Dysmetabolic features of the overweight patients receiving antipsychotic drugs: A comparison with normal weight and obese subjects

2014 ◽  
Vol 29 (3) ◽  
pp. 179-182 ◽  
Author(s):  
P. Manu ◽  
C.-U. Correll ◽  
M. Wampers ◽  
R. van Winkel ◽  
W. Yu ◽  
...  

AbstractBackground:Extensive research indicates that obesity, defined by a body mass index (BMI) greater or equal to 30, is common in patients treated with antipsychotic drugs and is frequently associated with carbohydrate and lipid abnormalities leading to metabolic syndrome and diabetes. In contrast, the metabolic health of overweight patients (BMI = 25–29.9) without metabolic syndrome or diabetes has not been thoroughly investigated.Objective:To assess the metabolic health of overweight patients receiving antipsychotic drugs.Methods:We compared standard metabolic parameters (BMI; waist circumference; hemoglobin A1c; fasting lipids; and fasting and post-challenge glucose and insulin) of normal weight, overweight and obese individuals from a consecutive cohort of antipsychotic-treated patients without metabolic syndrome and/or diabetes.Results:Compared with the normal weight subjects (n = 286), overweight patients (n = 212) had higher fasting insulin resistance as assessed with the homeostatic model (P = 0.023), insulin secretion during the oral glucose tolerance test (P = 0.0037), triglycerides (P = 0.0004) and low-density lipoprotein cholesterol (P = 0.0089), and lower levels of high-density lipoprotein cholesterol (P = 0.0014). The obese (n = 50) were different from the overweight subjects only with respect to higher post-challenge insulin levels (P = 0.0002). The average fasting glucose, post-challenge glucose, and hemoglobin A1c, severity of psychiatric disorders and antipsychotics used were similar in the three groups.Conclusions:Overweight (BMI = 25–29.9) patients receiving antipsychotics are metabolically closer to the obese than to normal weight counterparts. The findings suggest that interventions promoting weight loss and metabolic health are required for overweight patients even in the absence of metabolic syndrome or diabetes.

2015 ◽  
Vol 100 (5) ◽  
pp. 1997-2005 ◽  
Author(s):  
Jie Li ◽  
Hao Ma ◽  
Lixin Na ◽  
Shuo Jiang ◽  
Lin Lv ◽  
...  

Abstract Context: It is unclear why the prevalence of diabetes and prediabetes, especially prediabetes, between diagnosed by oral glucose tolerance test (OGTT) and hemoglobin A1c (HbA1c) criteria, is substantially discordant. Objective: We aimed to evaluate the effects of obesity on the agreement between HbA1c and OGTT for diagnosing diabetes and prediabetes and identify the optimal HbA1c cutoff values in different body mass index (BMI) classifications. Design Setting and Participants: In a population-based, cross-sectional study in Harbin, China, 4325 individuals aged 20–74 years without a prior diagnosed diabetes were involved in this study. Outcome: measure The performance and optimal cutoff points of HbA1c were assessed by receiver-operating characteristic curve. The contribution of BMI to HbA1c was analyzed by structural equational model. Results: The agreement between HbA1c criteria and OGTT decreased with BMI gain (κ = 0.359, 0.312, and 0.275 in a normal weight, overweight, and obese population, respectively). The structural equational model results showed that BMI was significantly associated with HbA1c in normal glucose tolerance and prediabetes subjects but not in diabetes subjects. At a specificity of 80% for prediabetes and 97.5% for diabetes, the optimal HbA1c cutoff points for prediabetes and diabetes were 5.6% and 6.4% in normal-weight, 5.7% and 6.5% in overweight, and 6.0% and 6.5% in an obese population. When the new HbA1c cutoff values were used, the agreement in obese subjects increased almost to the level in normal-weight subjects. Conclusions: The poor agreement between HbA1c and OGTT criteria in an obese population can be significantly improved through increasing the HbA1c threshold for prediabetes.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Young Suk Shim

Abstract The current study aimed to evaluate the distribution of the tri-ponderal mass index (TMI) according to sex and age and the relationship of obesity groups according to sex- and age-specific TMI with metabolic syndrome (MetS) and its components. A total of 8,464 subjects aged 10–20 years were classified into 4 groups according to sex- and age-specific TMI: (i) underweight, (ii) normal weight, (iii) overweight, and (iv) obese. The range of the 50th percentiles of TMI was from 13.24 kg/m3 at 10 years to 12.94 kg/m3 at 20 years among males and from 12.19 kg/m3 to 12.84 kg/m3 among females. In the analysis of covariance, obesity groups according to sex- and age-specific TMI were positively correlated with waist circumference (WC) standard deviation score; systolic blood pressure (BP); diastolic BP; and levels of glucose, total cholesterol, triglycerides (TGs), and low-density lipoprotein cholesterol, but for both sexes, the obesity groups were negatively related to high-density lipoprotein cholesterol (HDL-C). In the multiple logistic regression, subjects in the overweight group had higher odds ratios (ORs) for elevated WC (29.18), elevated BP (1.33), elevated TGs (2.55), reduced HDL-C (2.31), and MetS (8.93) than those with normal weight. Participants in the obesity group had increased ORs for elevated WC (154.67), elevated BP (2.22), elevated glucose (3.54), elevated TGs (4.12), reduced HDL-C (3.69), and MetS (25.57) compared to participants with normal weight after adjustment for confounders. Our results suggest that sex- and age-specific TMI may be applicable in the clinical setting as a useful screening tool.


2018 ◽  
Vol 1 (2) ◽  
pp. 9-24
Author(s):  
Adnan Alwan ◽  
Amina Alobaidi

Background: Asthma is a chronic inflammatory disease of the respiratory airways; its prevalence has increased worldwide. The disease may be associated with metabolic changes that could be either induced by treatment or may be due to inflammatory process. Aim: To clarify the status of lipid profile in Iraqi patients with asthma and allergic rhinitis. Patients and Methods: The study was performed on asthmatic patients (190), allergic rhinitis patients (110) and healthy control subjects (48). Age of subjects included were from 16-60 year, with a mean of 34.34 ±11.58 . At time of study inclusion, they all underwent full clinical examination after full history taking, pulmonary function tests, measuring body mass index and blood sampling. Results: Serum cholesterol was significantly higher in asthmatic with over weight (mean 219.93±60.02 mg/dl, P< 0.001), asthmatic with metabolic syndrome (mean 290.08±90.95 mg/dl, P<0.001), allergic rhinitis with overweight patients (mean 233.69±81.59mg/dl P< 0.001) than in control subjects (mean 145.95±36.52 mg/dl). It was of no significant difference in asthma with normal weight patients (mean 139.09±50.36 mg/dl, P-value 0.4291) and allergic rhinitis with normal weight patients (mean 155.81±49 mg/dl, P-value 0.2610) than in control subjects. Serum triglycerides was significantly higher in asthma with normal weight patients (mean 109.65±33.75 mg/dl, P-value 0.0123), asthma with over weight (mean 184.02±60.11 mg/dl, P<0.001), asthma with metabolic syndrome (mean 222.82±65.12 mg/dl, P<0.001) and allergic rhinitis with overweight patients (mean 173.62±54.27 mg/dl, P<0.001) than of control subjects (mean 92.63±35.37 mg/dl). It was of no significant difference in allergic rhinitis with normal weight patients (mean 101.56±36.29 mg/dl, P-value 0.2340) than of control subjects. High density lipoprotein-cholesterol was significantly lower in asthma with overweight group (mean 33.32±4.82 mg/dl, P<0.001), asthma with metabolic syndrome (mean 36.03±3.51 mg/dl, P<0.001), allergic rhinitis with over weight (mean 35.82±4.84mg/dl, P<0.001) than in control healthy group (mean 40.28±6.05mg/dl). It was of no significant difference between asthma with normal weight patients (mean 42.92±10.56 mg/dl, P-value 0.1215), allergic rhinitis with normal weight (mean 41.45±4.44 mg/dl, P-value 0.2600) than control subjects. Low density lipoprotein-cholesterol was significantly higher in asthma with over weight (mean 151.31±63.53 mg/dl. P<0.001); asthma with metabolic syndrome (mean 181.15±88.27 mg/dl, P<0.001); allergic rhinitis with normal weight (mean 108.42±38.05 mg/dl, P<0.01); allergic rhinitis with over weight (mean 163.49±80.92 mg/dl, P<0.001). It was significantly lower in asthma with normal weight patients (mean 68.76±32.66 mg/dl. P<0.05) than in control subjects (mean 85.84±39.39 mg/dl). Conclusion: Asthma and / or allergic rhinitis in Iraqi population were associated with dyslipidemia, whether in the presence of metabolic syndrome, or the patients were with normal or abnormal weight.


2006 ◽  
Vol 155 (2) ◽  
pp. 313-319 ◽  
Author(s):  
Marta López-Capapé ◽  
Milagros Alonso ◽  
Esmeralda Colino ◽  
Carmen Mustieles ◽  
José Corbatón ◽  
...  

Objective: Obesity is associated with insulin-resistance (IR), type 2 diabetes (T2D) and a constellation of cardiovascular risk factors at the early years of life. These features define the so-called metabolic syndrome (MS). Aims: To assess the frequency of the MS among obese pediatric Spanish population and analyse the individual contribution and the predictive potential of individual components to the development of the syndrome. Patients and methods: A total of 429 patients, 220 boys and 209 girls, aged 4–18 years, with a body mass index of > 2 standard deviation scores for Spanish normative charts, were included in the study. Forty-seven percent were prepubertal and ten percent had Hispanic ethnicity. HbA1c, lipids, liver enzymes and uric acid levels were determined from blood and a standard 2-h oral glucose tolerance test was performed. MS was defined by the National Cholesterol Education Program’s Adult Treatment Panel III criteria modified by Cook as having at least three features among: obesity, low high-density lipoprotein (HDL), hypertriglyceridemia, hypertension (HTA) or impaired glucose metabolism (IGM). We defined IR as homeostatic model assessment of IR index and/or fasting insulin levels> 95th centile of the control population. Results: Almost 18% of the patients had MS, with significantly higher frequency in Hispanic (32%) than in Caucasian (16%) population. There were no differences by sex or pubertal status. Prevalence of low HDL, HTA, hypertriglyceridemia and IGM were 27, 23, 16 and 7% respectively. No silent T2D was identified. According to International Obesity Task Force charts, 22% of the patients were overweight and not obese, but no differences in the frequency of individual features of MS between these two groups were observed. Among IR patients (35% of our population), the frequency of MS reached 28%. IR predicted the presence of MS independently from age and race. Conclusion: MS is present in 18% of our obese pediatric population. IR is closely associated with the components of MS and strongly predicts its development.


Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2921 ◽  
Author(s):  
Danuta Gajewska ◽  
Alicja Kucharska ◽  
Marcin Kozak ◽  
Shahla Wunderlich ◽  
Joanna Niegowska

Objective: The study aims to compare the effectiveness of individual and group nutrition education methods in improving key anthropometric and biochemical markers in drug-treated, overweight-obese hypertensive adults. Methods: The randomized trial included 170 patients with pharmacologically well-controlled primary hypertension and body mass index (BMI) ≥ 25 kg/m2. For six months, the patients received six sessions, either one-to-one individual nutrition education (IE, n = 89) or group education (GE, n = 81), developed by dietitians. Anthropometric measurements, body composition, and fasting measures of biochemical parameters were obtained at baseline and after six months of intervention. Results: 150 patients completed the nutrition education program. The IE group significantly improved in many parameters compared to the GE group, including weight (p < 0.001), waist circumference (p < 0.001), BMI (p < 0.001), systolic and diastolic blood pressure (BP) (p < 0.001), fasting plasma glucose (p = 0.011), oral glucose tolerance test (OGGT) (p = 0.030), and insulin resistance (homeostatic model assessment of insulin resistance, HOMA-IR) (p < 0.001). The groups did not differ in terms of total cholesterol, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) concentrations. Conclusion: Individual nutrition education is more effective than group education in terms of improving anthropometric and biochemical indices in overweight-obese hypertensive adults.


Author(s):  
Jiao Wang ◽  
Zhimin Wang ◽  
Feng Guo ◽  
Yinghui Zhang ◽  
Hongfei Ji ◽  
...  

Abstract Objectives To investigate the associations between individual and combined cardiometabolic morbidities and incident cardiovascular events in Chinese adults. Design A prospective, nationwide, and population-based cohort study. Participants 133572 participants aged ≥ 40 years were included in the study. Main Outcome Measures Cardiovascular disease (CVD) events. Results Compared with participants without diabetes, hypertension and dyslipidemia, participants with only diabetes (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.32-1.90) or only hypertension (2.04; 1.82-2.28) exhibited significantly higher risk for CVD events, while participants with only dyslipidemia (0.97; 0.84-1.12) exhibited no significantly higher risk for CVD events. When analyzed collectively, participants with diabetes plus hypertension (HR, 2.67; 95%CI, 2.33-3.06), diabetes plus dyslipidemia (1.57; 1.32-1.87), and hypertension plus dyslipidemia (2.12; 1.88-2.39) exhibited significantly higher risk for CVD. Moreover, participants with the combination of diabetes, hypertension and dyslipidemia exhibited the highest risk for CVD events (HR, 3.06; 95%CI, 2.71-3.46). Multivariable-adjusted HRs (95% CIs) for CVD associated with diabetes based on fasting glucose ≥7.0 mmol/L, oral glucose tolerance test-2h glucose ≥11.1 mmol/L, and hemoglobin A1c ≥6.5% were 1.64 (1.51-1.78), 1.57 (1.45-1.69), and 1.54 (1.42-1.66), respectively; associated with hypertension based on systolic blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg were 1.89 (1.76-2.03) and 1.74 (1.60-1.88), respectively; associated with dyslipidemia based on total cholesterol ≥6.22 mmol/L, low-density lipoprotein cholesterol ≥4.14 mmol/L, high-density lipoprotein cholesterol &lt;1.04 mmol/L, and triglycerides ≥2.26 mmol/L were 1.18 (1.08-1.30), 1.30 (1.17-1.44), 1.00 (0.92-1.09), and 1.10 (1.01-1.20), respectively. Conclusions Diabetes, hypertension and dyslipidemia showed additive associations with the risk of CVD events in middle-aged and elderly Chinese adults.


2020 ◽  
Vol 16 (1) ◽  
pp. 33-41
Author(s):  
Mohini C. Upadhye ◽  
Uday Deokate ◽  
Rohini Pujari ◽  
Vishnu Thakare

Background: Ficus glomerata (F. glomerata) Linn. Family Moraceace is a large tree found all over India including outer Himalayan ranges, Punjab, Chota Nagpur, Bihar, Orissa, West Bengal, Rajasthan, Deccan and also as a common plant in South India. It is planted around the home and temples. It is cultivated throughout the year, distributed in evergreen forests and moist localities. Objective: The Ethanolic Extract of roots of F. Glomerata (EEFG) belonging to the family Moraceace, was investigated for its antidiabetic activity using alloxan induced diabetic rats. Methods: Thirty rats were divided into 5 groups having 6 rats in each group. The alloxan was administered to the rats of all groups except normal control group through intraperitoneal route at a concentration of 140mg/kg body weight. A dose of 100mg/kg and 200 mg/kg body weight of EEFG was administered to alloxan induced diabetic rats. The administration of the extract was lasted for 11 days. Effectiveness of the extract on glucose, cholesterol, triglycerides, and high density lipoprotein and protein concentrations was analyzed. Results: Significant (p<0.05) reduction in the levels of glucose, cholesterol, triglyceride of the diabetic rats was observed after treatment with ethanolic extract. After subjecting to oral glucose tolerance test EEFG also showed significant improvement in glucose tolerance. Conclusion: F. glomerata root ethanolic extract showed that it possesses antidiabetic effect and can be found useful for the management of diabetes mellitus.


Author(s):  
R Garaa ◽  
F Norris ◽  
J Wright ◽  
L Morgan ◽  
S Hampton ◽  
...  

We investigated the contributions made by the entero-insular axis, proinsulin and the fractional hepatic extraction of insulin to the hyperinsulinaemia characteristic of polycystic ovarian syndrome (PCOS). We measured plasma glucose, gastric inhibitory polypeptide (GIP), glucagon-like peptide-1 (7–36 amide) (GLP-17–36 amide), immunoreactive insulin (IRI), intact proinsulin (IPI), and C-peptide concentrations during a 75 g oral glucose tolerance test in seven normal weight women with PCOS and eight healthy women. Women with PCOS had higher fasting ( P = 0·05) and integrated ( P < 0·01) IRI concentrations than controls. Fasting C-peptide levels were similar in both groups but integrated C-peptide ( P < 0·05) concentrations were greater in PCOS subjects than controls. Fasting and integrated concentrations of glucose, GIP and GLP-17–36 amide were similar in subjects with PCOS and controls. Although fasting IPI concentrations were similar in both groups, integrated IPI concentrations were higher ( P = 0·05) in patients with PCOS. Women with PCOS had similar fasting but higher ( P <0·05) integrated IRI: C-peptide molar ratios than controls. Fasting and integrated IPI: IRI molar ratios were similar in both groups. These results confirm that lean women with PCOS have peripheral hyperinsulinaemia. The mild fasting hyperinsulinaemia is due to increased pancreatic secretion, whereas the stimulated hyperinsulinaemia is due to both pancreatic hypersecretion and reduced fractional hepatic extraction of insulin. Hyperproinsulinaemia is modest and appropriate in PCOS. GIP and GLP-17–36 amide do not contribute to the stimulated hyperinsulinaemia in PCOS.


1999 ◽  
Vol 23 (6) ◽  
pp. 625-628 ◽  
Author(s):  
M Bougoulia ◽  
T Tzotzas ◽  
H Efthymiou ◽  
G Koliakos ◽  
TH Konstantinidis ◽  
...  

2005 ◽  
Vol 62 (11) ◽  
pp. 811-819
Author(s):  
Aleksandra Jovelic ◽  
Goran Radjen ◽  
Stojan Jovelic ◽  
Marica Markovic

Background/Aim. C-reactive protein is an independent predictor of the risk of cardiovascular events and diabetes mellitus in apparently healthy men. The relationship between C-reactive protein and the features of metabolic syndrome has not been fully elucidated. To assess the cross-sectional relationship between C-reactive protein and the features of metabolic syndrome in healthy people. Methods. We studied 161 military pilots (agee, 40?6 years) free of cardiovascular disease, diabetes mellitus and active inflammation on their regular annual medical control. Age, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglycerides, fasting glucose, glycosylated hemoglobin, blood pressure, smoking habit, waist circumference and body mass index were evaluated. Plasma C-reactive protein was measured by the immunonephelometry (Dade Behring) method. Metabolic syndrome was defined according to the National Cholesterol Education Program Expert Panel. Results. The mean C-reactive protein concentrations in the subjects grouped according to the presence of 0, 1, 2 and 3 or more features of the metabolic syndrome were 1.11, 1.89, 1.72 and 2.22 mg/L, respectively (p = 0.023) with a statistically, significant difference between those with 3, and without metabolic syndrome (p = 0.01). In the simple regression analyses C-reactive protein did not correlate with the total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, body mass index and blood pressure (p > 0.05). In the multiple regression analysis, waist circumference (? = 0.411, p = 0.000), triglycerides to high density lipoprotein cholesterol ratio (? = 0.774, p = 0.000), smoking habit (? = 0.236, p = 0.003) and triglycerides (? = 0.471, p = 0.027) were independent predictors of C-reactive protein. Conclusions. Our results suggested a cross-sectional independent correlation between the examined cardiovascular risk factors as the predominant features of metabolic syndrome and C-reactive protein in the group of apparently healthy subjects. The lack of correlation of C-reactive protein with the total cholesterol and low density lipoprotein cholesterol in our study may suggest their different role in the process of atherosclerosis and the possibility to determine C-reactive protein in order to identify high-risk subjects not identified with cholesterol screening.


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