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Non-linear relationship between sleep duration and metabolic syndrome: A population-based study.
Fan, L, Hao, Z, Gao, L, Qi, M, Feng, S, Zhou, G
Medicine. 2020;(2):e18753
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Abstract
The aims of this study were to evaluate the prevalence of metabolic syndrome (MetS) and explore the association between sleep duration and MetS. This study enrolled 8 272 adults aged 18 years and older from 6 urban and 8 rural areas during 2013 to 2014in Henan China. Participants were interviewed about demographic characteristics, lifestyle factors and medical history, and physical measurements were performed. The relationships between sleep duration and MetS were evaluated and plotted by Restricted Cubic Spline Regression. The mean age was 51.5 years (SD 14.2) and 4 916 (59.4%) were female. The crude prevalence of MetS was 30.3% and the age-standardized rate was 23.6%. Men were more likely to have MetS than women (P = .01). MetS was positively associated with age, education, smoking, drinking, BMI and sleep duration, and seemed irrelevant to occupation and sedentary behavior. In terms of individual component of MetS, high blood pressure was the most prevalent component for both men and women, while the lowest prevalent was high triglycerides in men and for women was low high-density lipoprotein cholesterol (HDL-C). There was a U-shaped relationship between sleep duration and MetS and its components. Sleep duration <6 hours or >9 hours were associated with higher risk of MetS (OR from 1.10 to 2.15). The MetS was prevalent, and more than half of total adult population was suffering from high blood pressure. Sleep duration may be a determinant of metabolic health. Both short (<6 hours) and long sleep duration (>9 hours) was linked to an increased risk of MetS.
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Prevalence of metabolic syndrome in patients with chronic obstructive pulmonary disease: An observational study in South Indians.
Priyadharshini, N, Renusha, RC, Reshma, S, Sindhuri Sai, M, Koushik Muthu, RM, Rajanandh, MG
Diabetes & metabolic syndrome. 2020;(4):503-507
Abstract
BACKGROUND AND AIMS Metabolic syndrome (MetS) has a significant association with airflow obstruction and physical inactivity, which are the relevant extra-pulmonary markers of chronic obstructive respiratory disease (COPD). This study aimed to estimate the prevalence of MetS and its correlation with comorbidities and health related quality of life (HRQoL) in South Indian patients with COPD. METHODS A cross-sectional study was conducted among the 76 COPD patients. Pulmonary function test (PFT) and parameters for MetS such as waist circumference, blood pressure, fasting blood glucose, triglycerides (TGs) and high density lipoprotein cholesterol (HDL-C) levels of COPD patients were measured. HRQoL was calculated using Saint George Respiratory Questionnaire (SGRQ). RESULTS 54% of COPD patients were presented with MetS especially in stage II and III. TGs and HDL-C were significantly associated with the severity of COPD (p < 0.05), while waist circumference, TGs and HDL-C were significantly (p < 0.05) correlated with PFT. Symptom, activity, impact and total scores of SGRQ was increased statistically (p < 0.05) in COPD patients with MetS than without MetS. CONCLUSION According to our findings, screening the grade II and III COPD patients for the presence of MetS is a reasonable option. The results of this study should be confirmed with a larger sample of population.
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Development of the Metabolic Syndrome: Study Design and Baseline Data of the Lufthansa Prevention Study (LUPS), A Prospective Observational Cohort Survey.
Müller-Wieland, D, Altenburg, C, Becher, H, Burchard, J, Frisch, A, Gebhard, J, Haas, J, Harth, V, Heeren, J, Hengelbrock, J, et al
Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association. 2020;(12):777-787
Abstract
The Lufthansa Prevention Study (LUPS) study is a prospective observation of a healthy worker cohort to identify early changes in metabolism leading to the Metabolic Syndrome (MetS) and to analyze their relation to behavioral factors like nutrition, physical activity, psychological status, and to underlying genetic conditions. The LUPS study recruited a sample of 1.962 non-diabetic healthy adults between 25-60 years, employed at a flight base of Lufthansa Technik GmbH in Hamburg, Germany. Baseline assessments included anthropometric measures, blood and urine samples and medical history. Psychosocial variables, dietary habits and life-style risk factors were assessed via self-reported questionnaires.In this report we describe the study design and present baseline parameters including the prevalence of the MetS using different classification criteria. The MetS was present in 20% of male and 12% of female subjects according to the 'Harmonizing the metabolic syndrome' definition. The prevalence varies between 2.6% in male and 2.3% in female subjects up to 48% in male and 41% in female subjects according to different classification criteria of MetS.In conclusion, this first cross-sectional view on the LUPS data confirms the expectation that this cohort is rather healthy and thus provides the opportunity to analyze early changes associated with the development of the MetS. The LUPS study is registered as a clinical trial NCT01313156.
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Positive association between metabolic syndrome and bone mineral density among Malaysians.
Chin, KY, Chan, CY, Subramaniam, S, Muhammad, N, Fairus, A, Ng, PY, Jamil, NA, Aziz, NA, Ima-Nirwana, S, Mohamed, N
International journal of medical sciences. 2020;(16):2585-2593
Abstract
Objectives: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that elevates the individual risk of cardiovascular diseases. These abnormalities are also known to alter bone remodelling. Therefore, MetS may be associated with osteoporosis. This study aims to determine the association between MetS and its components and bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry (DXA) among Malaysians. Methods: 400 Malaysians aged ≥ 40 years (52.5% women) residing in Klang Valley, Malaysia, were recruited. Subjects' demographic and lifestyle details were collected using a questionnaire, and blood pressure and body anthropometry were measured. Subjects' lumbar spine and total hip BMD were measured by DXA. Their fasting blood was collected for blood glucose level and lipid profile analysis. Regression analysis was used to analyze the relationship between MetS or its components and BMD. Results: Subjects with MetS had higher BMD compared to subjects without MetS in models unadjusted for BMI (spine p=0.008; hip p<0.001). This difference was attenuated with BMI adjustment (spine p=0.625; hip p=0.478). Waist circumference was associated positively with BMD in models unadjusted for BMI (spine p=0.012; hip p<0.001), but the association became negative with BMI adjustment (spine p=0.044; hip p=0.021). Systolic blood pressure was associated positively with total hip BMD (p=0.019) but BMI adjustment attenuated the relationship (p=0.080). Triglyceride level was associated with osteoporosis in a fully adjusted model (p=0.001). Overall, MetS was associated with osteoporosis (p=0.019) but lifestyle (p=0.188) and BMI adjustment attenuated the relationship (p=0.904). Conclusion: MetS is positively associated with BMD, and this relationship is predominantly mediated by BMI. Although MetS is not a significant risk factor for osteoporosis, the inverse relationship between waist circumference, a marker of central obesity, and BMD highlights the need to prevent adiposity to improve metabolic and skeletal health.
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Sex-Specific Regulation of Inflammation and Metabolic Syndrome in Obesity.
Ter Horst, R, van den Munckhof, ICL, Schraa, K, Aguirre-Gamboa, R, Jaeger, M, Smeekens, SP, Brand, T, Lemmers, H, Dijkstra, H, Galesloot, TE, et al
Arteriosclerosis, thrombosis, and vascular biology. 2020;(7):1787-1800
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Abstract
OBJECTIVE Metabolic dysregulation and inflammation are important consequences of obesity and impact susceptibility to cardiovascular disease. Anti-inflammatory therapy in cardiovascular disease is being developed under the assumption that inflammatory pathways are identical in women and men, but it is not known if this is indeed the case. In this study, we assessed the sex-specific relation between inflammation and metabolic dysregulation in obesity. Approach and Results: Three hundred two individuals were included, half with a BMI 27 to 30 kg/m2 and half with a BMI>30 kg/m2, 45% were women. The presence of metabolic syndrome was assessed according to the National Cholesterol Education Program-ATPIII criteria, and inflammation was studied using circulating markers of inflammation, cell counts, and ex vivo cytokine production capacity of isolated immune cells. Additionally, lipidomic and metabolomic data were gathered, and subcutaneous fat biopsies were histologically assessed. Metabolic syndrome is associated with an increased inflammatory profile that profoundly differs between women and men: women with metabolic syndrome show a lower concentration of the anti-inflammatory adiponectin, whereas men show increased levels of several pro-inflammatory markers such as IL (interleukin)-6 and leptin. Adipose tissue inflammation showed similar sex-specific associations with these markers. Peripheral blood mononuclear cells isolated from men, but not women, with metabolic syndrome display enhanced cytokine production capacity. CONCLUSIONS We identified sex-specific pathways that influence inflammation in obesity. Excessive production of proinflammatory cytokines was observed in men with metabolic syndrome. In contrast, women typically showed reduced levels of the anti-inflammatory adipokine adiponectin. These different mechanisms of inflammatory dysregulation between women and men with obesity argue for sex-specific therapeutic strategies.
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The Consumption of Fast Food Favors Weight Increase in Young Hellenic Navy Personnel: A 10-Year Follow-Up Study.
Doupis, J, Festas, G, Papakonstantinou, PE, Andrianesis, V, Efthymiou, V, Spanos, A, Rizzo, M, Papanas, N
Metabolic syndrome and related disorders. 2020;(10):493-497
Abstract
Introduction: Dietary habits and physical exercise have independently been recognized as important contributors to weight loss. However, the relative effect of diet and exercise on body weight is still unclear and warrants further investigation. We investigated the causes related to changes in body mass index (BMI) in a sample of young adult Greek Navy recruits over 10 years. Materials and Methods: We conducted a single-center prospective observational study, including consecutive healthy young adult officers and sailors (>18 years) at the Salamis Naval Base, Salamis, Attiki, Greece. BMI was calculated at the baseline visit. A questionnaire was selected to gather data regarding daily food consumption and daily physical exercise. The participants were followed up for 10 years (2005-2014). Results: Two hundred eighty-four young adults [mean age 31.1 ± 3.1 years; 25 (8.8%) females and 259 (91.2%) males] were included. Baseline median BMI was 24.1 kg/m2, while 10 years later, median BMI was 24.8 kg/m2 (P < 0.001). Physical activity was not significantly related to BMI change (P = 0.153). Multivariate logistic regression analysis showed a significant correlation between BMI increase and frequent fast food consumption (P = 0.044). Conclusions: Frequent fast food consumption is linked with a significant BMI increase, irrespective of physical activity. This has obvious dietary implications and needs to be examined in the general population.
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Metabolic syndrome in haemodialysis patients: prevalence, determinants and association to cardiovascular outcomes.
Delautre, A, Chantrel, F, Dimitrov, Y, Klein, A, Imhoff, O, Muller, C, Schauder, N, Hannedouche, T, Krummel, T
BMC nephrology. 2020;(1):343
Abstract
BACKGROUND In the general population, metabolic syndrome (MetS) is predictive of major adverse cardiovascular events (MACE). Waist circumference (WC), a component of the MetS criteria, is linked to visceral obesity, which in turn is associated with MACE. However, in haemodialysis (HD) patients, the association between MetS, WC and MACE is unclear. METHODS In a cross-sectional study of 1000 HD patients, we evaluated the prevalence and characterised the clinical predictors of MetS. The relationship between MetS and its components, alone or in combination, and MACE (coronary diseases, peripheral arteriopathy, stroke or cardiac failure), was studied using receiver operating characteristics (ROC) curves and logistic regression. RESULTS A total of 753 patients were included between October 2011 and April 2013. The prevalence of MetS was 68.5%. Waist circumference (> 88 cm in women, 102 cm in men) was the best predictor of MetS (sensitivity 80.2; specificity 82.3; AUC 0.80; p < 0.05). In multivariate analysis, MetS was associated with MACE (OR: 1.85; 95CI 1.24-2.75; p < 0.01), but not WC alone. There was a stronger association between the combination of abdominal obesity, hypertriglyceridaemia and low high-density lipoprotein cholesterol with MACE after exclusion of impaired fasting glucose and hypertension. CONCLUSIONS MetS is frequent and significantly associated with MACE in our haemodialysis cohort and probably in other European dialysis populations as well. In HD patients, a new simplified definition could be proposed in keeping with the concept of the "hypertriglyceridaemic waist".
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FGF21 and its Relationship with Inflammatory and Metabolic Parameters in HIV Patients after Antiretroviral Treatment.
Ruiz-Padilla, AJ, Ruiz-Noa, Y, Del Rocio Ibarra-Reynoso, L, Lazo-de-la-Vega-Monroy, ML, Alonso-Castro, AJ, Sánchez-Barajas, M, Alvarez-Alvarez, RM, Del Carmen Preciado-Puga, M
Current HIV research. 2020;(5):308-314
Abstract
BACKGROUND Fibroblast Growth Factor 21 (FGF21) serum levels are associated with insulin resistance and metabolic syndrome in HIV patients. OBJECTIVE To quantify FGF21 levels in HIV patients using antiretroviral therapy (ART) and to analyze a possible association between serum FGF21 levels and lipid profile, levels of proinflammatory cytokines, and atherogenic risk factors. MATERIALS AND METHODS Twenty patients with HIV infection, who received ART in a scheme consisting of Tenofovir/Emtricitabine+Lopinavir/Ritonavir, were enrolled in this study. The serum levels of FGF21, inflammatory parameters (IL-6 and IL-1β), glucose, cholesterol, triglycerides, and insulin were determined at baseline and after 36 weeks of treatment. The homeostatic model assessment for insulin resistance (HOMA-IR) and the atherogenic risk factor were also calculated. RESULTS After 36 weeks, serum FGF21 levels decreased significantly (p=0.011), whereas IL-6 levels (r=0.821, p=0.0001) and the CD4+ T cell count (r=0.446, p=0.048), showed a positive correlation with the decrease in FGF21 levels. There was an increase in total cholesterol (r=-0.483, p=0.031), LDL (r=-0.496, p=0.026), VLDL (r=-0.320, p=0.045), and the atherogenic index factor (r=-0.539, p=0.014), these values showed a negative correlation with FGF21 levels. CONCLUSION The decrease of serum FGF21 levels due to ART is associated with the alteration in lipid profile and an increased risk for cardiovascular diseases. These variations are predictors of inflammatory status in HIV patients using antiretroviral therapy.
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Effectiveness and safety assessment of drospirenone/ethinyl estradiol tablet in treatment of PCOS patients: a single center, prospective, observational study.
Li, L, Zhang, R, Zeng, J, Ke, H, Peng, X, Huang, L, Zhang, H, Chen, Z, Li, TT, Tan, Q, et al
BMC women's health. 2020;(1):39
Abstract
BACKGROUND To investigate the effectiveness and safety of 3 mg drospirenone and 20 μg ethinyl estradiol tablet (3 mg DRSP/20 μg EE) in the treatment of polycystic ovary syndrome (PCOS). METHODS This single center, prospective observational study was conducted in 140 patients with PCOS. They were prescribed 3 mg DRSP/20 μg EE in a 24/4/ regimen for 3 months. Patients were instructed to take oral DRSP/EE tablets (once daily) on the 2nd day of menstruation, for 28 consecutive days for 1 cycle. After 3 months of treatment, anthropometric assessments along with variations in sex hormones related index, glucolipid metabolic index, changes in bilateral ovarian volume, as well as adverse effect of the combination were evaluated. RESULTS When compared to baseline, body mass index (BMI, 22.07 ± 4.09 vs. 21.35 ± 3.22, p < 0.001) and waist hip ratio (WHR, 0.86 ± 0.07 vs. 0.854 ± 0.06, p = 0.026) decreased significantly after treatment. Sex-hormones such as luteinizing hormone (LH) (10.88 vs. 5.81 U/L), testosterone (T) (1.85 vs. 1.51 nmol/L) and free androgen index (FAI) (5.37 vs. 1.50) decreased significantly after treatment (p < 0.001). Follicular stimulating hormone (FSH) increased significantly at 3 months as compared to before treatment (5.13 vs. 5.42 U/L, p = 0.009). Plasma insulin (11.03 vs. 11.10 pmol/L), fasting (4.97 vs. 4.93 mmol/L) and 2 h-blood glucose levels (7.18 vs. 7.04 mmol/L) did not change when compared to baseline. Plasma triglycerides (TG, 1.32 vs. 1.65 mmol/L) significantly increased 3 months after treatment when compared to before treatment (p < 0.001). However, high density lipoprotein-cholesterol (HDL-C) levels increased significantly after treatment (1.41 vs. 1.57 mmol/L, p < 0.001). It was seen that, when compared to baseline, bilateral ovarian volume (left and right) was significantly lower after treatment (p < 0.05). It was seen that 81 patients reported no adverse reactions. Of the common discomforts reported, breast swelling and pain, gastrointestinal disorder and dizziness and headache were most frequent. CONCLUSIONS Treatment of PCOS patients with3 mg DRSP/20 μg EE has shown beneficial hormonal and lipid profile along with considerable safety profile. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900022001, March 2019, retrospectively registered.
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Outcome of revisional bariatric surgery for insufficient weight loss after laparoscopic Roux-en-Y gastric bypass: an observational study.
Linke, K, Schneider, R, Gebhart, M, Ngo, T, Slawik, M, Peters, T, Peterli, R
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2020;(8):1052-1059
Abstract
BACKGROUND Insufficient weight loss or secondary weight regain with or without recurrence of comorbidity can occur years after laparoscopic Roux en Y gastric bypass (LRYGB). In selected patients, increasing restriction or adding malabsorption may be a surgical option after conservative measures failed. OBJECTIVES Evaluation of short and long term results of revisional surgery for insufficient weight loss or weight regain after LRYGB. SETTING Tertiary hospital. METHODS Retrospective analysis of prospectively collected data from a cohort of 1150 LRYGB patients. Included were patients, who underwent revisional bariatric surgery after LRYGB for insufficient weight loss with a follow-up of minimal 1 year. RESULTS Fifty-four patients were included in the analysis. After an interdisciplinary evaluation, patients with insufficient weight loss, signs of dumping syndrome, and lacking restriction were offered a nonadjustable band around the pouch (banded group, n = 34) and patients with sufficient restriction, excellent compliance, and adherence were offered a revision to laparoscopic biliopancreatic diversion (BPD group, n = 20). The revisional procedure was performed 3.3 ± 2.3 years after LRYGB in the banded-group and after 6.4 ± 4.3 years in the BPD group (P = .001). Mean body mass index at the time of the primary bariatric procedure was 41.7 ± 6.2 kg/m2 in the banded group and 45.2 ± 8.2 kg/m2 in the BPD group (P = .08); minimal body mass index between both operations was 29.1 ± 4.7 kg/m2 in the banded group and 36.5 ± 9.4 kg/m2 in the BPD group, and, at the time of revisional surgery, 31.4 ± 5.5 kg/m2 in the banded group and 40.8 ± 6.7 kg/m2 in the BPD group (P = .0001). The mean body mass index difference 1 year after revisional surgery was 1.3 ± 3.0 kg/m2 in the banded group and 6.7 ± 4.5 kg/m2 in the BPD group (P = .01). In the banded group, 11 patients (32.4%) needed removal of the band, 4 patients (11.8%) needed an adjustment, and 4 patients (11.8%) were later converted to BPD. In the BPD group, 2 (10.0%) patients needed revision for severe protein malabsorption. CONCLUSIONS Insufficient weight loss or secondary weight regain after LRYGB is a rare indication for revisional surgery. Banded bypass has modest results for additional weight loss but can help patients suffering from dumping. In very carefully selected cases, BPD can achieve additional weight loss with acceptable complication rate but higher risk for reoperation. Future "adjuvant medical treatments," such as glucagon-like peptide 1 analogues and other pharmacologic treatment options could be an alternative for achieving additional weight loss and better metabolic response.