Biology of metabolic syndrome in a vascular patient

Vascular ◽  
2012 ◽  
Vol 20 (3) ◽  
pp. 156-165 ◽  
Author(s):  
Daynene Vykoukal ◽  
Mark G Davies
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Fasting Blood Glucose ◽  
Adverse Impact ◽  
Atherogenic Dyslipidemia ◽  
Elevated Blood ◽  
Vascular Beds ◽  
Vascular Patient

Metabolic syndrome is highly prevalent in vascular patients and has a significant impact on the outcomes of vascular interventions. It comprises of a set of metabolically driven risk factors, including truncal obesity, dyslipidemia, elevated blood pressure and elevated fasting blood glucose. Increased insulin resistance within the context of obesity and hypertension contributes to atherogenic dyslipidemia, hyperglycemia, and prothrombotic and proinflammatory states which lead to the adverse impact of metabolic syndrome on the response to injury and on atherosclerotic disease progression. This review focuses on the complex biology of metabolic syndrome and its relevance to management of vascular patients, including outcomes and implications for the coronary, cerebrovascular and lower-extremity vascular beds.

Investigation of the prevalence of cardiovascular risk factors in obese patients diagnosed with metabolic syndrome in childhood and examination of left ventricular function by echocardiography

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Güzin Özden ◽  
Ayşe Esin Kibar Gül ◽  
Eda Mengen ◽  
Ahmet Ucaktürk ◽  
Hazım Alper Gürsu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Left Ventricular ◽  
Atherogenic Index ◽  
Volume Index ◽  
Common Component

Abstract Objectives The objective of this study is to investigate the cardiovascular risk factors associated with metabolic syndrome (MetS), which is increasingly becoming prevalent in childhood obesity. Methods A total of 113 patients, 76 of whom were between the ages of 10 and 17 (mean age: 14.5 ± 1.8 years) and diagnosed with obesity (30 non-MetS and 46 MetS using IDF) and 37 of whom constituted the control group, participated in the study. Echocardiographic examination and atherogenicity parameters (Atherogenic index of plasma [AIP: logTG/HDL], total cholesterol/HDL, and TG/HDL ratio and non-HDL) were evaluated. Results The most common component accompanying obese MetS was found to be hypertension and low HDL. While obesity duration, body mass index (BMI), blood pressure, fasting insulin, insulin resistance, atherogenicity parameters were determined to be significantly higher in the obese-MetS group. Echocardiography showed that while the thickness, volume, and diameter of LV end-diastolic wall, left ventricular mass (LVM), LVM index (LVMI g/m2) and relative wall thickness (RWT) were significantly high in the MetS group, however, mitral E/A ratio was significantly lower (p<0.05). Change in LV geometry consistent with concentric remodeling (increased RWT, normal LVMI) was visible in obese groups. LVM were positively significantly related to BMI, waist circumference, insulin resistance, blood pressure, LDL level, and negative to mitral E/A ratio. In the obese-MetS group, LVMI was positively correlated to office systolic BP, left atrium end-diastolic volume/index. Conclusions LVMI and atherogenicity parameters that were found to be significantly higher in obese MetS exhibit increased cardiovascular risk in childhood.

scholarly journals Na+-sensitive elevation in blood pressure is ENaC independent in diet-induced obesity and insulin resistance

2016 ◽  
Vol 310 (9) ◽  
pp. F812-F820 ◽  
Author(s):  
Jonathan M. Nizar ◽  
Wuxing Dong ◽  
Robert B. McClellan ◽  
Mariana Labarca ◽  
Yuehan Zhou ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
High Fat ◽  
Electrolyte Excretion ◽  
Diet Induced Obesity ◽  
Collecting Ducts ◽  
Fat Feeding

The majority of patients with obesity, insulin resistance, and metabolic syndrome have hypertension, but the mechanisms of hypertension are poorly understood. In these patients, impaired sodium excretion is critical for the genesis of Na+-sensitive hypertension, and prior studies have proposed a role for the epithelial Na+ channel (ENaC) in this syndrome. We characterized high fat-fed mice as a model in which to study the contribution of ENaC-mediated Na+ reabsorption in obesity and insulin resistance. High fat-fed mice demonstrated impaired Na+ excretion and elevated blood pressure, which was significantly higher on a high-Na+ diet compared with low fat-fed control mice. However, high fat-fed mice had no increase in ENaC activity as measured by Na+ transport across microperfused cortical collecting ducts, electrolyte excretion, or blood pressure. In addition, we found no difference in endogenous urinary aldosterone excretion between groups on a normal or high-Na+ diet. High fat-fed mice provide a model of metabolic syndrome, recapitulating obesity, insulin resistance, impaired natriuresis, and a Na+-sensitive elevation in blood pressure. Surprisingly, in contrast to previous studies, our data demonstrate that high fat feeding of mice impairs natriuresis and produces elevated blood pressure that is independent of ENaC activity and likely caused by increased Na+ reabsorption upstream of the aldosterone-sensitive distal nephron.

scholarly journals The metabolic syndrome – What is it and how should it be managed?

2019 ◽  
Vol 26 (2_suppl) ◽  
pp. 33-46 ◽  
Author(s):  
Peter M Nilsson ◽  
Jaakko Tuomilehto ◽  
Lars Rydén
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Successful Management ◽  
Unhealthy Lifestyle ◽  
The Metabolic Syndrome ◽  
Frail Elderly People

A cluster of metabolic factors have been merged into an entity named the metabolic syndrome. Although the characteristics of this syndrome have varied over time the presently used definition was established in 2009. The presence of three abnormal findings out of five components qualifies a person for the metabolic syndrome: elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting plasma glucose. Cut points have been defined for all components apart from waist circumference, for which national or regional values are used. The metabolic syndrome predicts cardiovascular disease and type 2 diabetes. This associated risk does not exceed its components whereof elevated blood pressure is the most frequent. A successful management should, however, address all factors involved. The management is always based on healthy lifestyle choices but has not infrequently to be supported by pharmacological treatment, especially blood pressure lowering drugs. The metabolic syndrome is a useful example of the importance of multiple targets for preventive interventions. To be successful management has to be individualized not the least when it comes to pharmacological therapy. Frail elderly people should not be over-treated. Knowledge transfer of how risk factors act should be accompanied by continuous trust building and motivation. In complex situations with a mix of biological risk factors, adverse social conditions and unhealthy lifestyle, everything cannot be changed at once. It is better to aim for small steps that are lasting than large, unsustainable steps with relapses to unhealthy behaviours. A person with the metabolic syndrome will always be afflicted by its components, which is the reason that management has to be sustained over a very long time. This review summarizes the knowledge on the metabolic syndrome and its management according to present state of the art.

scholarly journals High TSH Level within Normal Range Is Associated with Obesity, Dyslipidemia, Hypertension, Inflammation, Hypercoagulability, and the Metabolic Syndrome: A Novel Cardiometabolic Marker

2019 ◽  
Vol 8 (6) ◽  
pp. 817 ◽  
Author(s):  
Yi-Cheng Chang ◽  
Shih-Che Hua ◽  
Chia-Hsuin Chang ◽  
Wei-Yi Kao ◽  
Hsiao-Lin Lee ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Central Obesity ◽  
Cardiometabolic Risk ◽  
Fasting Glucose ◽  
Reference Group ◽  
Elevated Blood ◽  
Normal Range ◽  
The Metabolic Syndrome

(1) Background: Overt and subclinical hypothyroidism has been associated with increased cardiometabolic risks. Here we further explore whether thyroid function within normal range is associated with cardiometabolic risk factors in a large population-based study. (2) Methods: We screened 24,765 adults participating in health examinations in Taiwan. Participants were grouped according to high-sensitive thyroid-stimulating hormone (hsTSH) level as: <50th percentile (0.47–1.48 mIU/L, the reference group), 50–60th percentile (1.49–1.68 mIU/L), 60–70th percentile (1.69–1.94 mIU/L), 70–80th percentile (1.95–2.3 mIU/L), 80–90th percentile (2.31–2.93 mIU/L), and >90th percentile (>2.93 mIU/L). Cardiometabolic traits of each percentile were compared with the reference group. (3) Results: Elevated hsTSH levels within normal range were dose-dependently associated with increased body mass index, body fat percentage, waist circumferences, blood pressure, hemoglobin A1c (HbA1c), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), high homeostasis model of assessment of beta-cell (HOMA-β), triglycerides, total cholesterols, fibrinogen, and uric acids (p-for-trend <0.001), but not with fasting glucose levels. The association remained significant after adjustment of age, sex, and lifestyle. As compared to the reference group, subjects with the highest hsTSH percentile had significantly increased risk of being overweight (adjusted odds ratio (adjOR): 1.35), increased body fat (adjOR: 1.29), central obesity (adjOR: 1.36), elevated blood pressure (adjOR: 1.26), high HbA1c (adjOR: 1.20), hyperinsulinemia (adjOR: 1.75), increased HOMA-IR (adjOR: 1.45), increased HOMA-β (adjOR: 1.40), hypertriglyceridemia (adjOR: 1.60), hypercholesterolemia (adjOR: 1.25), elevated hsCRP (adjOR: 1.34), increased fibrinogen (adjOR: 1.45), hyperuricemia (adjOR: 1.47), and metabolic syndrome (adjOR: 1.42), but significant risk of low fasting glucose (adjOR: 0.89). Mediation analysis indicates that insulin resistance mediates the majority of the association between thyroid hormone status and the metabolic syndrome. (4) Conclusion: Elevated hsTSH within the normal range is a cardiometabolic risk marker associated with central obesity, insulin resistance, elevated blood pressure, dyslipidemia, hyperuricemia, inflammation, and hypercoagulability.

scholarly journals The Metabolic Syndrome and Risk of Chronic Kidney Disease: Pathophysiology and Intervention Strategies

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Heather A. LaGuardia ◽  
L. Lee Hamm ◽  
Jing Chen
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Intervention Strategies ◽  
Elevated Blood ◽  
The Metabolic Syndrome ◽  
Prevalence Of Obesity ◽  
Complications And Mortality

Metabolic syndrome is characterized by a clustering of cardiovascular risk factors, including abdominal obesity, elevated blood pressure and glucose concentrations, and dyslipidemia. The presence of this clinical entity is becoming more pervasive throughout the globe as the prevalence of obesity increases worldwide. Moreover, there is increased recognition of the complications and mortality related to this syndrome. This paper looks to examine the link between metabolic syndrome and the development of chronic kidney disease.

Evaluation of insulin resistance and its associated risk factors: Identification of adolescents at higher risk for diabetes

2021 ◽  
Vol 2 (1) ◽  
pp. 092-100
Author(s):  
Ugomma Ude Agwu ◽  
Michael Erem Kalu ◽  
Vivian Abomah Okeoghene ◽  
Marvis Njoku ◽  
Victor Udo Usanga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Diseases ◽  
Demographic Data ◽  
Strong Association ◽  
Fasting Blood Glucose ◽  
The Elderly ◽  
Tertiary Institutions ◽  
Associated Risk Factors

Insulin resistance is a major risk factor for developing type 2 diabetes mellitus and metabolic diseases. It is a decrease response to the effect of the hormone, mainly by the liver, skeletal muscles and adipose tissues. Despite its widely reported prevalence among the elderly, information on its prevalence among adolescents is relatively limited. The study was aimed at assessing the prevalence of insulin resistance and its contributing risk factors among the students of a tertiary institutions in Ebonyi State, Nigeria. A total of 260 students who consented to the study were recruited, fasting blood glucose (FBG) and fasting blood insulin (FBI) levels were determined, anthropometric data were collected using meter rule, flexible tape and digital scale for calculation of body mass index (BMI) and waist/hip ratio (WHR). A structured questionnaire was used to collect demographic data and information on lifestyle. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were also measured. The findings showed a 5.4% prevalence of insulin resistance with more in males than in females. Sociodemographic and anthropometric characteristics were found to positively correlate with HOMA-IR. A strong association (p < 0.05) was observed between HOMA-IR and lifestyle. The differences in the levels of HOMA-IR within and between the various groups of participants were not statistically significant (p > 0.05) except in gender. The findings of this study may have potential implications with regards to strategies for amelioration and prevention of insulin resistance amongst adolescents.

scholarly journals Obesity and metabolic syndrome: clinical and therapeutic review

2005 ◽  
Vol 64 (1) ◽  
Author(s):  
Andrea Cuppini ◽  
Paola Matteini
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Multidisciplinary Approach ◽  
Atherogenic Dyslipidemia ◽  
Obese Patients ◽  
Abdominal Adiposity ◽  
The Individual ◽  
Positive Results

The recent ATP III classification defines metabolic syndrome as including ≥3 of the following characteristics: abdominal adiposity, atherogenic dyslipidemia, high blood pressure, and insulin resistance. In these patients the visceral fat may produce inflammatory cytochines that may account for an enhanced cardiovascular risk. The treatment of obese patients is complex and often ineffective: patients may initially reduce weight but subsequently regain or even increase it, according to the socalled “yo-yo syndrome”. Given the difficulties of treatment of patients with incresed BMI, visceral adiposity, or metabolic syndrome, a multidisciplinary approach to these patients may yield more frequent positive results. The different strategies that may be applied, in varying mix targeted to the individual patient, include diet, drugs, educational and psychological support and, in few selected cases, surgery.

scholarly journals LIGHT-ROASTED GREEN COFFEE EXTRACT IMPROVED ADIPONECTIN, INSULIN RESISTANCE, AND METABOLIC PROFILE OF METABOLIC SYNDROME RAT MODEL

2017 ◽  
Vol 10 (9) ◽  
pp. 279 ◽  
Author(s):  
Mifetika Lukitasari ◽  
Dwi Adi Nugroho ◽  
Mohammad Saifur Rohman ◽  
Nur Ida Panca Nugrahini ◽  
Teguh Wahyu Sardjono
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Body Weight ◽  
Blood Glucose ◽  
Metabolic Profile ◽  
Adiponectin Level ◽  
Fasting Blood Glucose ◽  
Enzyme Linked Immunosorbent Assay ◽  
Green Coffee

  Objective: The objective of this study is to investigate the effect of light-roasted green coffee bean extract (GCE) administration for 7 weeks on the improvement of metabolic profile, adiponectin level, homeostatic model assessment insulin resistance (HOMA-IR) index in metabolic syndrome (MS) rat model.Methods: Adult male Sprague-Dawley rats were induced by a combination of high sucrose and high-fat diet for 8 weeks and streptozotocin injection in the 2nd week. The MS was confirmed by NCEP-ATP III criteria. They were divided into six weight-matched groups (n=5), normal control, MS, metformin and simvastatin-treated group (DMS), 100 and 200/body weight (bw) GCE (GCE 100 and GCE 200, respectively). The extracts were given through oral gavage daily for 7 weeks. The effect of GCE on body weight, serum glucose, triglyceride, (TG) and high-density lipoprotein (HDL) level was analyzed by colorimetric method. HOMA-IR index and adiponectin were analyzed by enzyme-linked immunosorbent assay methods.Result: Fasting blood glucose, TG, and systolic blood pressure decreased significantly (p<0.05) in both GCE groups. Moreover, after 7 weeks, those parameters were significantly lower (p<0.05) compared to that of MS group. Only GCE 100 group that showed a significant decrease in HDL level. GCE 100 mg/bw and 200 mg/bw group showed significantly higher adiponectin level compared to that of MS and DMS group. Furthermore, GCE 100, GCE 200, and DMS group showed a significant lower HOMA-IR index compared to that of MS group.Conclusion: 7 weeks GCE administration could decrease fasting blood glucose, profile lipid, blood pressure, and improved adiponectin level and HOMA-IR index.

METABOLIC SYNDROME - THIS IS SERIOUS!

2019 ◽  
Vol 25 (4) ◽  
pp. 234-237
Author(s):  
Tatiana I. Turkina ◽  
S. N Shcherbo ◽  
P. D Vaganov
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Cardiovascular Diseases ◽  
Common Variant ◽  
The Metabolic Syndrome ◽  
Clinical Disorders

Metabolic syndrome is a complex of metabolic, hormonal and clinical disorders that are risk factors for the development of cardiovascular diseases, which are based on insulin resistance and compensatory hyperinsulinemia. The main mechanisms of the effects of chronic hyperinsulinemia on blood pressure are given, and the main symptoms and manifestations of the metabolic syndrome are given. The most common variant of dyslipidemia in the metabolic syndrome is the lipid triad.

scholarly journals Gender-based differences in the clustering of metabolic syndrome factors in children and adolescents

2020 ◽  
Vol 33 (2) ◽  
pp. 279-288 ◽  
Author(s):  
Valeria Calcaterra ◽  
Daniela Larizza ◽  
Annalisa De Silvestri ◽  
Riccardo Albertini ◽  
Federica Vinci ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Children And Adolescents ◽  
Fasting Blood Glucose ◽  
Treatment Strategies ◽  
Normal Weight ◽  
Model Assessment ◽  
Significant Difference ◽  
Gender Based

AbstractBackgroundWe depicted gender-differences in metabolic syndrome (MS) clustering before and after puberty in pediatrics, in order to develop gender specific preventive strategies for childhood obesity.MethodsWe considered 1079 children and adolescents (529 females and 550 males; mean age 11.5 ± 2.8 year). According to body mass index (BMI) percentiles the subjects were classified as normal weight BMI <75th, overweight BMI 75–95th and with obesity BMI >95th. MS was diagnosed when three of the following criteria for age and sex percentiles were met: BMI >95th, triglycerides (TGs) level >95th, high-density lipoprotein-cholesterol (HDL-c) level <5th, blood pressure (blood pressure) >95th percentile, fasting blood glucose (FBG) >100 mg/dL and/or homeostatic model assessment- insulin resistance (HOMA-IR) >97.5th percentile.ResultsThe prevalence of dismetabolic factors was similar in both genders, except for pathological BP, which was higher in males (p = 0.02). MS was detected only in patients with obesity, with a higher prevalence in pubertal than late/post-pubertal subjects (p < 0.001), without any significant difference between gender. In pre-puberty, the most common MS combination was obesity (HBMI) + hypertension (HBP) + hyperglycemia/insulin resistance (HGLY/IR) followed by HBMI + low HDL-levels (LHDL) + HGLY/IR versus HBMI + HBP + HGLY/IR followed by HBMI + HBP + LHDL, respectively, in females and males. In the early and late/post-pubertal periods, the most prevalent combination remained similar to pre-puberty, additionally in both sexes other combinations, such as HBMI + HTG + HBP + HGLY/IR, HBMI +  HBP + LHDL + HGLY/IR, HBMI + HTG + LHDL + HGLY/IR and HBMI + HTG + LHDL + HBP + HGLY/IR were also detected, differently distributed in males and females.ConclusionsWe confirm that MS is an important consequence related to obesity, particularly in the post-puberty stage. Some gender-based differences should be considered early in order to identify specific preventive and treatment strategies.

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