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Impact of the Triglyceride/High-Density Lipoprotein Cholesterol Ratio and the Hypertriglyceremic-Waist Phenotype to Predict the Metabolic Syndrome and Insulin Resistance.
von Bibra, H, Saha, S, Hapfelmeier, A, Müller, G, Schwarz, PEH
Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme. 2017;(7):542-549
Abstract
Insulin resistance is the underlying mechanism for the metabolic syndrome and associated dyslipidaemia that theoretically implies a practical tool for identifying individuals at risk for cardiovascular disease and type-2-diabetes. Another screening tool is the hypertriglyceremic-waist phenotype (HTW). There is important impact of the ethnic background but a lack of studied European populations for the association of the triglyceride/high-density lipoprotein cholesterol (HDL-C) ratio and insulin resistance. This observational, retrospective study evaluated lipid ratios and the HTW for predicting the metabolic syndrome/insulin resistance in 1932 non-diabetic individuals from Germany in the fasting state and during a glucose tolerance test. The relations of triglyceride/HDL-C, total-cholesterol/HDL-C, and low-density lipoprotein cholesterol/HDL-C with 5 surrogate estimates of insulin resistance/sensitivity and metabolic syndrome were analysed by linear regression analysis and receiver operating characteristics (ROC) in participants with normal (n=1 333) or impaired fasting glucose (n=599), also for the impact of gender. Within the lipid ratios, triglyceride/HDL-C had the strongest associations with insulin resistance/sensitivity markers. In the prediction of metabolic syndrome, diagnostic accuracy was good for triglyceride/HDL-C (area under the ROC curve 0.817) with optimal cut-off points (in mg/dl units) of 2.8 for men (80% sensitivity, 71% specificity) and 1.9 for women (80% sensitivity, 75% specificity) and fair for HTW and HOMA-IR (area under the curve 0.773 and 0.761). These data suggest the triglyceride/HDL-C ratio as a physiologically relevant and practical index for predicting the concomitant presence of metabolic syndrome, insulin resistance and dyslipidaemia for therapeutic and preventive care in apparently healthy European populations.
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Factors Associated with Adiposity, Lipid Profile Disorders and the Metabolic Syndrome Occurrence in Premenopausal and Postmenopausal Women.
Suliga, E, Kozieł, D, Cieśla, E, Rębak, D, Głuszek, S
PloS one. 2016;(4):e0154511
Abstract
The aim of the study was the assessment of the dependencies between a woman's menopausal status and adiposity, lipid profile and metabolic syndrome occurrence, as well as finding out whether the correlations between the socio-demographic profile and lifestyle elements and adiposity, lipid profile and the risk of MetS are the same before and after menopause. A cross-sectional study was carried out on 3636 women, aged between 40-59, which involved a questionnaire interview, anthropometric measurements and fasting blood samples, on the basis of which the concentration of triglycerides, cholesterol and glucose was estimated. Before menopause, a greater adiposity (BMIβ = 0.08; %BFβ = 0.07; WCβ = 0.06) was characteristic for women living in a stable relationship than for single women. Women who smoked in the past were characterized by a higher BMI (β = 0.09) and WC (β = 0.06) in comparison with women who have never smoked, while after menopause a greater adiposity (%BFβ = 0.12) and a worse lipid profile (TCβ = 0.08; LDLβ = 0.07; HDLβ = -0.05; TGβ = 0.14) were present in women currently smoking, in comparison to women who have never smoked. After menopause, in women who had two or more children, a greater adiposity (BMIβ = 0.07 and 0.09; %BFβ = 0.05 and 0.07) and a higher risk of MetS (OR = 1.22, 95%CI: 1.03-1.44) was observed compared to nulliparous women, than before menopause. In women with a higher level of education, the risk of MetS after menopause was significantly lower compared with women with a lower level of education (OR = 0.74, 95%CI: 0.61-0.90). Physical activity after menopause had a higher influence on the decrease in the women's adiposity (BMIβ = -0.11 v. -0.06; %BFβ = -0.11 v. -0.06; WCβ = -0.14 v. -0.08), than before menopause. In women not undergoing hormone replacement therapy, some of the socio-demographic factors and lifestyle elements affected adiposity, lipid profile and the risk of MetS differently before and after menopause, which requires verification through long-term research.
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Quantifying phenotypic flexibility as the response to a high-fat challenge test in different states of metabolic health.
Kardinaal, AF, van Erk, MJ, Dutman, AE, Stroeve, JH, van de Steeg, E, Bijlsma, S, Kooistra, T, van Ommen, B, Wopereis, S
FASEB journal : official publication of the Federation of American Societies for Experimental Biology. 2015;(11):4600-13
Abstract
Metabolism maintains homeostasis at chronic hypercaloric conditions, activating postprandial response mechanisms, which come at the cost of adaptation processes such as energy storage, eventually with negative health consequences. This study quantified the metabolic adaptation capacity by studying challenge response curves. After a high-fat challenge, the 8 h response curves of 61 biomarkers related to adipose tissue mass and function, systemic stress, metabolic flexibility, vascular health, and glucose metabolism was compared between 3 metabolic health stages: 10 healthy men, before and after 4 wk of high-fat, high-calorie diet (1300 kcal/d extra), and 9 men with metabolic syndrome (MetS). The MetS subjects had increased fasting concentrations of biomarkers representing the 3 core processes, glucose, TG, and inflammation control, and the challenge response curves of most biomarkers were altered. After the 4 wk hypercaloric dietary intervention, these 3 processes were not changed, as compared with the preintervention state in the healthy subjects, whereas the challenge response curves of almost all endocrine, metabolic, and inflammatory processes regulating these core processes were altered, demonstrating major molecular physiologic efforts to maintain homeostasis. This study thus demonstrates that change in challenge response is a more sensitive biomarker of metabolic resilience than are changes in fasting concentrations.
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Measurement of waist and hip circumference with a body surface scanner: feasibility, validity, reliability, and correlations with markers of the metabolic syndrome.
Jaeschke, L, Steinbrecher, A, Pischon, T
PloS one. 2015;(3):e0119430
Abstract
OBJECTIVE Body surface scanners (BS), which visualize a 3D image of the human body, facilitate the computation of numerous body measures, including height, waist circumference (WC) and hip circumference (HC). However, limited information is available regarding validity and reliability of these automated measurements (AM) and their correlation with parameters of the Metabolic Syndrome (MetS) compared to traditional manual measurements (MM). METHODS As part of a cross-sectional feasibility study, AM of WC, HC and height were assessed twice in 60 participants using a 3D BS (VitussmartXXL). Additionally, MM were taken by trained personnel according to WHO guidelines. Participants underwent an interview, bioelectrical impedance analysis, and blood pressure measurement. Blood samples were taken to determine HbA1c, HDL-cholesterol, triglycerides, and uric acid. Validity was assessed based on the agreement between AM and MM, using Bland-Altman-plots, correlation analysis, and paired t-tests. Reliability was assessed using intraclass correlation coefficients (ICC) based on two repeated AM. Further, we calculated age-adjusted Pearson correlation for AM and MM with fat mass, systolic blood pressure, HbA1c, HDL-cholesterol, triglycerides, and uric acid. RESULTS Body measures were higher in AM compared to MM but both measurements were strongly correlated (WC, men, difference = 1.5 cm, r = 0.97; women, d = 4.7 cm, r = 0.96; HC, men, d = 2.3 cm, r = 0.97; women, d = 3.0 cm; r = 0.98). Reliability was high for all AM (nearly all ICC>0.98). Correlations of WC, HC, and the waist-to-hip ratio (WHR) with parameters of MetS were similar between AM and MM; for example the correlation of WC assessed by AM with HDL-cholesterol was r = 0.35 in men, and r = -0.48 in women, respectively whereas correlation of WC measured manually with HDL cholesterol was r = -0.41 in men, and r = -0.49 in women, respectively. CONCLUSIONS Although AM of WC, HC, and WHR are higher when compared to MM based on WHO guidelines, our data indicate good validity, excellent reliability, and similar correlations to parameters of the MetS.
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Delayed clearance of triglyceride-rich lipoproteins in young, healthy obese subjects.
Larsen, MA, Goll, R, Lekahl, S, Moen, OS, Florholmen, J
Clinical obesity. 2015;(6):349-57
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Abstract
Obesity is associated with the metabolic syndrome. The aims were, first, to study the postprandial triglyceride clearance in young, healthy obese subjects and, second, to investigate if fasting triglycerides can predict delayed postprandial triglyceride clearance. Eighteen apparently healthy, obese subjects with no clinical signs of metabolic disturbances participated. Controls were age- and sex-matched, healthy, normal weight subjects. Subclinical markers of metabolic disturbances were assessed by measuring postprandial triglycerides in serum and in chylomicrons by oral fat tolerance test. Postprandial triglyceride clearance for 8 h was assessed indirectly as removal of the lipid from serum during the oral fat tolerance test. Insulin resistance was measured by the homeostasis model assessment of insulin resistance (HOMA-IR). Twelve (66%) of the apparently healthy obese individuals had insulin resistance measured by HOMA-IR. There was a delayed clearance of serum triglycerides and chylomicron triglycerides at 6 h when compared with the control group, while, at 8 h, the differences were only detected for the chylomicron triglyceride clearance. Triglyceride response was significantly greater in the obese subjects. Fasting triglycerides in upper normal level predicted a delayed postprandial triglyceride clearance and insulin resistance. In young, apparently healthy obese subjects early metabolic disturbances including insulin resistance and delayed postprandial triglyceride clearance can be detected. Fasting serum triglyceride in upper normal level predicted delayed postprandial triglyceride clearance and insulin resistance.
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Effect of a weight loss program on body composition and metabolic syndrome markers in obese weight cyclers.
Oetoro, S, Makmun, LH, Lukito, W, Wijaya, A
Acta medica Indonesiana. 2014;(3):199-208
Abstract
AIM: to evaluate the effect of weight loss program on fat mass, visceral fat rating and metabolic syndrome markers in obese subjects with weight cycling. METHODS this was an 8-week open trial. The subjects were recruited consecutively from Balai Kota DKI Jaya. Subjects were classified into two groups according to the fluctuation of weight gain (weight cycling/WC and first encounter obesity/FEO group). Both groups were assigned to receive weight loss program consisted with following goals: a 1000 kcal energy intake reduction and 45 minutes mild-to-moderate intensity physical activity three times a week. Body composition (fat mass, visceral fat rating), and metabolic syndrome markers (waist circumference and triglyceride levels) were measured at baseline, week 4 and at the end of study. RESULTS seventy two subjects completed the study (34 subjects in WC group and 38 subjects in FEO group). Following weight loss program, a decrease in fat mass, visceral fat rating, and waist circumference was lower in WC group compared with FEO group but it was not statistically significant (p>0.05). Triglyceride levels were decreased in the FEO group while it was increased in WC group. However the difference was not significant (p=0.055). CONCLUSION weight loss program may contribute to changes in body composition and metabolic syndrome markers in obese subjects, which the response appears to be worse in weight cyclers.
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[Effect of atorvastatin (liptonorm) on indicators of the lipid spectrum of blood in patients with the metabolic syndrome].
Vasil'eva, LV, Lakhin, DI
Advances in gerontology = Uspekhi gerontologii. 2010;(2):281-4
Abstract
In this work the effects of Atorvastatin (liptonorm) in a dosage of 10 mg/24h during 12 months concerning the basic indicators of a lipid spectrum of blood in the patients with a metabolic syndrome are estimated. We have noticed its positive effect concerning not only the general cholesterol and cholesterol lipoproteid of low density, but also concerning thriglicerol and cholesterol lipoproteid of high density, which confirms its favorable influence on the basic indicators of a lipid spectrum in the patients with a metabolic syndrome.
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Soluble fibre (Plantago ovata husk) reduces plasma low-density lipoprotein (LDL) cholesterol, triglycerides, insulin, oxidised LDL and systolic blood pressure in hypercholesterolaemic patients: A randomised trial.
Solà, R, Bruckert, E, Valls, RM, Narejos, S, Luque, X, Castro-Cabezas, M, Doménech, G, Torres, F, Heras, M, Farrés, X, et al
Atherosclerosis. 2010;(2):630-7
Abstract
UNLABELLED The objective was to evaluate whether the soluble fibre Plantago ovata (Po)-husk improves cardiovascular disease (CVD) risk biomarkers including low-density lipoprotein cholesterol (LDL-C). METHODS In a multi-centred, double-blind, placebo-controlled, parallel, randomised trial conducted in primary care-clinics in Spain, France and Holland, mild-moderate hypercholesterolaemic patients (age range: 43-67 years) received 14 g/d of Po-husk (n=126) or placebo (microcrystalline-cellulose 14 g/d; n=128) in a low saturated fat diet for 8 weeks. Subsequently, if LDL-C remained > or = 3.35 mmol/L [130 mg/dL], participants proceeded with the fibre plus simvastatin (20mg/d) for further 8 weeks. Lipid profile, blood pressure (BP), insulin, oxidised LDL and some gene polymorphisms involved in CVD risk were measured. RESULTS Relative to placebo, Po-husk reduced plasma LDL-C by -6% (P<0.0002), total cholesterol (TC) by -6%, triglycerides (TG) by -21.6%, apolipoprotein (Apo) B-100 by -6.7%, oxidised LDL by a mean of -6.82 U/L (95%CI: 3.15-10.48), insulin by -4.68 pmol/L (95%CI: 0.68-8.67) and systolic BP by -4.0mm Hg (95%CI; 1.2-6.7) (P<0.05). The TG-lowering effect in the Po-husk group was magnified by variants in plasminogen-activator-inhibitor (PAI-1; rs1799768) and fatty acid-binding protein (FABP-2; rs1799883) genes. At 16 weeks, the intra-group action of simvastatin (20mg/d) added to Po-husk or placebo was a similar LDL-C reduction. CONCLUSIONS Po-husk, apart from lowering LDL-C, also reduced TG, TG related to certain gene variants, TC, Apo B-100, oxLDL, insulin-resistance and systolic BP in mild-moderate hypercholesterolaemic individuals. Thus, the target patients to receive Po-husk would be those who present a cluster of various CVD risk factors, such as metabolic syndrome.
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The influence of dietary fibre source and gender on the postprandial glucose and lipid response in healthy subjects.
Ulmius, M, Johansson, A, Onning, G
European journal of nutrition. 2009;(7):395-402
Abstract
BACKGROUND Consumption of soluble dietary fibre is correlated with decreased postprandial glucose and insulin responses and hence has beneficial effects on the metabolic syndrome. AIM OF THE STUDY To investigate the effects on postprandial glucose, insulin and triglyceride concentrations of meals enriched with soluble dietary fibres from oats, rye bran, sugar beet fibre or a mixture of these three fibres. METHODS Thirteen healthy human volunteers (6 men and 7 women, aged 20-28 years) were included in the study. The subjects came to the study centre once a week after an overnight fast to ingest test meals and a control meal in random order. The meals contained either oat powder (62 g, of which 2.7 soluble fibre), rye bran (31 g, of which 1.7 g soluble fibre), sugar beet fibre (19 g, of which 5 g soluble fibre), a mixture of these three fibres (74 g, of which 1.7 g soluble fibre from each source, giving 5 g soluble fibre) or no added fibre (control) and were all adjusted to contain the same total amount of available carbohydrates. Blood samples were drawn before and every 30 min up to 180 min after the meals. RESULTS Meals with rye bran gave a lower postprandial glucose peak when compared with the control meal, and this effect was more pronounced in women compared to men. Oat powder, containing a low amount of total fibre and a high amount of carbohydrates in liquid matrix, gave a higher incremental glucose peak concentration compared to rye bran and sugar beet fibre and higher insulin incremental area under curve compared to control. The oat powder also influenced the effects of the mixed meal, diminishing the glucose-lowering effects. Postprandial triglyceride levels tended to be higher after all fibre-rich meals, but only significant for oat powder and the mixed meal when compared with the control meal. CONCLUSIONS Postprandial glucose, insulin and triglyceride concentrations are influenced by dietary fibre-rich meals, depending on fibre source, dose of soluble and total fibre and possibly gender.
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Aerobic exercise and postprandial lipemia in men with the metabolic syndrome.
Mestek, ML, Plaisance, EP, Ratcliff, LA, Taylor, JK, Wee, SO, Grandjean, PW
Medicine and science in sports and exercise. 2008;(12):2105-11
Abstract
INTRODUCTION It is currently unclear as to how exercise prescription variables influence attenuations of postprandial lipemia (PPL) in men with the metabolic syndrome (MetS) after exercise. Therefore, the purposes of this investigation were to compare the effects of low- and moderate-intensity exercise and accumulated versus continuous exercise on PPL in males with MetS. METHODS Fourteen males with MetS (waist circumference (WC) = 110.2 +/- 10.9 cm; triglycerides (TG) = 217 +/- 84 mg dL(-1); fasting blood glucose = 105 +/- 7 mg dL(-1); high-density lipoprotein cholesterol (HDL-C) = 44 +/- 7 mg dL(-1); systolic blood pressure (SBP) = 120 +/- 12 mm Hg; diastolic blood pressure (DBP) = 76 +/- 10 mm Hg) completed a control condition consisting of a high-fat meal and blood sampling at 2 h intervals for 6 h. Next, participants completed the following exercise conditions: 1) continuous moderate-intensity (MOD-1), 2) continuous low-intensity (LOW-1), and 3) two accumulated moderate-intensity sessions (MOD-2). The test meal and blood sampling were repeated 12-14 h after exercise. Area under the curve (AUC) scores and temporal postprandial responses were analyzed using repeated-measures ANOVA for TG and insulin. RESULTS The TG AUC decreased by 27% after LOW-1. TG concentrations were also reduced by 22% and 21% at 4 h postmeal after LOW-1 and MOD-1, yet TG parameters were no different from the control condition after MOD-2 (P < 0.05 for all). CONCLUSION These findings indicate that 500 kcal of continuous aerobic exercise before a meal attenuates PPL in men with MetS. This outcome can be achieved through low- or moderate-intensity exercise performed in a single session. Accumulating moderate-intensity exercise does not appear to effectively modulate PPL in men with MetS.