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Effectiveness of a Smartphone Application for the Management of Metabolic Syndrome Components Focusing on Weight Loss: A Preliminary Study.
Toro-Ramos, T, Lee, DH, Kim, Y, Michaelides, A, Oh, TJ, Kim, KM, Jang, HC, Lim, S
Metabolic syndrome and related disorders. 2017;(9):465-473
Abstract
BACKGROUND There are inconsistent results for the effectiveness of using smartphone applications (apps) or websites on weight loss. We investigated the efficacy of a smartphone intervention using a designated app that utilizes a lifestyle intervention-focused approach, including a human coaching element, toward weight loss in overweight or obese Korean adults. METHODS One hundred four adults aged 20-60 years with a body mass index ≥23 kg/m2, who signed up for a smartphone program for weight loss (using the Noom app), were recruited. Participants received an in-person orientation about the study and app use, and a baseline blood sample was obtained. The in-app intervention with daily behavior and nutrition education content and coaching lasted 15 weeks. The primary endpoint of the study was a change in weight. The secondary endpoints were changes in metabolic risk factors such as blood pressure, waist circumference, and glucose and lipid profiles. Body composition changes were also assessed, and body weight at 52 weeks was measured to ascertain long-term effects. RESULTS Participants showed a clinically significant weight loss effect of -7.5% at the end of the 15-week program (P < 0.001), and at a 52-week follow-up, a weight loss effect of -5.2% was maintained. At 15 weeks, percent body fat and visceral fat decreased by -6.0 ± 5.4% and -3.4 ± 2.7 kg, respectively (both P < 0.001). Fasting glucose level also decreased significantly by -5.7 ± 14.6 mg/dL at 15 weeks. Lipid parameters showed significant improvements, except for high-density lipoprotein cholesterol. The frequency of logging meals and exercise was associated with body fat loss. CONCLUSIONS This advanced smartphone app was a useful tool to maintain weight loss in overweight or obese people.
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[Estimation of plasma vitamin A, C and E levels in patients with metabolic syndrome].
Godala, M, Materek-Kuśmierkiewicz, I, Moczulski, D, Rutkowski, M, Szatko, F, Gaszyńska, E, Kowalski, J
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 2014;(215):320-3
Abstract
UNLABELLED Metabolic syndrome (MS) is a coexistence of metabolic risk factors affecting development of cardiovascular diseases. In the pathogenesis of MS there participate reactive oxygen species which are excessively produced in such elements of MS as hyperglycemia, insulin resistance and obesity. Vitamins A, C and E are an important part of the non-enzymatic antioxidative barrier in humans. The aim of the study was to estimate plasma vitamin A, C and E levels in patients with symptoms of MS. MATERIAL AND METHODS The study included 68 patients with symptoms of MS according to International Diabetes Federation criteria (2005), 37 men and 31 women, aged 34-65 years (mean age 57, 76 +/- 8, 29 years). The control group consisted of 24 healthy individuals without MS, 18 men and 6 women, aged 49-67 (mean age 58, 5 +/- 5, 6 years). Plasma vitamin A, C and E levels were estimated in patients and the control group with spectrophotometry using T60V spectrophotometer (PG Instruments). RESULTS The plasma vitamin A, C and E levels were significantly lower (p < 0.05) in MS patients than in the healthy individuals without symptoms of MS. The most significant differences in the level of antioxidative vitamins in both groups were related to vitamin C and vitamin E. CONCLUSIONS The decreased level of vitamins A, C and E points to the weakening of antioxidative barrier in patients with MS.
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Effect of an isoenergetic traditional Mediterranean diet on the high-density lipoprotein proteome in men with the metabolic syndrome.
Richard, C, Couture, P, Desroches, S, Nehmé, B, Bourassa, S, Droit, A, Lamarche, B
Journal of nutrigenetics and nutrigenomics. 2014;(1):48-60
Abstract
BACKGROUND/AIMS: The objective of this preliminary study was to examine the impact of the Mediterranean diet (MedDiet) on the high-density lipoprotein (HDL) proteome in men with the metabolic syndrome (MetS). METHODS Twenty-six men with the MetS first consumed a standardized baseline North American isoenergetic control diet (5 weeks) and then consumed an isoenergetic MedDiet (5 weeks), both in full feeding condition. The HDL fraction was isolated by ultracentrifugation at the end of each diet and the HDL proteome assessed by isobaric tags for relative and absolute quantitation and mass spectrometry. RESULTS Of all proteins identified within HDL, only 3 showed significant changes in relative abundance after the MedDiet versus the control diet, including a reduction in inflammation-related inter-α-trypsin inhibitor heavy chain H4 (fold change: 0.62) and hemoglobin subunits α (fold change: 0.40) and β (fold change: 0.46). Other HDL-bound proteins associated with functions related to lipid metabolism/cholesterol homeostasis, oxidation, coagulation, complement activation and immunity were unchanged after consumption of the MedDiet for 5 weeks. CONCLUSIONS Changes in the HDL proteome may explain, at least partly, the well-known anti-inflammatory effect ascribed to the MedDiet. Otherwise, short-term consumption of the MedDiet seems to have little impact on other features of the HDL proteome in men with the MetS.
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Effects of GLP-1 on forearm vasodilator function and glucose disposal during hyperinsulinemia in the metabolic syndrome.
Tesauro, M, Schinzari, F, Adamo, A, Rovella, V, Martini, F, Mores, N, Barini, A, Pitocco, D, Ghirlanda, G, Lauro, D, et al
Diabetes care. 2013;(3):683-9
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Abstract
OBJECTIVE Patients with the metabolic syndrome (MetS) have impaired insulin-induced enhancement of vasodilator responses. The incretin hormone glucagon-like peptide 1 (GLP-1), beyond its effects on blood glucose, has beneficial actions on vascular function. This study, therefore, aimed to assess whether GLP-1 affects insulin-stimulated vasodilator reactivity in patients with the MetS. RESEARCH DESIGN AND METHODS Forearm blood flow responses to acetylcholine (ACh) and sodium nitroprusside (SNP) were assessed in MetS patients before and after the addition of GLP-1 to an intra-arterial infusion of saline (n = 5) or insulin (n = 5). The possible involvement of oxidative stress in the vascular effects of GLP-1 in this setting was investigated by infusion of vitamin C (n = 5). The receptor specificity of GLP-1 effect during hyperinsulinemia was assessed by infusing its metabolite GLP-1(9-36) (n = 5). The metabolic actions of GLP-1 were also tested by analyzing forearm glucose disposal during hyperinsulinemia (n = 5). RESULTS In MetS patients, GLP-1 enhanced endothelium-dependent and -independent responses to ACh and SNP, respectively, during hyperinsulinemia (P < 0.001 for both), but not during saline (P > 0.05 for both). No changes in vasodilator reactivity to ACh and SNP were seen after GLP-1 was added to insulin and vitamin C (P > 0.05 for both) and after GLP-1(9-36) was given during hyperinsulinemia (P > 0.05 for both). Also, GLP-1 did not affect forearm glucose extraction and uptake during hyperinsulinemia (P > 0.05 for both). CONCLUSIONS In patients with the MetS, GLP-1 improves insulin-mediated enhancement of endothelium-dependent and -independent vascular reactivity. This effect may be influenced by vascular oxidative stress and is possibly exerted through a receptor-mediated mechanism.
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Nurse-led empowerment strategies for hypertensive patients with metabolic syndrome.
Chang, AK, Fritschi, C, Kim, MJ
Contemporary nurse. 2012;(1):118-28
Abstract
PURPOSE The aim of this study was to compare the effect of a nurse-led empowerment-based intervention to that of standard care on metabolic syndrome risk factors, self-management behaviors, and walking activity in Korean hypertensive patients. METHODS Using a quasi-experimental design, patients participated in an experimental group (N = 30) or control group (N = 22). The experimental group received eight weekly empowerment sessions, including lifestyle modification education, empowerment group discussions, and exercise training, while the control group received standard hypertension care. RESULTS The experimental group had significantly improved metabolic syndrome symptoms and prevalence, empowerment scores, self-management behaviors, and walking (all p < 0.05). CONCLUSIONS Findings from this study suggest that, in Korean hypertensive patients, empowerment interventions are more effective than standard care in improving metabolic syndrome risk factors, empowerment, self-management behaviors, and walking.
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Effect of rosiglitazone on HDL metabolism in subjects with metabolic syndrome and low HDL.
Millar, JS, Ikewaki, K, Bloedon, LT, Wolfe, ML, Szapary, PO, Rader, DJ
Journal of lipid research. 2011;(1):136-42
Abstract
Treatment with the peroxisome proliferator-activated receptor γ agonist rosiglitazone has been reported to increase HDL-cholesterol (HDL-C) levels, although the mechanism responsible for this is unknown. We sought to determine the effect of rosiglitazone on HDL apolipoprotein A-I (apoA-I) and apoA-II metabolism in subjects with metabolic syndrome and low HDL-C. Subjects were treated with placebo followed by rosiglitazone (8 mg) once daily. At the end of each 8 week treatment, subjects (n = 15) underwent a kinetic study to measure apoA-I and apoA-II production rate (PR) and fractional catabolic rate. Rosiglitazone significantly reduced fasting insulin and high-sensitivity C-reactive protein (hsCRP) and increased apoA-II levels. Mean apoA-I and HDL-C levels were unchanged following rosiglitazone treatment, although there was considerable individual variability in the HDL-C response. Rosiglitazone had no effect on apoA-I metabolism, whereas the apoA-II PR was increased by 23%. The change in HDL-C in response to rosiglitazone was significantly correlated with the change in apoA-II concentration but not to changes in apoA-I, measures of glucose homeostasis, or hsCRP. Treatment with rosiglitazone significantly increased apoA-II production in subjects with metabolic syndrome and low HDL-C but had no effect on apoA-I metabolism. The change in HDL-C in response to rosiglitazone treatment was unrelated to effects on apoA-I, instead being related to the change in the metabolism of apoA-II.
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LDL from obese patients with the metabolic syndrome show increased lipid peroxidation and activate platelets.
Colas, R, Sassolas, A, Guichardant, M, Cugnet-Anceau, C, Moret, M, Moulin, P, Lagarde, M, Calzada, C
Diabetologia. 2011;(11):2931-40
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AIMS/HYPOTHESIS This study assessed oxidative stress in LDL from obese patients with the metabolic syndrome and compared it with that in LDL from type 2 diabetic patients or control volunteers. It also determined the effect on platelets of LDL from the three groups. METHODS The profiles of lipids, fatty acids and fatty acid oxidation products were determined in LDL isolated from plasma of patients with the metabolic syndrome, patients with type 2 diabetes and volunteers (n = 10 per group). The effects of LDL from the participant groups on the platelet arachidonic acid signalling cascade and aggregation were investigated. RESULTS Compared with LDL from control volunteers, LDL from obese metabolic syndrome and type 2 diabetic patients had lower cholesteryl ester, higher triacylglycerol and lower ethanolamine plasmalogen levels. Proportions of linoleic acid were decreased in phosphatidylcholine and cholesteryl esters in LDL from both patient groups. Among the markers of lipid peroxidation, oxidation products of linoleic acid (hydroxy-octadecadienoic acids) and malondialdehyde were increased by 59% and twofold, respectively in LDL from metabolic syndrome and type 2 diabetic patients. LDL from metabolic syndrome and type 2 diabetic patients were equally potent in activating the platelet arachidonic acid signalling cascade through increased phosphorylation of p38 mitogen-activated protein kinase and cytosolic phospholipase A(2), and through increased thromboxane B(2) formation. LDL from patients with the metabolic syndrome and type 2 diabetes potentiated platelet aggregation by threefold and 3.5-fold respectively, whereas control LDL had no activating effects on platelets. CONCLUSIONS/INTERPRETATION The metabolic syndrome in obese patients, without or with diabetes, is associated with increased oxidative stress in LDL, which triggers platelet activation.
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Skeletal muscle fatty acid handling in insulin resistant men.
van Hees, AM, Jans, A, Hul, GB, Roche, HM, Saris, WH, Blaak, EE
Obesity (Silver Spring, Md.). 2011;(7):1350-9
Abstract
Disturbances in skeletal muscle lipid metabolism may precede or contribute to the development of whole body insulin resistance. In this study, we examined fasting and postprandial skeletal muscle fatty acid (FA) handling in insulin resistant (IR) men. Thirty men with the metabolic syndrome (MetS) (National Cholesterol Education Program-Adult Treatment Panel III) were included in this sub-study to the LIPGENE study, and divided in two groups (IR and control) based on the median of insulin sensitivity (S(I) = 2.06 (mU/l(-1))·min(-1)·10(-4)). Fasting and postprandial skeletal muscle FA handling were examined by combining the forearm balance technique with stable isotopes of palmitate. [(2)H(2)]-palmitate was infused intravenously to label endogenous triacylglycerol (TAG) and free FAs (FFAs) in the circulation and [U-(13)C]-palmitate was incorporated in a high-fat mixed meal (2.6 MJ, 61 E% fat) to label chylomicron-TAG. Muscle biopsies were taken to determine muscle TAG, diacylglycerol (DAG), FFA, and phospholipid (PL) content, their fractional synthetic rates (FSRs) and degree of saturation, as well as messenger RNA (mRNA) expression of genes involved in lipid metabolism. In the first 2 h after meal consumption, forearm muscle [(2)H(2)]-labeled TAG extraction was higher in IR vs. control (P = 0.05). Fasting percentage saturation of muscle DAG was higher in IR vs. control (P = 0.016). No differences were observed for intramuscular TAG, DAG, FFA, and PL content, FSR, and muscle mRNA expression. In conclusion, increased muscle (hepatically derived) TAG extraction during postprandial conditions and increased saturation of intramuscular DAG are associated with insulin resistance, suggesting that disturbances in skeletal muscle FA handling could play a role in the development of whole body insulin resistance and type 2 diabetes.
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Effects of fenofibrate treatment on cardiovascular disease risk in 9,795 individuals with type 2 diabetes and various components of the metabolic syndrome: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study.
Scott, R, O'Brien, R, Fulcher, G, Pardy, C, D'Emden, M, Tse, D, Taskinen, MR, Ehnholm, C, Keech, A, ,
Diabetes care. 2009;(3):493-8
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Abstract
OBJECTIVE We explored whether cardiovascular disease (CVD) risk and the effects of fenofibrate differed in subjects with and without metabolic syndrome and according to various features of metabolic syndrome defined by the Adult Treatment Panel III (ATP III) in subjects with type 2 diabetes in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. RESEARCH DESIGN AND METHODS The prevalence of metabolic syndrome and its features was calculated. Cox proportional models adjusted for age, sex, CVD status, and baseline A1C levels were used to determine the independent contributions of metabolic syndrome features to total CVD event rates and the effects of fenofibrate. RESULTS More than 80% of FIELD participants met the ATP III criteria for metabolic syndrome. Each ATP III feature of metabolic syndrome, apart from increased waist circumference, increased the absolute risk of CVD events over 5 years by at least 3%. Those with marked dyslipidemia (elevated triglycerides >or=2.3 mmol/l and low HDL cholesterol) were at the highest risk of CVD (17.8% over 5 years). Fenofibrate significantly reduced CVD events in those with low HDL cholesterol or hypertension. The largest effect of fenofibrate to reduce CVD risk was observed in subjects with marked dyslipidemia in whom a 27% relative risk reduction (95% CI 9-42, P = 0.005; number needed to treat = 23) was observed. Subjects with no prior CVD had greater risk reductions than the entire group. CONCLUSIONS Metabolic syndrome components identify higher CVD risk in individuals with type 2 diabetes, so the absolute benefits of fenofibrate are likely to be greater when metabolic syndrome features are present. The highest risk and greatest benefits of fenofibrate are seen among those with marked hypertriglyceridemia.
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LDL-cholesterol calculation formulas in patients with or without the metabolic syndrome.
Gazi, IF, Elisaf, M
International journal of cardiology. 2007;(3):414-5
Abstract
The present study compares the low-density lipoprotein cholesterol (LDL-C) values obtained by the Friedewald formula (LDL-F) with those derived from a new equation that uses only the concentrations of total cholesterol and triglycerides (LDL-A) in patients with the metabolic syndrome (MS) (n=118) and in age- and sex-matched controls (n=112). According to our results, LDL-A was correlated with LDL-F in the MS as well as in the control group (p for both <0.001). However, LDL-A slightly overestimated the LDL-C levels compared with LDL-F in the control group, possible due to the higher high-density lipoprotein cholesterol (HDL-C) levels in these individuals. Importantly, no difference was observed between the two equations in the MS group. LDL-A may be useful for the calculation of LDL-C levels when HDL-C level are not easily available.