scholarly journals Hyperhomocysteinemia is an independent risk factor of atherosclerosis in patients with metabolic syndrome

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Giuseppina Piazzolla ◽  
Mafalda Candigliota ◽  
Margherita Fanelli ◽  
Anna Castrovilli ◽  
Elsa Berardi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Uric Acid ◽  
Folic Acid ◽  
Carotid Stenosis ◽  
Color Doppler ◽  
Elevated Serum ◽  
C Peptide ◽  
Group 2 ◽  
Group 1

Abstract Background Metabolic syndrome (MetS) is a clinical condition potentially promoting the development of atherosclerotic disease. To date, the clinical impact of elevated serum homocysteine (Hcy) levels in MetS is still under discussion. The aim of this cross sectional study was to evaluate the relationship between MetS and hyperhomocysteinemia and the potential role of Hcy in the pathogenesis of atherosclerotic complications of MetS. Methods We recruited 300 outpatients with MetS. All patients underwent a medical history collection, physical examination, blood sampling and carotid ultrasound echo-color Doppler. According to Hcy levels, MetS patients were divided into two groups: “normal” (< 10.7 μmol/l; n = 140, group 1) and “high” Hcy (≥ 10.7 μmol/l; n = 160, group 2). Comparisons between groups were made by Student’s t-test or Chi-square test. The effects of potential covariates on group differences were evaluated by general linear models. The relationships between continuous variables were assessed by simple or multiple correlation and by linear regression. Multiple regression models were built to evaluate the effects of Hcy, together with other potential risk factors, on carotid atherosclerosis. Results Patients with high Hcy were predominantly male and slightly older than group 1 patients. Smokers and non-smokers exhibited similar Hcy levels, nor was a statistical relationship between pack-years and Hcy observed. Group 2 showed lower levels of folic acid, vitamin D, high density lipoprotein (HDL)-cholesterol and glomerular filtration rate (e-GFR) than group 1, but higher levels of C-peptide, uric acid and triglycerides. In all patients, Hcy was positively correlated with C-peptide and uric acid and negatively with folic acid and e-GFR. Intima-media thickness (IMT) and carotid stenosis degree were significantly higher in patients with high Hcy and a positive relationship between Hcy and both IMT and carotid stenosis was detected in all patients. Finally, Hcy atherogenic effects were independent of other well-known atherosclerosis risk factors. Conclusions Our results highlight a link between MetS and hyperhomocysteinemia and a direct effect of Hcy on atherogenic process during MetS. Early correction of folic acid levels may contribute to prevent cardiovascular complications in MetS patients.

scholarly journals Insulin resistance and endothelial function are improved after folate and vitamin B12 therapy in patients with metabolic syndrome: relationship between homocysteine levels and hyperinsulinemia

2004 ◽  
pp. 483-489 ◽  
Author(s):  
E Setola ◽  
LD Monti ◽  
E Galluccio ◽  
A Palloshi ◽  
G Fragasso ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Folic Acid ◽  
Endothelial Dysfunction ◽  
Vitamin B12 ◽  
Model Assessment ◽  
Insulin Levels ◽  
Group 2 ◽  
Folate And Vitamin B12 ◽  
Group 1

OBJECTIVE: The purpose of this study was (a) to study whether a folate and vitamin B12 treatment, aimed at decreasing homocysteine levels, might ameliorate insulin resistance and endothelial dysfunction in patients with metabolic syndrome according to the National Cholesterol Education Program-Adult Treatment Panel-III criteria and (b) to evaluate whether, under these metabolic conditions, there is a relationship between hyperhomocysteinemia and insulin resistance. DESIGN AND METHODS: A double-blind, parallel, identical placebo-drug, randomized study was performed for 2 months in 50 patients. Patients were randomly allocated to two groups. In group 1, patients were treated with diet plus placebo for 2 months. In group 2, patients were treated with diet plus placebo for 1 month, followed by diet plus folic acid (5 mg/day) plus vitamin B12 (500 microg/day) for another month. RESULTS: In group 2, folate treatment significantly decreased homocysteine levels by 27.8% (12.2+/-1.2 vs 8.8+/-0.7 micromol/l; P<0.01). A significant decrement was observed for insulin levels (19.9+/-1.7 vs 14.8+/-1.6 microU/ml; P<0.01) accompanied by a 27% reduction in the homeostasis model assessment levels. A positive relationship was found between the decrement of homocysteine and insulin levels (r=0.60; P<0.002). In parallel, endothelial dysfunction significantly improved in the treated group, since post-ischemic maximal hyperemic vasodilation increased by 29.8% and cGMP by 13.6% while asymmetrical dimethylarginine levels decreased by 21.7%. On the contrary, in group 1 patients, treated with placebo, no changes were shown in any of the variables. CONCLUSIONS: Folate and vitamin B12 treatment improved insulin resistance and endothelial dysfunction, along with decreasing homocysteine levels, in patients with metabolic syndrome, suggesting that folic acid has several beneficial effects on cardiovascular disease risk factors.

scholarly journals Metabolic and psychological effects of increased consumption of less-processed foods in daily diets

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Nano ◽  
G Isoardo ◽  
G Migliaretti ◽  
S Ciullo
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Fasting Glucose ◽  
Communicable Diseases ◽  
The State ◽  
C Peptide ◽  
Non Communicable Diseases ◽  
Group 2 ◽  
Positive Effect ◽  
Group 1

Abstract Aim This study evaluated whether the consumption of locally produced food without additives might have a positive effect on known risk factors for non-communicable diseases (NCDs) such as hypertension, and levels of fasting glucose and visceral adipose tissue (VAT). Attention was focused on various types of cheese, sausages, fresh pasta, pastries, biscuits and chocolate without additives to make them palatable and durable for transport. Methods Healthy volunteers were randomized to purchase the foods under study from either local producers not using additives (group 1) or supermarkets (group 2). At baseline and after 6 months, both groups underwent evaluation for weight, blood pressure, VAT, serum sodium, potassium, fasting glucose, insulin, C-peptide and creatinine levels, and also the State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI-II) by examiners blinded to group allocation. At baseline, the state part of the STAI and Wechsler Adult Intelligence Scale IV were also performed, and body mass index, HOMA index and estimated glomerular filtration rate calculated. Results Data for 159 subjects (89 in group 1, 70 in group 2) were analyzed. Baseline evaluations did not differ between groups. At 6 months, HOMA scores and fasting glucose levels were lower in group 1 than in group 2 (P &lt; 0.01). Also, in group 1, VAT (P = 0.006), systolic blood pressure (P = 0.001) and BDIII score (P = 0.0005) were decreased, whereas serum fasting glucose (P = 0.04) and C-peptide (P = 0.03) levels, and diastolic blood pressure (P = 0.02), were increased in group 2. Conclusions Consumption of the locally produced food under study improved some of the major risk factors for NCDs after 6 months. Key messages We evaluate whether the consumption of locally produced food without additives might have a positive effect on known risk factors for non-communicable diseases (NCDs) and psychological factors. Consumption of the locally produced food under study improved some of the major risk factors for NCDs and psychological test scores after 6 months.

Efficacy evaluation of the CEUS-LI-RADS-v2017 system in differential diagnosis of liver tumors

2019 ◽  
pp. 57-67
Author(s):  
A. N. Katrich ◽  
V. A. Porkhanov ◽  
N. S. Ryabin
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Liver Tumors ◽  
Morphological Data ◽  
Malignant Neoplasms ◽  
Diagnostic Efficiency ◽  
Efficacy Evaluation ◽  
General Group ◽  
Group 2 ◽  
Group 1

Objective: efficacy evaluation of the CEUS LI RADS v2017® system for differential diagnosis of liver tumors in patients with and without cirrhosis.Materials and methods. Retrospective analysis of diagnostic results of the 165 patients with liver tumors (177 nodules) was done. All patients underwent CEUS with results interpretation in accordance to the CEUS LIRADSv2017 ® criteria. Patients were divided into 2 groups based on clinical and morphological data. Group 1 included 62 patients with cirrhosis and/or CVH. Group 2 included 110 patients without risk factors for HCC.Results. Diagnostic efficiency of CEUS LI RADS v2017® for HCC identification was: group 1 – Se – 100%, Sp – 88%, Ac – 95.5%; group 2 – Se – 100%, Sp – 68.8%, Ac – 72.7%; general group Se – 100%, Sp – 72.2%, Ac – 81.4%. In the 2nd group, 21 out of 22 neoplasms, confirmed morphologically as FNH, we classified as LR 4. By applying benign character and specific contrasting patterns of FNG, they were transferred from LR 4 to LR 3. This allowed to increase sensitivity and specificity of differential diagnosis in group 2 (Se – 100%, Sp – 90.6%, Ac – 91.8%) and in general group (Se – 100%, Sp – 90.1%, Ac – 93.2%). Diagnostic efficiency of the criteria for non hepatocellular malignant neoplasms (LR M) was: group 1 – Se – 77.8%, Sp – 100%, Ac – 97%; group 2 – Se – 90%, Sp – 96.7%, Ac – 93.6%; general group- Se – 88.1%, Sp – 98.3%, Ac – 94.9%.Conclusion. Our study confirmed high accuracy of the CEUS LI RADS v2017® system in the differential diagnosis of focal liver tumors. Modification of the system (in particular, transfer of typical FNG forms from the LR 4 category) will make it possible to increase the accuracy of diagnostics by 20%. It will allow to use the LI RADS v2017® system for interpretation CEUS not only among patients with liver cirrhosis, but also in a general group without risk factors of GCC.

Evaluation of clinical, endocrine and metabolic findings in obese children with and without hepatosteatosis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Gunce Basarir ◽  
Bahar Ozcabi ◽  
Ozden Aksu Sayman ◽  
Hatice Ozturkmen Akay ◽  
Feyza M. Yildiz
Keyword(s):  
Uric Acid ◽  
Density Lipoprotein ◽  
Thyroid Stimulating Hormone ◽  
Fasting Insulin ◽  
Obese Children ◽  
Pubertal Stage ◽  
Alcoholic Fatty Liver ◽  
Group 2 ◽  
Group 1

Abstract Objectives Non-alcoholic fatty liver disease (NAFLD) is a common obesity-related comorbidity in childhood. In this study, we aimed to evaluate predictors of NAFLD by comparing clinical, endocrine and metabolic findings in obese children with and without hepatosteatosis. Methods Two hundred and eight obese children aged 6–18 years were included. The patients were divided into group 1 (patients with NAFLD, n=94) and group 2 (patients without NAFLD, n=114). Anthropometric measurements, pubertal stage, lipid profiles, fasting glucose and insulin, homeostatic model of assessment for insulin resistance (HOMA-IR), uric acid, total bilirubin, alanine aminotransferase (ALT), blood urea nitrogen, thyroid-stimulating hormone and free thyroxine parameters were compared retrospectively. Results The mean body weight, body mass index (BMI), height, tri-ponderal mass index (TMI), insulin, HOMA-IR, triglyceride, ALT and uric acid values were significantly higher, while high-density lipoprotein-cholesterol (HDL-C) values were significantly lower in group 1. The 70.7% of obese children with hepatosteatosis and 83.9% of those without hepatosteatosis were correctly estimated by parameters including age, gender, ALT, HDL-C, fasting insulin and uric acid values. Conclusions Since obesity-associated hepatosteatosis induces various long-term metabolic impacts in children, early detection is of critical importance. Age, gender, TMI, BMI, ALT, HDL-C, fasting insulin and uric acid values may help to predict the risk of hepatosteatosis. Besides, we assessed whether TMI compared to BMI does not have a better utility in estimating obesity-induced hepatosteatosis in children. This is the first study to show the association between TMI and hepatosteatosis in children.

Serum uric acid as a predictor for nephritis in Egyptian patients with systemic lupus erythematosus

Lupus ◽  
2020 ◽  
pp. 096120332097904
Author(s):  
Eman Ahmed Hafez ◽  
Sameh Abd El-mottleb Hassan ◽  
Mohammed Abdel Monem Teama ◽  
Fatma Mohammed Badr
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Function ◽  
Uric Acid ◽  
Lupus Nephritis ◽  
Serum Creatinine ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Group 2 ◽  
Group 1

Objective Lupus nephritis (LN) is closely associated with hyperuricemia, and uric acid is considered a risk factor for renal involvement in systemic lupus erythematosus (SLE). This study aimed to examine the association between serum uric acid (SUA) level and LN development and progression in SLE patients with normal renal function. Methods A total of 60 SLE patients with normal renal function from Ain Shams University Hospital were selected and assigned to group 1 (30 patients with LN) and group 2 (30 patients without LN). All patients were subjected to history taking, clinical examination, disease activity assessment based on SLE disease activity index (SLEDAI) and renal SLEDAI (SLEDAI-R) scores, and laboratory investigations, including as SUA, complete blood count, blood urea nitrogen (BUN), serum creatinine, creatinine clearance, urine analysis, protein/creatinine ratio, 24-h urinary protein excretion, Antinuclear antibodies (ANA), anti-dsDNA antibody, and serum complement (C3, C4). Results Disease duration, SLEDAI score, and SUA level were higher in group 1 than in group 2 (p < 0.001). SUA level was positively correlated with SLEDAI and SLEDAI-R scores, proteinuria, urinary casts, renal biopsy class, disease activity and chronicity indices, BUN level, and serum creatinine level but was negatively correlated with creatinine clearance (p < 0.05). SUA was a predictor of LN development in SLE patients (sensitivity, 83.3%; specificity, 70%). Conclusion SUA is associated with the development of lupus nephritis in patients with normal kidney function also SUA in-dependently correlated with disease activity and chronicity in LN.

scholarly journals Metabolic Syndrome Prevalence and Cardiovascular Risk Assessment in HIV-Positive Men with and without Antiretroviral Therapy

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 578
Author(s):  
Win-Long Lu ◽  
Yuan-Ti Lee ◽  
Gwo-Tarng Sheu
Keyword(s):  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
Naive Group ◽  
Treatment Naïve ◽  
Group 2 ◽  
Group 1

Treatment of HIV infection is a lifelong process and associated with chronic diseases. We evaluated the prevalence and predictors of metabolic syndrome (MetS) and cardiovascular diseases (CVDs) with individual antiretroviral drugs exposure among HIV-infected men in Taiwan. A total of 200 patients’ data were collected with a mean age of 32.9. Among them, those who had CD4 positive cell number less than 350/mL were eligible to have highly active antiretroviral therapy (HAART). Patients were divided into group-1 that contains 45 treatment-naïve participants, and group-2 that includes 155 HAART treatment-experienced participants. MetS prevalence between group-1 and group-2 was 18% and 31%, respectively. The Framingham Risk Score (FRS) for the naïve and experienced groups were 4.7 ± 4.2 and 3.87 ± 5.92, respectively. High triglyceride (TG > 150 mg/dL) in group-1 and group-2 were 15.6% and 36.6% (p < 0.05), whereas, lower high-density lipoprotein (HDL < 39 mg/dL) in group-1 and group-2 presented as 76.7% versus 51% (p < 0.05), respectively. In group-2, treatment with protease inhibitors (PIs) resulted in higher TG levels when compared with non-nucleotide reverse transcriptase inhibitors (NNRTIs) and integrase inhibitors (InSTIs). The prevalence of MetS in the treatment-naïve group was lower than that of the treatment-experienced group; high TG level resulted in higher MetS prevalence in the treatment-experienced group. In contrast, the cardiovascular risk of FRS in the treatment-naïve group was higher than that of the treatment-experienced group, which may result from the low HDL level. Although group-1 participants have a higher risk of developing CVDs, in group-2, an increasing TG level in PIs user indicated higher CVDs risk. TG and HDL are two significant biofactors that required regular evaluation in HIV-positive individuals.

scholarly journals Effect of Hyperglycemia on the Total Surface Charge of the Erythrocyte Membrane in Patients with Metabolic Syndrome

2019 ◽  
Vol 15 (3) ◽  
pp. 322-327
Author(s):  
V. I. Podzolkov ◽  
T. V. Koroleva ◽  
M. G. Kudryavtseva
Keyword(s):  
Metabolic Syndrome ◽  
Surface Charge ◽  
Erythrocyte Membrane ◽  
Negative Charge ◽  
Fasting Blood Glucose ◽  
Microvascular Blood Flow ◽  
Erythrocyte Membranes ◽  
Vascular Changes ◽  
Group 2 ◽  
Group 1

Aim. To study the effect of hyperglycemia on the total surface charge of the erythrocyte membrane (SCEM) in patients with metabolic syndrome (MS).Material and methods. 112 MS patients were examined (45 men and 67 women) (mean age 61.4±7.2 years, average MS duration 8.7±5.2 years). The level of SCEM was determined by adsorption of a positive cationic dye (cationic blue O) on the surface of the plasma membrane of erythrocytes to completely neutralize their negative charge, followed by photometry of the solution and calculation of the number of charges on the cell surface of erythrocytes.Results. In the main group of patients with MS, abdominal obesity was observed in 100% of patients, arterial hypertension – in 73%, hyperglycemia – in 75%, dyslipidemia – in 80%. The level of glycated hemoglobin (HbA1c) was determined in all patients with MS, which was 7.3±1.9%. Patients with MS were conditionally divided according to the level of HbA1c into 2 groups (group 1 – HbA1c from 6.6 to 7.8%, group 2 – more than 7.8%). In MS patients with hyperglycemia, the SCEM values were significantly lower than in the group of patients without hyperglycemia (1.58±0.05×107 and 1.64±0.03×107, respectively; p=0.001)., Significant negative correlations between SCEM and the fasting blood glucose level, hyperglycemia duration, HbA1c level were found in patients with MS.Conclusion. SCEM indices reliably depended on the presence, severity and duration of hyperglycemia, which indicated the effect of impaired carbohydrate metabolism on the state of electric charge of erythrocyte membranes and, therefore, on the mechanisms of microvascular blood flow, thereby contributing to the development of vascular changes in patients with MS.

scholarly journals Metabolic Syndrome in Adults with Nonalcoholic Fatty Liver Disease

2021 ◽  
Vol 5 (2) ◽  
pp. 34-37
Author(s):  
Zhahid Hassan ◽  
Muzamil Latief ◽  
Mahroosa Ramzan ◽  
Farhat Abbas ◽  
Summyia Farooq
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Care Hospital ◽  
Nonalcoholic Fatty Liver ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, obesity, and other features of metabolic syndrome. It is identified as the most common cause of liver enzyme derangement. Lately, NAFLD has generated interest in exploring treatment options, including weight loss and dietary interventions. An association of NAFLD with metabolic syndrome has been suggested in contemporary literature. In this study, we attempted to look into the association of NAFLD with metabolic syndrome. In this study, 80 adult NAFLD patients were recruited from a tertiary care hospital. Among these, 42 were males and 38 females with a mean age of 44.46±13.146 years (range 18–82 years). Grades of fatty liver and presence or absence of metabolic syndrome were studied in this patient population. Patients who did not qualify for the criteria of met-abolic syndrome were placed in Group 1 and those who fulfilled the stated criteria were considered in Group 2. There were 29 (36.25%) patients in Group 1 and 51 (63.75%) in Group 2. All the patients in Group 1 were having Grade I fatty liver whereas patients in Group 2 were found to having varying grades of fatty liver, with six patients having Grade III fatty liver. We found statistically significant difference in various parameters of study (liver enzymes, high-density lipoprotein (HDL), triglycerides, and blood pressure) between Group 1 and Group 2. Ultrasound evidence of a fatty liver should be considered as a predictor of metabolic syndrome, and these patients must be investigated for the different components of metabolic syndrome so as to have early diagnosis and intervention to alter development of long-term metabolic disorders and their inherent complications.

scholarly journals Factors associated with the risk subclinical carotid atherosclerosis in rotational shift workers in the Arctic

2021 ◽  
Vol 27 (1) ◽  
pp. 100-109
Author(s):  
N. P. Shurkevich ◽  
A. S. Vetoshkin ◽  
L. I. Gapon ◽  
S. M. Dyachkov ◽  
A. A. Simonyan
Keyword(s):  
Risk Factors ◽  
Total Cholesterol ◽  
Work Experience ◽  
Gas Production ◽  
The Arctic ◽  
Step Method ◽  
Shift Workers ◽  
Group 2 ◽  
Traditional Risk Factors ◽  
Group 1

Objective. To determine the most unfavorable predictors of atherosclerotic plaque (ASP) in carotid arteries (CA) in rotational shift workers in the Arctic using traditional risk factors, clinical and instrumental methods of research.Design and methods. In 2010–2012, we randomly selected 424 males aged 30–59 years from 1708 rotational shift workers at the medical unit of the gas production company “Gazprom dobycha Yamburg” (Yamburg settlement, 68ºN) and performed preventive medical examination. Subjects were divided into 2 groups according to blood pressure (BP) level. Group 1 included 294 patients with hypertension (HTN) of 1 or 2 stages > 140/90 mmHg and group 2 was comprised of 130 people with BP < 140/90 mmHg. The groups did not differ by age, total work experience in the Arctic and rotational shiftwork duration. Ultrasound examination of CA showed presence or absence of ASP and stenosis by NASCET method. In addition, we assessed traditional risk factors and performed 24-hour BP monitoring and blood tests including lipid spectrum, glucose level, creatinine.Results. ASP was found more often in subjects with HTN (group 1) than in people with normal BP in the same age group, 95 % CI 56–60 % vs 95 % CI 14–20 %, (p < 0,0001). The groups did not differ significantly in the nutritional habits (p = 0,067). At the same time, the rate of smoking (p = 0,039), low physical activity (p = 0,007), overweight (p < 0,0001) was significantly higher in group 1 compared to subjects with normal BP. According to multivariate analysis, three variables with the most significant predictors associated with ASP in CA with sensitivity 75,9 % were selected using step-by-step method: diastolic BP 24 (DBP24) (p < 0,0001), glucose (p = 0,017) and total cholesterol (p = 0,044). The linear function was obtained: F = –7,664 + 0,225 × Chol + 0,366 × Glu + 0,057 × DBP24, where the variable “Chol” is the level of total cholesterol in the blood in mmol/l; “Glu” — the level of blood glucose in mmol/l; “DBP24” — average 24-hour diastolic BP. Based on the model, we concluded that DBP24 increment by 1 mmHg increases the risk for developing ASB in CA by 5,9 %, OR = 1,059 (95 % CI: 1,033; 1,087); the increment in glucose and total cholesterol by 1 mmol/l increases the risk by 44,1 % and 25,2 %, respectively: OR = 1,441 (95 % CI: 1,084; 1,966), OR = 1,252 (95 % CI: 1,010; 1,565).Conclusions. Our data enable to determine the most unfavorable predictors of ASP in CA and can potentially serve as a guideline for early diagnosis and medical management to prevent cardiovascular diseases in rotational shift workers in the Arctic.

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