproduction. Lotti Francesco,Marchiani Sara,Corona Giovanni,Maggi Mario International journal of molecular sciences Metabolic syndrome (MetS) and infertility are two afflictions with a high prevalence in the general population. MetS is a global health problem increasing worldwide, while infertility affects up to 12% of men. Despite the high prevalence of these conditions, the possible impact of MetS on male fertility has been investigated by a few authors only in the last decade. In addition, underlying mechanism(s) connecting the two conditions have been investigated in few preclinical studies. The aim of this review is to summarize and critically discuss available clinical and preclinical studies on the role of MetS (and its treatment) in male fertility. An extensive Medline search was performed identifying studies in the English language. While several studies support an association between MetS and hypogonadism, contrasting results have been reported on the relationship between MetS and semen parameters/male infertility, and the available studies considered heterogeneous MetS definitions and populations. So far, only two meta-analyses in clinical and preclinical studies, respectively, evaluated this topic, reporting a negative association between MetS and sperm parameters, testosterone and FSH levels, advocating, however, larger prospective investigations. In conclusion, a possible negative impact of MetS on male reproductive potential was reported; however, larger studies are needed. 10.3390/ijms22041988
Definition and early diagnosis of metabolic syndrome in children. Christian Flemming Gunter Matthias,Bussler Sarah,Körner Antje,Kiess Wieland Journal of pediatric endocrinology & metabolism : JPEM With this review, we aim to focus the attention on some established as well as new concepts for the metabolic syndrome (MetS) in children and adolescents spanning from definition to recommendations for the diagnostic approach. Even though there is no international commonly used definition of the metabolic syndrome in children and adolescents, all definitions include obesity as precondition for the development of MetS even in children. Obesity is one of the major cardiometabolic risk factors and it is strongly linked to other metabolic diseases like hyperlipidemia, hyperinsulinemia as well as hypertension. The metabolic syndrome is commonly known as a constellation of the mentioned morbidities. Pediatricians and researchers agree that early diagnosis and early interventions of the MetS are important to improve the prevention of cardiovascular disease and type 2 diabetes in adulthood. However, this requires appropriate screening tools for children and adolescents at risk for the MetS and its comorbidities. Due to controversies regarding the definition of MetS and the lack of consensus thresholds for the single components in children and adolescents, there is no internationally accepted diagnostic pathway for MetS available. However, several consensus statements and national guidelines for the assessment of obesity and its comorbidities in children and adolescents are available. Obesity seems to be the driving factor for the development of the other risk factors of MetS. In order to avoid conflicts concerning the definition of overweight and obesity, we recommend using the WHO definition of overweight (one standard deviation body mass index for age and sex and obesity; two standard deviations body mass index for age and sex) in children and adolescents. 10.1515/jpem-2019-0552
Bile acids and the metabolic syndrome. McGlone Emma Rose,Bloom Stephen R Annals of clinical biochemistry Bile acids have important roles in the regulation of lipid, glucose and energy metabolism. Metabolic diseases linked to obesity, including type 2 diabetes mellitus and non-alcoholic fatty liver disease, are associated with dysregulation of bile acid homeostasis. Here, the basic chemistry and regulation of bile acids as well as their metabolic effects will be reviewed. Changes in circulating bile acids associated with obesity and related diseases will be reviewed. Finally, pharmaceutical manipulation of bile acid homeostasis as therapy for metabolic diseases will be outlined. 10.1177/0004563218817798
Metabolic syndrome and cardiovascular diseases: Going beyond traditional risk factors. Silveira Rossi João Leonardo,Barbalho Sandra Maria,Reverete de Araujo Renan,Bechara Marcelo Dib,Sloan Kátia Portero,Sloan Lance Alan Diabetes/metabolism research and reviews Metabolic syndrome (MS) is a chronic non-infective syndrome characterised clinically by a set of vascular risk factors that include insulin resistance, hypertension, abdominal obesity, impaired glucose metabolism, and dyslipidaemia. These risk factors are due to a pro-inflammatory state, oxidative stress, haemodynamic dysfunction, and ischaemia, which overlap in 'dysmetabolic' patients. This review aimed to evaluate the relationship between the traditional components of MS with cardiovascular disease (CVD), inflammation, and oxidative stress. MEDLINE-PubMed, EMBASE, and Cochrane databases were searched. Chronic low-grade inflammatory states and metaflammation are often accompanied by metabolic changes directly related to CVD incidence, such as diabetes mellitus, hypertension, and obesity. Moreover, the metaflammation is characterised by an increase in the serum concentration of pro-inflammatory cytokines, mainly interleukin-1 β (IL-1β), IL-6, and tumour necrosis factor-α (TNF-α), originating from the chronically inflamed adipose tissue and associated with oxidative stress. The increase of reactive oxygen species overloads the antioxidant systems causing post-translational alterations of proteins, lipids, and DNA leading to oxidative stress. Hyperglycaemia contributes to the increase in oxidative stress and the production of advanced glycosylation end products (AGEs) which are related to cellular and molecular dysfunction. Oxidative stress and inflammation are associated with cellular senescence and CVD. CVD should not be seen only as being triggered by classical MS risk factors. Atherosclerosis is a multifactorial pathological process with several triggering and aetiopathogenic mechanisms. Its medium and long-term repercussions, however, invariably constitute a significant cause of morbidity and mortality. Implementing preventive and therapeutic measures against oxy-reductive imbalances and metaflammation states has unquestionable potential for favourable clinical outcomes in cardiovascular medicine. 10.1002/dmrr.3502
Metabolic Syndrome Pathophysiology and Predisposing Factors. Bovolini António,Garcia Juliana,Andrade Maria Amparo,Duarte José Alberto International journal of sports medicine Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors with high prevalence among adult populations and elevated costs for public health systems worldwide. Despite the lack of consensus regarding the syndrome definition and diagnosis criteria, it is characterized by the coexistence of risk factors such as abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, a prothrombotic and pro-inflammatory state, insulin resistance (IR), and higher glucose levels, factors indubitably linked to an increased risk of developing chronic conditions, such as type 2 diabetes (T2D) and cardiovascular disease (CVD). The syndrome has a complex and multifaceted origin not fully understood; however, it has been strongly suggested that sedentarism and unbalanced dietary patterns might play a fundamental role in its development. The purpose of this review is to provide an overview from the syndrome epidemiology, costs, and main etiological traits from its relationship with unhealthy diet patterns and sedentary lifestyles. 10.1055/a-1263-0898
Role of the Circadian Clock in the Metabolic Syndrome and Nonalcoholic Fatty Liver Disease. Shetty Akshay,Hsu Jennifer W,Manka Paul P,Syn Wing-Kin Digestive diseases and sciences Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in industrialized nations and is strongly associated with the metabolic syndrome. The prevalence of NAFLD continues to rise along with the epidemic of the metabolic syndrome. Metabolic homeostasis is linked to the circadian clock (rhythm), with multiple signaling pathways in organs regulated by circadian clock genes, and recent studies of circadian clock gene functions suggest that disruption of the circadian rhythm is associated with significant morbidity and mortality, including the metabolic syndrome. In the industrialized world, various human behaviors and activities such as work and eating patterns, jet lag, and sleep deprivation interfere with the circadian rhythm, leading to perturbations in metabolism and development of the metabolic syndrome. In this review, we discuss how disruption of the circadian rhythm is associated with various metabolic conditions that comprise the metabolic syndrome and NAFLD. 10.1007/s10620-018-5242-x
Electrodiagnosis in the Patient with Metabolic Syndrome: Adding Value to Patient Care. Barr Karen P Physical medicine and rehabilitation clinics of North America Patients with metabolic syndrome are at increased risk of peripheral neuropathy; entrapment neuropathies, such as carpal tunnel syndrome; and spine disease that can lead to radiculopathy or spinal stenosis. Electrodiagnostic studies are a valuable part of patient care in this population. They can confirm suspected diagnoses, uncover additional conditions, and lead to the diagnosis of other causes of neuropathy that require treatment. By assessing the severity of neuropathy, patients at high risk for falls, functional decline, and foot ulcers are identified to guide prevention, treatment, and patient education. 10.1016/j.pmr.2018.06.008
Nutrition-based interventions to address metabolic syndrome in the Navajo: a systematic review. Nava Lorenzo T,Zambrano Jenelle M,Arviso Karen P,Brochetti Denise,Becker Kathleen L Journal of clinical nursing AIMS AND OBJECTIVES:The objective of this systematic review is to identify nutrition-based interventions that may be effective for the prevention and treatment of metabolic syndrome in the Navajo. BACKGROUND:Metabolic syndrome, a major risk factor for cardiovascular disease, affects almost half of the Navajo population. The diet of the Navajo, heavy in fat and refined carbohydrates, has been identified as an important contributing factor to the high rates of metabolic syndrome in this population. DESIGN:A search was conducted on PubMed, EMBASE and CINAHL to identify studies published before October, 2013, involving nutrition-based interventions in adult populations similar to the Navajo targeting at least one measure of metabolic syndrome. METHODS:Data on efficacy and participation were gathered and synthesised qualitatively. RESULTS:Out of 19 studies included in this systematic review, 11 interventions were identified to be effective at improving at least one measure of metabolic syndrome. Level of exposure to the intervention, frequency of intervention activities, family and social support, cultural adaptation and case management were identified as factors that may improve the efficacy of an intervention. CONCLUSIONS:Multiple nutrition-based interventions have been found to be effective in populations similar to the Navajo. RELEVANCE TO CLINICAL PRACTICE:Development of a strategy to address metabolic syndrome in the Navajo may involve aspects from multiple interventions to increase efficacy and maximise participation. 10.1111/jocn.12921
Epigenetic manifestation of metabolic syndrome and dietary management. Chaudhary Nidhi,Nakka Kiran Kumar,Maulik Nilanjana,Chattopadhyay Samit Antioxidants & redox signaling SIGNIFICANCE:Metabolic syndrome constitutes a group of disorders such as insulin resistance, hypertension, and hypertriglyceridemia, predisposing an individual to risk factors such as cardiovascular disease, diabetes, obesity, and dyslipidemia. A majority of these diseases are influenced by the environmental factors, nutrient uptake, and genetic profile of an individual that together dysregulate gene function. These genetic and nongenetic factors are reported to introduce epigenetic cues that modulate the gene function which is inherited by the offspring. RECENT ADVANCES:Considering the epigenetic modulation of the metabolic disorders, nutrigenomics has been distinctly categorized as a branch that deals with modulatory effect of nutrients on metabolic disorders and disease progression by supplementing the individuals with key nutrient-enriched diets which are derived from plant and animal sources. CRITICAL ISSUES:Nutritional components of the diet regulate the metabolic health of an individual either by controlling the expression of some key genes related to metabolic pathways or by modulating the epigenetic events on such genes. The present article discusses various metabolic disorders in detail and the effect of nutrients on the specific genes causing those disorders. We also highlight the molecular mechanisms of some metabolic disorders through epigenetic modifications and possible therapeutic interventions. FUTURE DIRECTIONS:With the advent of high-throughput technologies and epigenetic modulation of the metabolic disorders, an altered epigenetic code that is programmed due to improper nutrients can be reverted back by supplementing the diet with various plant-derived compounds. The implication of small molecular drugs is also of utmost significance for challenging the metabolic disorders. 10.1089/ars.2011.4387
The metabolic syndrome, hyperlipidemia, and insulin resistance. Fonseca Vivian A Clinical cornerstone The metabolic syndrome is a cluster of cardiovascular risk factors associated with obesity. The defining components of the metabolic syndrome, according to the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), are elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose. The pathophysiologic basis of metabolic syndrome is complex and reflects several interrelated disturbances of glucose and lipid homeostasis. Metabolic syndrome is prevalent in the United States and developed nations, and patients with this disorder are at risk for type 2 diabetes mellitus and cardiovascular disease, underscoring the need for prompt patient identification and management. The first-line approach to control of metabolic syndrome is weight control and exercise. A wide range of pharmacologic interventions (eg, statins, antihypertensive drugs, insulin sensitizers, and thiazolidinediones) have been shown to be effective in controlling the individual components of metabolic syndrome. Obesity, which is a necessary component of metabolic syndrome, has reached epidemic proportions in the United States. Although lifestyle management or medications can control the underlying risk factors and most of the components of metabolic syndrome, long-term weight loss is difficult to achieve. Several promising pharmacologic interventions that may have an important role in the management of metabolic syndrome by treating adipose tissue-mediated metabolic disturbances are in the early stages of development. 10.1016/s1098-3597(05)80069-9
The metabolic syndrome: A high-risk state for cancer? Cowey Stephanie,Hardy Robert W The American journal of pathology The metabolic syndrome is composed of cardiovascular risk factors including increased body mass index/waist circumference, blood pressure, plasma glucose, and triglycerides, as well as decreased high-density lipoprotein cholesterol. The essence of the metabolic syndrome lies in the clustering of these risk factors, which are associated with cardiovascular disease. Interestingly, most of the components of the metabolic syndrome have individually been linked in some way to the development of cancer. However, epidemiological studies linking the metabolic syndrome to cancer are scarce. Nevertheless, two such studies indicate that the clustering of metabolic syndrome components significantly increases the risk of colon cancer mortality compared with the individual components. The purpose of this review is to further explore the potential relationship between the metabolic syndrome and cancer risk. Specifically, we examine the hypothesis that individual components of the metabolic syndrome contribute to the development of several processes, including insulin resistance, aromatase activity, adipokine production, angiogenesis, glucose utilization, and oxidative stress/DNA damage, which can work together to increase cancer risk beyond that of the individual components alone. We propose that the metabolic syndrome be considered as a high-risk state for certain types of cancer and that this relationship should be systematically explored across cancer types. 10.2353/ajpath.2006.051090
Clinical features of metabolic syndrome in patients with Parkinson's disease. Meléndez-Flores J D,Castillo-Torres S A,Cerda-Contreras C,Chávez-Luévanos B,Estrada-Bellmann I Revista de neurologia INTRODUCTION:Focus on the metabolic causes underlying dopaminergic cell loss in Parkinson's disease (PD) has increased lately. Glucose imbalances have been shown to be present in patients with PD. A syndrome characterized principally by insulin resistance and glucose dysregulations is metabolic syndrome. Scarce literature has evaluated the relation between these two diseases. AIM:To determine the prevalence and clinical features of metabolic syndrome and its components in patients with PD. PATIENTS AND METHODS:We analyzed data from 99 patients with PD diagnosis. Scales that evaluate motor, non-motor, and cognitive function, as well as sleep disorders and quality of life were registered. Metabolic syndrome was diagnosed according to the World Health Organization criteria. RESULTS:Metabolic syndrome was reported in 8% of the population. When subdividing patients based on positivity to metabolic syndrome criteria, no significant differences in motor and cognitive function, as well as quality of life and sleep disorders were observed between groups. However, patients with metabolic syndrome showed worse scores in Non-Motor Symptom Scale compared to patients without the syndrome, especially gastrointestinal, mood/apathy, sexual function, perceptual and miscellaneous symptoms. No significant differences in clinical correlates were observed when grouping patients based on which single metabolic syndrome component was present. CONCLUSION:Metabolic syndrome might have an effect on non-motor symptomatology in PD, as patients with metabolic syndrome showed worse scores in Non-Motor Symptom Scale. 10.33588/rn.7201.2020323
Revisiting the metabolic syndrome. Chew Gerard T,Gan Seng Khee,Watts Gerald F The Medical journal of Australia Metabolic syndrome (MS) refers to the clustering of cardiometabolic risk factors - including abdominal obesity, hyperglycaemia, dyslipidaemia and elevated blood pressure - that are thought to be linked to insulin resistance. MS is associated with increased risk of cardiovascular disease and type 2 diabetes. MS is common, affecting a quarter to a third of adults, and its prevalence is rising, in parallel with increasing obesity and population ageing. Operational definitions of MS have been proposed by the World Health Organization and the National Cholesterol Education Program. Recently, the International Diabetes Federation proposed a global definition that emphasised the importance of central adiposity. In cardiovascular risk assessment, MS encapsulates the contribution of non-traditional risk factors and provides a clinically useful framework for early identification of people at increased long-term risk. It should be used in conjunction with standard algorithms based on conventional risk factors, which better predict short-term risk. Management of MS should emphasise lifestyle interventions (eg, physical activity, healthy diet and weight reduction) to reduce long-term risk of cardiovascular disease and diabetes. Those at increased short-term risk should also have individual risk factors treated according to established guidelines. 10.5694/j.1326-5377.2006.tb00644.x
A review of the metabolic syndrome. Balkau B,Valensi P,Eschwège E,Slama G Diabetes & metabolism While the concept of this syndrome has been described more than 60 years ago, and more formally almost 20 years ago, the controversy continues as to its utility, which of the various syndrome definitions should be used and their ability to predict diabetes and/or cardiovascular disease. The metabolic syndrome, of cardiovascular risk factors, provides an early warning of at risk subjects and emphasises the need to treat more aggressively (by at least lifestyle modification) patients with multiple abnormalities even though the abnormalities might be slight. Further, the syndrome can be easily used in clinical practice and when it is assessed against the background of the patient's age, sex and smoking habits, it provides an evaluation of potential cardiovascular risk. Prospective intervention studies are the only means of definitively accepting or refuting the usefulness of the syndrome. The metabolic syndrome is an entity which merits attention from both the medical profession and public health authorities. 10.1016/j.diabet.2007.08.001
The metabolic syndrome in women. Bentley-Lewis Rhonda,Koruda Katherine,Seely Ellen W Nature clinical practice. Endocrinology & metabolism The metabolic syndrome is estimated to be present in 47 million US residents with a similar age-adjusted prevalence in men (24%) and women (23%). The consideration of various metabolic risk factors as a single entity in the metabolic syndrome provides clinicians with a tool by which they can identify a population at increased risk for type 2 diabetes mellitus and increased cardiovascular morbidity and mortality. Cardiovascular disease is the leading cause of mortality in women in the US. To reduce the risk of cardiovascular disease, efforts have focused on modifying the metabolic risk factors that constitute the metabolic syndrome: abdominal obesity, dyslipidemia, glucose intolerance, and hypertension. In addition, because of several circumstances specific to women, including pregnancy, polycystic ovary syndrome, oral contraceptive therapy use, and menopause, there are special considerations regarding risk factor identification, modification, and clinical management. This article provides a review of diagnostic and therapeutic issues that clinicians should consider when caring for women at risk for developing or diagnosed with the metabolic syndrome. 10.1038/ncpendmet0616
Metabolic syndrome and risk of prostate cancer: a systematic review and meta-analysis. Panminerva medica INTRODUCTION:Emerging evidence supports the hypothesis that metabolic syndrome is associated with cancer pathogenesis. In particular regarding prostate cancer, observational studies from various settings report different results. This systematic review and meta-analysis aimed to provide a quantitative estimate of the association between metabolic syndrome in prostate cancer, in particular Gleason Score >6, accounting for different study designs. EVIDENCE ACQUISITION:Systematic research of available literature in English language until 2020 was conducted through in Embase, Medline, Cochrane Library and NIH Registry of Clinical Trials. For each study, information regarding the study design, the population, the definition of metabolic syndrome, data relating to prostate cancer were collected, the association between MetS and outcome of interest was determined by calculating the generic inverse variance with random effects method. EVIDENCE SYNTHESIS:In the final sample 19 studies were included with total of 114,329 patients, 29.4% met the criteria for metabolic syndrome. We report a significant association between metabolic syndrome and prostate cancer in cross-sectional studies (OR=1.30; 95% CI: 1.13-1.49) and for patients with clinically significant prostate cancer (OR=1.56; 95% CI: 1.23-1.99). Association between metabolic syndrome and prostate cancer combining all studies, in cohort studies and case-control studies was not significant. CONCLUSIONS:Growing evidence support the association between metabolic syndrome and prostate cancer, bias derived from observational studies might conceal further findings. 10.23736/S0031-0808.21.04507-9
Renal Impairment in Patients with Metabolic Syndrome after Living Kidney Donation: A Systematic Review. Alajlan Fadiyah Abdullah,Aljulifi Mohammed Zaid,Mahzari Moeber Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia Metabolic syndromes are considered a significant risk factor for renal impairment in renal transplant patients. However, the impact of metabolic syndrome on long-term kidney function is still unclear. This study aims to review the medical literature to investigate the long-term impact of metabolic syndrome on renal impairment in kidney donors. The literature was evaluated through PubMed, Embase, Cochrane, and CINAHL databases in the duration between 1990 and May 2019. Searching terms included synonyms and components for "metabolic syndrome," "renal impairment," "kidney donors," combined with the operators "OR" and "AND." Following this, results were refined to include only original research articles evaluating the long-term effects of kidney donation on kidney function in donors with metabolic syndrome. Eligible trials mentioned the exact duration of follow-up. A total of 820 articles were recovered. After the exclusion of articles on animals and including only analyses on humans, 38 studies appeared. A total of eight studies were considered eligible, covering a total of 1574 living donors with metabolic syndrome. Two studies were observational cohort, while three studies were retrospective and three randomized controlled studies. Living donors with metabolic syndrome are at risk of reduced renal functions of the remaining kidney after donation, with obesity appearing to be the significant contributor. Further randomized controlled studies with a longer follow-up duration are required. 10.4103/1319-2442.336756
Psoriasis and Metabolic Syndrome--scientific evidence and therapeutic implications. Voiculescu V M,Lupu M,Papagheorghe L,Giurcaneanu C,Micu E Journal of medicine and life Psoriasis is a chronic inflammatory disease, predominantly affecting the skin, being included in the group of Immune Mediated Inflammatory Diseases. Growing evidence from the last 10 years suggests that several systemic conditions like metabolic syndrome, cardiovascular disease, diabetes, psychological disorders or inflammatory bowel disease are prevalent in psoriasis patients. The linker might be the chronic secretion of pro-inflammatory cytokines. In this current review, the scientific evidence that explains the relationship between psoriasis and the metabolic syndrome in particular will be addressed, as the metabolic syndrome comprises a group of risk factors for cardiovascular disease, thus offering an overall picture of the systemic involvement in psoriasis. An integrated approach, with an early detection and treatment of the components of the metabolic syndrome, are important steps in psoriasis management. Attention should be paid on influence of psoriasis treatment upon comorbidities and vice-versa.
Metabolic Syndrome: Foreword. Williams Tracy,Walling Anne,Bragg Dee Ann,Mayans Laura,Mortada Rami FP essentials
The future of the metabolic syndrome. Schwarz P E H,Bornstein S R,Hanefeld M Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme 10.1055/s-0029-1192042
The metabolic syndrome: a glance at its history. Sarafidis Panteleimon A,Nilsson Peter M Journal of hypertension Although the modern era of what we now call the 'metabolic syndrome' or the 'insulin resistance syndrome' seems to have started less than two decades ago with the description of syndrome X by G.M. Reaven in the late 1980s, the history of this syndrome is much longer. In particular, a considerable number of scientists, starting as early as almost 90 years ago, have described the very common coexistence of the various components of the syndrome, including hypertension, and some of them gave several names to this clustering. On the other hand, during the past few years several international organizations have tried to form a reference context of what is included under the terms 'metabolic syndrome' and 'insulin resistance syndrome', proposing various 'definitions' for them. This review summarizes the history of the syndrome, from the early descriptions and other valuable contributions to the recent attempts to define it, as a small piece in honour of the pioneer workers in this field during the twentieth century. 10.1097/01.hjh.0000217840.26971.b6
Metabolic comorbidity, the new enemy. Metabolic syndrome and steatohepatitis. Rivera Esteban J M,Augustin Recio S Revista espanola de sanidad penitenciaria 10.18176/resp.00010
The Role of microRNAs in Metabolic Syndrome-Related Oxidative Stress. Włodarski Adam,Strycharz Justyna,Wróblewski Adam,Kasznicki Jacek,Drzewoski Józef,Śliwińska Agnieszka International journal of molecular sciences Oxidative stress (OxS) is the cause and the consequence of metabolic syndrome (MetS), the incidence and economic burden of which is increasing each year. OxS triggers the dysregulation of signaling pathways associated with metabolism and epigenetics, including microRNAs, which are biomarkers of metabolic disorders. In this review, we aimed to summarize the current knowledge regarding the interplay between microRNAs and OxS in MetS and its components. We searched PubMed and Google Scholar to summarize the most relevant studies. Collected data suggested that different sources of OxS (e.g., hyperglycemia, insulin resistance (IR), hyperlipidemia, obesity, proinflammatory cytokines) change the expression of numerous microRNAs in organs involved in the regulation of glucose and lipid metabolism and endothelium. Dysregulated microRNAs either directly or indirectly affect the expression and/or activity of molecules of antioxidative signaling pathways (SIRT1, FOXOs, Keap1/Nrf2) along with effector enzymes (e.g., GPx-1, SOD1/2, HO-1), ROS producers (e.g., NOX4/5), as well as genes of numerous signaling pathways connected with inflammation, insulin sensitivity, and lipid metabolism, thus promoting the progression of metabolic imbalance. MicroRNAs appear to be important epigenetic modifiers in managing the delicate redox balance, mediating either pro- or antioxidant biological impacts. Summarizing, microRNAs may be promising therapeutic targets in ameliorating the repercussions of OxS in MetS. 10.3390/ijms21186902
A Review of Metabolic Syndrome Research in Malaysia. Lim K G,Cheah W K The Medical journal of Malaysia Seventy-three articles related to metabolic syndrome were found in a search through databases dedicated to indexing all literature with original data involving the Malaysian population between years 2000 and 2015. Metabolic syndrome affects 25 to 40% of adult population of Malaysia with the risk increasing with age. Obese children are also at risk. Indian ethnicity has the highest rates, followed by Malay and chinese. It was found that socioeconomics determinants such as living in urban areas, unemployment, lower income, lower education level and shift workers had higher prevalence of metabolic syndrome. Metabolic syndrome is associated with other medical conditions like cardiovascular diseases, psychiatric disorders, erectile dysfunction, polycystic ovarian syndrome and colorectal cancer. Several biomarkers have been determined to be relevant to our local population but their usage in clinical setting needs further research. Literature into effectiveness of management of metabolic syndrome in Malaysia is lacking and the results were only modest. there are several diagnostic criteria available for metabolic syndrome internationally and their individual significant to our local population is not clear. It also makes it difficult to compare results between studies using different criteria. Finally, we could not identify any local study to look at the health economic burden of metabolic syndrome locally.
Metabolic syndrome in pediatrics: old concepts revised, new concepts discussed. D'Adamo Ebe,Santoro Nicola,Caprio Sonia Pediatric clinics of North America The worldwide epidemic of childhood obesity in the last decades is responsible for the occurrence in pediatrics of disorders once mainly found in adults, such as the metabolic syndrome. A key factor in the pathogenesis of metabolic syndrome is insulin resistance, a phenomenon occurring mainly in obese subjects with a general resistance to the insulin effect only on carbohydrates metabolism. Given that the metabolic syndrome is driven by obesity, the prevalence of the latter will strongly influence the prevalence of metabolic syndrome. This article addresses the causes of metabolic syndrome and the relevance of obesity in the pediatric population. 10.1016/j.pcl.2011.07.005
Metabolic syndrome: definition and therapeutic implications. Prasad Hari,Ryan Debra A,Celzo Ma Florence,Stapleton Dwight Postgraduate medicine The collection of impaired glucose metabolism, central obesity, elevated blood pressure, and dyslipidemia is identified as metabolic syndrome (MetS). It is estimated that approximately 25% of the world's population has MetS. In the United States, MetS is more common in men and Hispanics, and its incidence increases with age. Metabolic syndrome increases the risk of developing cardiovascular disease and type 2 diabetes mellitus. The underlying risk factors include insulin resistance and abdominal obesity. Confusion about MetS exists in part due to the lack of a consensus definition and treatment protocol. Treatment of MetS begins with therapeutic lifestyle changes and then pharmacologic treatment of the syndrome's individual components. Effective interventions include diet modification, exercise, and use of pharmacologic agents to treat risk factors. Weight loss and increasing physical activity significantly improve all aspects of MetS. A diet that includes more fruits, vegetables, whole grains, monounsaturated fats, and low-fat dairy products will benefit most patients with MetS. Physicians can be most effective in advising patients by customizing specific lifestyle recommendations after assessing patients for the presence of risk factors. 10.3810/pgm.2012.01.2514
Gut microbiome and metabolic syndrome. Mazidi Mohsen,Rezaie Peyman,Kengne Andre Pascal,Mobarhan Majid Ghayour,Ferns Gordon A Diabetes & metabolic syndrome The gut microbiome contributes approximately 2kg of the whole body weight, and recent studies suggest that gut microbiota has a profound effect on human metabolism, potentially contributing to several features of the metabolic syndrome. Metabolic syndrome is defined by a clustering of metabolic disorders that include central adiposity with visceral fat accumulation, dyslipidemia, insulin resistance, dysglycemia and non-optimal blood pressure levels. Metabolic syndrome is associated with an increased risk of cardiovascular diseases and type 2 diabetes. It is estimated that around 20-25 percent of the world's adult population has metabolic syndrome. In this manuscript, we have reviewed the existing data linking gut microbiome with metabolic syndrome. Existing evidence from studies both in animals and humans support a link between gut microbiome and various components of metabolic syndrome. Possible pathways include involvement with energy homeostasis and metabolic processes, modulation of inflammatory signaling pathways, interferences with the immune system, and interference with the renin-angiotensin system. Modification of gut microbiota via prebiotics, probiotics or other dietary interventions has provided evidence to support a possible beneficial effect of interventions targeting gut microbiota modulation to treat components or complications of metabolic syndrome. 10.1016/j.dsx.2016.01.024
Anti-cancer therapy-induced metabolic syndrome. Vnitrni lekarstvi The increasing number of long-term survivors that underwent the anti-cancer therapy faces the late treatment-related adverse effects and the increased risk of developing metabolic syndrome. This article defines the pathophysiology that underlies development of anti-cancer therapy-related metabolic syndrome and outlines the possibility of optimisation of comprehensive care focusing on prevention. Considering the preventability of metabolic syndrome, effective screening and follow-up appropriate for patients at increased risk of related adverse events should be established. Subsequently, early initiation of therapy targeting the hallmarks of metabolic syndrome may ease its manifestation in long-term perspective.
Metabolic syndrome and urological diseases. Panminerva medica 10.23736/S0031-0808.21.04638-3
Metabolic syndrome: dietary interventions. Aude Y Wady,Mego Pedro,Mehta Jawahar L Current opinion in cardiology PURPOSE OF REVIEW:Metabolic syndrome affects almost a quarter of the adult American population and its incidence is rising in the rest of the world. Its treatment involves both pharmacologic and nonpharmacologic interventions. In this review the authors focus on foods with potential benefits for this disease. RECENT FINDINGS:Metabolic syndrome is associated with the risk of diabetes, and thus cardiovascular disease. In recent years, many scientific studies have evaluated the role of different foods and diets in the treatment of the components of metabolic syndrome, especially atherogenic dyslipidemia. SUMMARY:It is imperative to identify strategies that favorably impact this deadly syndrome. Here the authors review how different nutrients in food can modify metabolic syndrome, potentially altering its natural history, and related consequences. Although there is no "all-inclusive" diet yet, it seems plausible that a Mediterranean-style diet exhibits most of the desired attributes. 10.1097/01.hco.0000134610.68815.05
The Metabolic Syndrome and the Relevance of Nutrients for its Onset. Schnack Lauren L,Romani Andrea M P Recent patents on biotechnology BACKGROUND:Metabolic Syndrome is a pathological condition characterized by the copresence of various dysmetabolic and pathological processes including hypertension, dyslipidemia, type 2 diabetes mellitus, obesity, and cardiovascular complications. Because these conditions manifest themselves differently in a given patient, the ensuing pathophysiological state varies from patient to patient. Consequently, the order in which signs and symptoms manifest themselves can vary, making difficult to establish cause-effect relationship, and efficacious treatment and prevention options. Furthermore, the available therapeutic options do not necessarily apply in an effective manner to all patients due to the modality of the syndrome's onset and progression, and the fact that each patient presents different clinical manifestations. RESULTS:Where do the metabolic disturbances originate? Genetic predisposition, maternal health, age, and ethnicity are possible influential factors, which put individuals at higher risk for developing metabolic defects. More recently, dietary factors and deficiency in key macro- and micro-nutrients have been indicated as key players in the onset and progression of the disease. We revised all possible patents applying to this topic. Aside from pharmacological agents used to treat specific medical conditions, no patents were observed to be registered for specific dietary macro- and micro-nutrients. CONCLUSION:The present review attempts to provide a framework to help the reader understand the causes behind the development of the metabolic syndrome and its complication. 10.2174/1872208311666170227112013
Metabolic Syndrome: An Evolving Clinical Construct. Vassallo Patricia,Driver Steven L,Stone Neil J Progress in cardiovascular diseases Metabolic syndrome (MetS), a clustering of metabolic risk factors, identifies individuals at increased risk of diabetes and cardiovascular disease (CVD). Measurement of waist circumference, high-density lipoprotein-cholesterol, triglycerides, blood pressure and fasting blood glucose are easily obtained in the clinic. At any level of low-density lipoprotein-cholesterol, presence of MetS increases the risk of adverse CVD outcomes including bothatherosclerotic CVD and atrial fibrillation. The MetS construct should focus the clinician on recommending behavioral lifestyle modification as this improves all of its components. The challenge, however, has been the lack of a standardized approach to achieve effective and sustained lifestyle modification in clinical practice. We briefly review various approaches useful to the clinician in counseling such patients. These include group lifestyle programs and emerging mobile technology. Technology alone may not be sufficient, but as an adjunct has the promise to improve low rates of behavioral change currently seen with traditional programs. 10.1016/j.pcad.2016.07.012
The metabolic syndrome--a new worldwide definition. Alberti K George M M,Zimmet Paul,Shaw Jonathan, Lancet (London, England) 10.1016/S0140-6736(05)67402-8
The metabolic syndrome. Cornier Marc-Andre,Dabelea Dana,Hernandez Teri L,Lindstrom Rachel C,Steig Amy J,Stob Nicole R,Van Pelt Rachael E,Wang Hong,Eckel Robert H Endocrine reviews The "metabolic syndrome" (MetS) is a clustering of components that reflect overnutrition, sedentary lifestyles, and resultant excess adiposity. The MetS includes the clustering of abdominal obesity, insulin resistance, dyslipidemia, and elevated blood pressure and is associated with other comorbidities including the prothrombotic state, proinflammatory state, nonalcoholic fatty liver disease, and reproductive disorders. Because the MetS is a cluster of different conditions, and not a single disease, the development of multiple concurrent definitions has resulted. The prevalence of the MetS is increasing to epidemic proportions not only in the United States and the remainder of the urbanized world but also in developing nations. Most studies show that the MetS is associated with an approximate doubling of cardiovascular disease risk and a 5-fold increased risk for incident type 2 diabetes mellitus. Although it is unclear whether there is a unifying pathophysiological mechanism resulting in the MetS, abdominal adiposity and insulin resistance appear to be central to the MetS and its individual components. Lifestyle modification and weight loss should, therefore, be at the core of treating or preventing the MetS and its components. In addition, there is a general consensus that other cardiac risk factors should be aggressively managed in individuals with the MetS. Finally, in 2008 the MetS is an evolving concept that continues to be data driven and evidence based with revisions forthcoming. 10.1210/er.2008-0024
Metabolic syndrome: what are the risks for humans? Gupta Abhishek,Gupta Vani Bioscience trends Metabolic syndrome (MetS) is a widely prevalent and multi-factorial disorder. The syndrome has been given several names such as insulin resistance (IR) syndrome, plurimetabolic syndrome, Reaven's syndrome, Syndrome X, and the deadly quartet. The formulation of National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP) guidelines has led to some uniformity and standardization of the definition of MetS and has been helpful epidemiologically. The clinical relevance of MetS is related to its role in the development of cardiovascular disease. Weight reduction is one of the mainstays of treatment. This article provides a comprehensive discussion of metabolic risk factors, the history of MetS, and its diagnosis, epidemiology, etiology, pathophysiology, and treatment. There is a need to comprehensively review this particular syndrome in view of the ever increasing-incidence of this condition.
Abdominal obesity and metabolic syndrome. Després Jean-Pierre,Lemieux Isabelle Nature Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease risk. But abdominal obesity - the most prevalent manifestation of metabolic syndrome - is a marker of 'dysfunctional adipose tissue', and is of central importance in clinical diagnosis. Better risk assessment algorithms are needed to quantify diabetes and cardiovascular disease risk on a global scale. 10.1038/nature05488