scholarly journals Abdominal Obesity and Dyslipidemia in the Metabolic Syndrome: Importance of Type 2 Diabetes and Familial Combined Hyperlipidemia in Coronary Artery Disease Risk

2004 ◽  
Vol 89 (6) ◽  
pp. 2601-2607 ◽  
Author(s):  
Molly C. Carr ◽  
John D. Brunzell

Abstract Regional body fat distribution has an important influence on metabolic and cardiovascular risk factors. Increased abdominal (visceral) fat accumulation is a risk factor for coronary artery disease (CAD), dyslipidemia, hypertension, stroke, and type 2 diabetes. The recent emphasis on treatment of the dyslipidemia of the metabolic syndrome (hypertriglyceridemia, reduced high-density lipoprotein, and increased small, dense low-density lipoprotein particle number) has compelled practitioners to consider lipid-lowering therapy in a greater number of their patients, as one in two individuals over age 50 has the metabolic syndrome. Individuals with the metabolic syndrome typically have normal low-density lipoprotein cholesterol levels, and current lipid-lowering guidelines may underestimate their cardiovascular risk. Two subgroups of patients with the metabolic syndrome are at particularly high risk for premature CAD. One, individuals with type 2 diabetes, accounts for 20–30% of early cardiovascular disease. The second, familial combined hyperlipidemia, accounts for an additional 10–20% of premature CAD. Familial combined hyperlipidemia is characterized by the metabolic syndrome in addition to a disproportionate elevation of apolipoprotein B levels. The measurement of fasting glucose and apolipoprotein B, in addition to the fasting lipid profile, can help to estimate CAD risk in patients with the metabolic syndrome.

Background. Nowadays the importance of lifestyles in the prevention of type 2 diabetes and the metabolic syndrome has been largely accertained. Objective. The purpose of our work is to implement programs that promote a nutritional culture in adolescents and young adults of the La Sabana University. Methods. The methodology entailed, after the corresponding informed consent, taking measures of the triceps and supraescapular skinfolds, waist circumference, body mass index (BMI), lean mass, and fat mass. Fasting blood samples were also taken to quantify cholesterol, triglycerides, high density lipoprotein (HDL) and low density lipoprotein (LDL). Results. The results obtained show that of the 165 students, 10.3% were underweight, 13.93% were overweight and 0.6% were obese. With regards to gender, 4.8% of the men and 9% of the women were overweight, 3% of the men and 7.2% of the women were underweight, and 0.6% of the women were obese. The blood chemistry showed that 30% had hypercholesterolemia, 18% hypertriglyceridemia, 17% reported low HDL levels and 67% reported high LDL levels. Of all the cases studied, 40% are at risk of a metabolic syndrome. 60% claimed not to practice any physical activity - especially women who reported 44.70%. Conclusions. These findings have allowed us at the institution to implement a culture of healthy habits. The have also allowed us to identify students with risk factors for type 2 diabetes and metabolic syndrome. This is why the cardiometabolic monitoring and control based on healthy eating and physical activity are important.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Divya Yogi-Morren ◽  
Rachel Galioto ◽  
Sarah Elizabeth Strandjord ◽  
L. Kennedy ◽  
Pooja Manroa ◽  
...  

Type 2 diabetes (T2D) is now recognized as an independent risk factor for accelerated cognitive decline and neurological conditions like Alzheimer’s disease. Less is known about the neurocognitive function of T2D patients with comorbid metabolic syndrome, despite their elevated risk for impairment. Computerized testing in 47 adults with T2D that met criteria for NCEP metabolic syndrome revealed that cognitive impairment was prevalent, including 13% in tests of memory, 50% in attention, and 35% in executive function. Partial correlations showed that longer duration of diabetes was associated with poorer performance on tests of basic attention (r=-0.43), working memory (r=0.43), and executive function (r=0.42). Strong associations between very low density lipoprotein and poor cognitive function also emerged, including tests of set shifting (r=0.47) and cognitive inhibition (r=-0.51). Findings suggest that patients with T2D that meet criteria for metabolic syndrome are at high risk for cognitive impairment. Prospective studies should look to replicate these findings and examine the possible neuroprotective effects of lipid-lowering medication in this population.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Giuseppina Russo ◽  
Basilio Pintaudi ◽  
Carlo Giorda ◽  
Giuseppe Lucisano ◽  
Antonio Nicolucci ◽  
...  

Background. Dyslipidemia contribute to the excess of coronary heart disease (CHD) risk observed in women with type 2 diabetes (T2DM). Low density lipoprotein-cholesterol (LDL-C) is the major target for CHD prevention, and T2DM women seem to reach LDL-C targets less frequently than men.Aim. To explore age- and gender-related differences in LDL-C management in a large sample of outpatients with T2DM.Results. Overall, 415.294 patients (45.3% women) from 236 diabetes centers in Italy were included. Women were older and more obese, with longer diabetes duration, higher total-cholesterol, LDL-C, and HDL-C serum levels compared to men (P<0.0001). Lipid profile was monitored in ~75% of subjects, women being monitored less frequently than men, irrespective of age. More women did not reach the LDL-C target as compared to men, particularly in the subgroup treated with lipid-lowering medications. The between-genders gap in reaching LDL-C targets increased with age and diabetes duration, favouring men in all groups.Conclusions. LDL-C management is worst in women with T2DM, who are monitored and reach targets less frequently than T2DM men. Similarly to men, they do not receive medications despite high LDL-C. These gender discrepancies increase with age and diabetes duration, exposing older women to higher CHD risk.


Author(s):  
Hannele Yki-Järvinen

Insulin resistance, largely caused by obesity and physical inactivity, both precedes and predicts type 2 diabetes. The insulin resistance preceding type 2 diabetes is commonly referred to as the metabolic syndrome. The latter condition consists of a cluster of risk factors, which are thought to be either causes or consequences of insulin resistance. The development of type 2 diabetes, overt hyperglycaemia, also requires the presence of a relative defect in insulin secretion. This defect appears, at least in part, genetically determined. Insulin resistance can be defined as the inability of insulin to produce its usual biological actions at circulating concentrations that are effective in normal subjects. This chapter is focused on defining and characterizing defects in insulin action and in insulin and glucagon secretion in patients with type 2 diabetes, and the effects that these defects have on the body. The causes of insulin resistance in different tissues is also discussed. Hepatic insulin resistance and metabolic syndrome can be linked to atherosclerosis and cardiovascular disease, the main cause of the excess mortality in type 2 diabetes, by increased very-low-density lipoprotein production which leads to the generation of small, dense, and atherogenic LDL particles. Insulin resistance is also seen in adipose tissue and skeletal muscle, altering glucose and fatty acid handling in these tissues and the liver. The hepatic manifestation of insulin resistance in type 2 diabetes is nonalcoholic fatty liver disease (NAFLD). NFALD is defined as excess fat in the liver which is not due to excess alcohol use, and can lead to hepatic inflammation and even cirrhosis. There are defects in both insulin and glucagon secretion in type 2 diabetes, the exact cause of which remains speculative. Whilst family history and genetic factors appear to play a significant role in determining the susceptibility to overt type 2 diabetes, the only certain aspect of its aetiology and pathogenesis is that its incidence can very significantly be reduced by increasing physical activity and avoiding obesity.


Metabolism ◽  
2004 ◽  
Vol 53 (11) ◽  
pp. 1516 ◽  
Author(s):  
Ana M. Wägner ◽  
Jordi Ordóñez-Llanos ◽  
Oscar Jorba ◽  
Antonio Pérez

2016 ◽  
Vol 14 (2) ◽  
pp. 36-40 ◽  
Author(s):  
Arabinda Mohan Bhattarai ◽  
HS Batra ◽  
Suchit Bandyopadhyay ◽  
Pratibha Misra ◽  
Manushri Sharma ◽  
...  

Introduction: Atherosclerotic Coronary Artery Disease (CAD) is fundamentally related to disorders of lipid metabolism. Health problems like obesity, glucose intolerance and metabolic syndrome increase atherosclerotic CAD risk.  A fraction of Low density lipoprotein cholesterol (LDL) is called small dense low density lipoprotein cholesterol (sdLDL). These particles are more atherogenic because they are taken up more easily by arterial wall, readily oxidized and not easily cleared from plasma. Every LDL particle contain an Apo B molecule.Methods: In this cross sectional study we recruited 100 known cases each of CAD, type 2 diabetes, overweight and 100 age and sex matched healthy controls. We took a detailed case summary along with anthropometric measurements. We measured sdLDL by heparin magnesium precipitation method followed by direct estimation of the LDL in the supernatant.Result: Linear regressive analysis showed positive correlation between sdLDL and Apolipoprotein B (Apo B) with LDL cholesterol (r=0.61, p=0.004), (r=0.754, p=0.0034) respectively. Multiple Comparisons after Kruskalwallis test of sdLDL and Apo B levels of  type 2 diabetes, CAD and overweight with controls were significant (p<0.001).Conclusion: Our findings suggest that the estimation of sdLDL and Apo B provide a complimentary benefit in assessment of cases with CAD, type 2 diabetes and overweight.


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