The burden of metabolic syndrome on osteoarthritic joints

Abstract Background The prevalence of osteoarthritis (OA) increases with obesity, with up to two thirds of the elderly obese population affected by OA of the knee. The metabolic syndrome (MetS), frequently associated with central obesity and characterised by elevated waist circumference, raised fasting plasma glucose concentration, raised triglycerides, reduced high-density lipoproteins, and/or hypertension, is implicated in the pathogenesis of OA. This narrative review discusses the mechanisms involved in the influence of MetS on OA, with a focus on the effects on macrophages and chondrocytes. Main text A skewing of macrophages towards a pro-inflammatory M1 phenotype within synovial and adipose tissues is thought to play a role in OA pathogenesis. The metabolic perturbations typical of MetS are important drivers of pro-inflammatory macrophage polarisation and activity. This is mediated via alterations in the levels and activities of the cellular nutrient sensors 5′ adenosine monophosphate-activated protein kinase (AMPK) and mammalian target of rapamycin complex 1 (mTORC1), intracellular accumulation of metabolic intermediates such as succinate and citrate, and increases in free fatty acids (FFAs) and hyperglycaemia-induced advanced glycation end-products (AGEs) that bind to receptors on the macrophage surface. Altered levels of adipokines, including leptin and adiponectin, further influence macrophage polarisation. The metabolic alterations in MetS also affect the cartilage through direct effects on chondrocytes by stimulating the production of pro-inflammatory and catabolic factors and possibly by suppressing autophagy and promoting cellular senescence. Conclusions The influence of MetS on OA pathogenesis involves a wide range of metabolic alterations that directly affect macrophages and chondrocytes. The relative burden of intra-articular versus systemic adipose tissue in the MetS-associated OA remains to be clarified. Understanding how altered metabolism interacts with joints affected by OA is crucial for the development of further strategies for treating this debilitating condition, such as supplementing existing therapies with metformin and utilising ω-3 fatty acid derivatives to restore imbalances in ω-3 and ω-6 fatty acids.

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The Relationship Between Fiber Intake and Omega 3 and 6 Fatty Acid intake and Metabolic Syndrome in 4 Countries Spanning the Epidemiologic Transition

Current Developments in Nutrition ◽

10.1093/cdn/nzaa043_093 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 242-242

Author(s):

Supal Mehta ◽

Lara Dugas ◽

Amy Luke

Keyword(s):

Metabolic Syndrome ◽

Fatty Acids ◽

High Density Lipoproteins ◽

Calorie Intake ◽

Fiber Intake ◽

Omega 3 ◽

Epidemiologic Transition ◽

Wide Range ◽

Omega 6 ◽

Insoluble Fiber

Abstract Objectives Dietary modifications can be an effective therapeutic approach to prevent and manage metabolic syndrome. The aim of this study is to explore the association between fiber intake with metabolic syndrome and between omega 3 and 6 fatty acids with metabolic syndrome in four countries spanning the epidemiological transition. The study participants eat very different diets across the countries. Methods Data were obtained from a cohort of 2000 adults, aged 25–45, enrolled in the Modeling the Epidemiologic Transition Study from US, Ghana, Jamaica and Seychelles. Dietary intake was measured using two 24hr recalls and analyzed using Nutrient Data System for Research. Participants were categorized as having metabolic syndrome if they had at least three of the following condition: high triglyceride levels (>150 mg/dL), reduced high-density lipoproteins (<40 mg/dL), elevated blood pressure (>130/85 mmHg), increased fasting blood glucose (>100 mg/dL) and a waist circumference (>89 cm for women and >103 cm for men). The association between fiber and metabolic syndrome was analyzed using quartiles of total, soluble, and insoluble fiber intake. The association between metabolic syndrome and the combined intake of omega 3 and 6 fatty acids was analyzed using quartiles of the omega 3 index, the sum of eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), and quartiles of the ratio of omega 6:3 fatty acids. Data were analyzed using logistic regressions adjusted for age, sex, calorie intake, alcohol intake and smoking status. Results Participants with metabolic syndrome were 1.7 times (95% CI: 1.2, 2.3) as likely to be in the lowest compared to the highest quartile of total fiber intake and 1.5 times (1.1, 2.0) as likely to in the lowest quartile of insoluble fiber intake. Participants with metabolic syndrome were 1.9 times (1.3, 2.7) as likely to be in the lowest quartile of the of EPA + DHA intake. Risk of metabolic syndrome was not significantly associated with omega 6:3 ratio. Conclusions These findings expand on prior research supporting a beneficial role for dietary fiber and omega 3 fatty acids in reducing the risk of metabolic syndrome in understudied populations consuming a wide range of diets. In aggregate, these results support an important role of diet in metabolic syndrome risk regardless of population. Funding Sources National Institute of Health. Stritch School of Medicine.

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A longitudinal study over 40 years to study the metabolic syndrome as a risk factor for cardiovascular diseases

Scientific Reports ◽

10.1038/s41598-021-82398-8 ◽

2021 ◽

Vol 11 (1) ◽

Cited By ~ 1

Author(s):

Lars Lind ◽

Johan Sundström ◽

Johan Ärnlöv ◽

Ulf Risérus ◽

Erik Lampa

Keyword(s):

Metabolic Syndrome ◽

Risk Factor ◽

Longitudinal Study ◽

Clinical Intervention ◽

The Elderly ◽

Adult Men ◽

The Metabolic Syndrome ◽

The Impact ◽

Over 40 Years

AbstractThe impact of most, but not all, cardiovascular risk factors decline by age. We investigated how the metabolic syndrome (MetS) was related to cardiovascular disease (CVD) during 40 years follow-up in the Uppsala Longitudinal Study of Adult Men (ULSAM, 2,123 men all aged 50 at baseline with reinvestigations at age 60, 70, 77 and 82). The strength of MetS as a risk factor of incident combined end-point of three outcomes (CVD) declined with ageing, as well as for myocardial infarction, ischemic stroke and heart failure when analysed separately. For CVD, the risk ratio declined from 2.77 (95% CI 1.90–4.05) at age 50 to 1.30 (95% CI 1.05–1.60) at age 82. In conclusion, the strength of MetS as a risk factor of incident CVD declined with age. Since MetS was significantly related to incident CVD also at old age, our findings suggest that the occurrence of MetS in the elderly should not be regarded as innocent. However, since our data were derived in an observational study, any impact of MetS in the elderly needs to be verified in a randomized clinical intervention trial.

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Individual Diet Modification Reduces the Metabolic Syndrome in Patients Before Pharmacological Treatment

Nutrients ◽

10.3390/nu13062102 ◽

2021 ◽

Vol 13 (6) ◽

pp. 2102

Author(s):

Małgorzata Elżbieta Zujko ◽

Marta Rożniata ◽

Kinga Zujko

Keyword(s):

Physical Activity ◽

Metabolic Syndrome ◽

Fatty Acids ◽

Waist Circumference ◽

Nutrition Education ◽

Dietary Habits ◽

Fasting Glucose ◽

Intervention Group ◽

Control Group ◽

The Metabolic Syndrome

Modification of lifestyle, including healthy nutrition, is the primary approach for metabolic syndrome (MetS) therapy. The aim of this study was to estimate how individual nutrition intervention affects the reduction of MetS components. Subjects diagnosed with MetS were recruited in the Lomza Medical Centre. The study group consisted of 90 participants and was divided into one intervention group (individual nutrition education group (INEG)) and one control group (CG). The research was conducted over 3 months. The following measurements were obtained during the first visit and after completion of the 3 months intervention: body mass, waist circumference, body composition, blood pressure, fasting glucose, and blood lipids. Dietary assessments were performed before and post-intervention using 3-day 24-h dietary recalls. Dietary knowledge was evaluated with the KomPAN questionnaire. The total polyphenol content of the diet was calculated. Sociodemographic and lifestyle characteristics were collected from a self-reported questionnaire. The physical activity was assessed by the short version of the International Physical Activity Questionnaire (IPAQ). It was found that the individual nutrition education was an effective method to improve the knowledge, dietary habits, and physical activity of the study participants. The modification of the diet in terms of higher intake of polyphenols (flavonoids and anthocyanins), fiber, polyunsaturated fatty acids (PUFA), PUFA n-3, and lower intake of saturated fatty acids (SFA) had a significant impact on the improvement of some MetS risk factors (waist circumference, fasting glucose, and HDL-cholesterol).

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Prevalence and factors associated with Metabolic Syndrome in elderly users of the Unified Health System

Revista Brasileira de Epidemiologia ◽

10.1590/1809-4503201400040001 ◽

2014 ◽

Vol 17 (4) ◽

pp. 805-817 ◽

Cited By ~ 10

Author(s):

Edna Cunha Vieira ◽

Maria do Rosário Gondim Peixoto ◽

Erika Aparecida da Silveira

Keyword(s):

Metabolic Syndrome ◽

Health System ◽

Health Workers ◽

The Elderly ◽

World Health ◽

Fat Percentage ◽

Cross Sectional ◽

Factors Associated ◽

Unified Health System ◽

The Metabolic Syndrome

OBJECTIVE: To evaluate the prevalence and factors associated with metabolic syndrome in the elderly. METHODS: Cross-sectional study, with 133 individuals randomly selected in the Unified Health System in Goiania, Goiás. The following variables were researched: anthropometric (BMI, waist circumference, fat percentage by Dual X-ray absorptiometry), sociodemographic (gender, age, color, income, marital status and years of schooling), lifestyle (physical activity, smoking and risk alcohol consumption) and food intake (risk and protective foods). The metabolic syndrome was assessed according to harmonized criteria proposed by the World Health Organization (WHO). The combinations were tested by Poisson regression for confounding factors. RESULTS: The prevalence of metabolic syndrome was 58.65% (95%CI 49.8 - 67.1), with 60.5% (95%CI 49.01 - 71.18) for females and 55.7% (95%CI 41.33 - 69.53) for males. Hypertension was the most prevalent component of the syndrome in both men, with 80.8% (95%CI 64.5 - 90.4), and women, with 85.2% (95%CI 75.5 - 92.1). After the multivariate analysis, only the excess of weight measured by body mass index (prevalence ratio = 1.66; p < 0.01) remained associated with the metabolic syndrome. CONCLUSIONS: The prevalence of metabolic syndrome in this sample was high, indicating the need for systematic actions by health workers in the control of risk factors through prevention strategies and comprehensive care to the elderly.

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Disentangling the Effects of Monounsaturated Fatty Acids from Other Components of a Mediterranean Diet on Serum Metabolite Profiles: A Randomized Fully Controlled Dietary Intervention in Healthy Subjects at Risk of the Metabolic Syndrome

Molecular Nutrition & Food Research ◽

10.1002/mnfr.201801095 ◽

2019 ◽

Vol 63 (9) ◽

pp. 1801095 ◽

Cited By ~ 10

Author(s):

Charlotte C. J. R. Michielsen ◽

Roland W.J. Hangelbroek ◽

Edith J. M. Feskens ◽

Lydia A. Afman

Keyword(s):

Metabolic Syndrome ◽

At Risk ◽

Fatty Acids ◽

Mediterranean Diet ◽

Healthy Subjects ◽

Dietary Intervention ◽

Monounsaturated Fatty Acids ◽

The Metabolic Syndrome ◽

Metabolite Profiles

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MULTIPARTICULATE FLOATING DRUG DELIVERY SYSTEM OF ANAGLIPTIN: DESIGN AND OPTIMIZATION FOR ITS EFFICACY IN MANAGEMENT OF METABOLIC SYNDROME

International Journal of Applied Pharmaceutics ◽

10.22159/ijap.2019v11i4.33249 ◽

2019 ◽

pp. 171-181

Author(s):

RAKESH V. MISHRA ◽

SHASHIKANT N. DHOLE

Keyword(s):

Metabolic Syndrome ◽

Drug Release ◽

Wistar Rats ◽

Lag Time ◽

Cafeteria Diet ◽

High Density Lipoproteins ◽

Eudragit Rs ◽

The Metabolic Syndrome ◽

Male Wistar Rats ◽

Eudragit Rl

Objective: The present research aims to design and optimize gastroretentive floating pellets of anagliptin (a dipeptidyl peptidase-4 inhibitor), so as to reduce P-Glycoprotein (PGP)–mediated efflux in the intestine hence to improve oral bioavailability. Methods: The drug-containing core pellets were prepared by extrusion and spheronization process followed by subsequent coating with three successive layers i.e. Eudragit RS 100, sodium bicarbonate (NaHCO3): hydroxypropyl methylcellulose E5LV (HPMC E5LV) and Eudragit RL 100 using fluidized bed processor. A 3 level 3 factor box-behnken design was adopted to investigate the effect of Eudragit RS 100, NaHCO3: HPMC E5LVand Eudragit RL 100 on floating lag time and drug release at 10 h. Desirability function under numerical optimization technique was used to identify the optimum formulation. Results: The study reveals the significant effect of the amount of NaHCO3 and coating level of polymers on floating lag time and drug release. The optimum system could float within 4 min and exhibited more than 85% drug release in 10 h. The pharmacokinetic study conducted in male Wistar rats indicated 2.51 fold increase in relative bioavailability of optimized formulation compare to anagliptin drug. Formulated anagliptin pellets were evaluated in cafeteria diet-induced metabolic syndrome model in male Wistar rats. Anagliptin floating pellets treatment compared to cafeteria diet group significantly inhibited increase in body weight (238.79±2.52 g vs. 277.98±3.69 g, P<0.001), calorie intake (2283.99 kcal vs. 3086.05 kcal, P<0.05) and serum levels of total cholesterol (95.19±0.61 mg/dl vs. 110.04±1.31 mg/dl, P<0.01), triglycerides (96.12±1.25 mg/dl vs. 105.99±1.29 mg/dl, P<0.01) while high-density lipoproteins levels were improved (42.15±0.92 mg/dl vs. 30.92±0.77 mg/dl, P<0.01) indicated its hypophagic and anti-hyperlipidemic effects. Conclusion: The gastroretentive floating pellets of anagliptin was obtained and could be a promising technique to deliver anagliptin with improved bioavailability in the management of the metabolic syndrome.

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Total and Subtypes of Dietary Fat Intake and Its Association with Components of the Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Risk

Nutrients ◽

10.3390/nu11071493 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1493 ◽

Cited By ~ 12

Author(s):

Alicia Julibert ◽

Maria Bibiloni ◽

Cristina Bouzas ◽

Miguel Martínez-González ◽

Jordi Salas-Salvadó ◽

...

Keyword(s):

Metabolic Syndrome ◽

Fatty Acids ◽

Dietary Fat ◽

Saturated Fatty Acids ◽

Mediterranean Population ◽

Fat Intake ◽

Cvd Risk ◽

Dietary Fat Intake ◽

The Metabolic Syndrome ◽

Total Fat

Background: The effect of dietary fat intake on the metabolic syndrome (MetS) and in turn on cardiovascular disease (CVD) remains unclear in individuals at high CVD risk. Objective: To assess the association between fat intake and MetS components in an adult Mediterranean population at high CVD risk. Design: Baseline assessment of nutritional adequacy in participants (n = 6560, men and women, 55–75 years old, with overweight/obesity and MetS) in the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial. Methods: Assessment of fat intake (total fat, monounsatured fatty acids: MUFA, polyunsaturated fatty acids: PUFA, saturated fatty acids: SFA, trans-fatty acids: trans-FA, linoleic acid, α-linolenic acid, and ω-3 FA) using a validated food frequency questionnaire, and diet quality using 17-item Mediterranean dietary questionnaire and fat quality index (FQI). Results: Participants in the highest quintile of total dietary fat intake showed lower intake of energy, carbohydrates, protein and fiber, but higher intake of PUFA, MUFA, SFA, TFA, LA, ALA and ω-3 FA. Differences in MetS components were found according to fat intake. Odds (5th vs. 1st quintile): hyperglycemia: 1.3–1.6 times higher for total fat, MUFA, SFA and ω-3 FA intake; low high-density lipoprotein cholesterol (HDL-c): 1.2 higher for LA; hypertriglyceridemia: 0.7 lower for SFA and ω-3 FA intake. Conclusions: Dietary fats played different role on MetS components of high CVD risk patients. Dietary fat intake was associated with higher risk of hyperglycemia.

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Obesity and the Metabolic Syndrome in the Elderly – A Mini-Review

Gerontology ◽

10.1159/000161734 ◽

2008 ◽

Vol 54 (5) ◽

pp. 253-259 ◽

Cited By ~ 49

Author(s):

Monika Lechleitner

Keyword(s):

Metabolic Syndrome ◽

The Elderly ◽

The Metabolic Syndrome

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Modern fat technology: what is the potential for heart health?

Proceedings of The Nutrition Society ◽

10.1079/pns2005446 ◽

2005 ◽

Vol 64 (3) ◽

pp. 379-386 ◽

Cited By ~ 40

Author(s):

J. E. Upritchard ◽

M. J. Zeelenberg ◽

H. Huizinga ◽

P. M. Verschuren ◽

E. A. Trautwein

Keyword(s):

Metabolic Syndrome ◽

Fatty Acids ◽

Unsaturated Fatty Acids ◽

Disease Risk ◽

Saturated Fatty Acids ◽

Saturated Fat ◽

Blood Cholesterol ◽

Medical Community ◽

The Metabolic Syndrome ◽

Increased Risk

Saturated andtrans-fatty acids raise total cholesterol and LDL-cholesterol and are known to increase the risk of CHD, while dietary unsaturated fatty acids play important roles in maintaining cardiovascular health. Replacing saturated fats with unsaturated fats in the diet often involves many complex dietary changes. Modifying the composition of foods high in saturated fat, particularly those foods that are consumed daily, can help individuals to meet the nutritional targets for reducing the risk of CHD. In the 1960s the Dutch medical community approached Unilever about the technical feasibility of producing margarine with a high-PUFA and low-saturated fatty acid composition. Margarine is an emulsion of water in liquid oil that is stabilised by a network of fat crystals. In-depth expertise of fat crystallisation processes allowed Unilever scientists to use a minimum of solid fat (saturated fatty acids) to structure a maximum level of PUFA-rich liquid oil, thus developing the first blood-cholesterol-lowering product, Becel. Over the years the composition of this spread has been modified to reflect new scientific findings and recommendations. The present paper will briefly review the developments in fat technology that have made these improvements possible. Unilever produces spreads that are low in total fat and saturated fat, virtually free oftrans-fatty acids and with levels ofn-3 andn-6 PUFA that are in line with the latest dietary recommendations for the prevention of CHD. Individuals with the metabolic syndrome have a 2–4-fold increased risk of developing CHD; therefore, these spreads could make a contribution to CHD prevention in this group. In addition, for individuals with the metabolic syndrome the spreads could be further modified to address their unique dyslipidaemia, i.e. elevated blood triacylglycerols and low HDL-cholesterol. Research conducted in the LIPGENE study and other dietary intervention studies will deliver the scientific evidence to justify further modifications in the composition of spreads that are healthy for the heart disease risk factors associated with the metabolic syndrome.

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