From the metabolic syndrome to the concept of global cardiometabolic risk

2009 ◽  
Vol 150 (18) ◽  
pp. 821-829 ◽  
Author(s):  
Judit Nádas ◽  
György Jermendy
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Central Obesity ◽  
Cardiometabolic Risk ◽  
Adult Population ◽  
Continuous Treatment ◽  
The Metabolic Syndrome ◽  
Cardiovascular Morbidity And Mortality

Although the clustering of cardiovascular risk factors is unquestionable, the clinical significance of the metabolic syndrome as a distinct entity has been debated in the past years. Recently, the term ‘metabolic syndrome’ has been replaced by ‘global cardiometabolic risk’ which implies cardiovascular risk factors beyond the metabolic syndrome. The metabolic syndrome can be frequently detected among people in western and developing countries affecting 25-30% of adult population, and its prevalence rate is increasing. Prospective studies show that the metabolic syndrome is a significant predictor of incident diabetes but has a weaker association with cardiovascular morbidity and mortality. At the same time the metabolic syndrome is inferior to established predicting models for either type 2 diabetes or cardiovascular disease.The underlying pathomechanism of the metabolic syndrome is still poorly understood. The role of insulin resistance – although not as a single factor – is still considered as a key component. In the last decade the importance of abdominal obesity has received increased attention but some studies, mainly in the Asian population, showed that central obesity is not an essential component of the syndrome. Regardless of the theoretical debates the practical implications are indisputable. The frequent clustering of hypertension, dyslipidaemia and glucose intolerance, that often accompanies central obesity, can not be ignored. Following the detection of one risk factor, the presence of other, traditional and non-traditional factors should be searched for, as the beneficial effect of intensive, target oriented, continuous treatment of metabolic and cardiovascular risk factors has been proven in both the short and long term.

scholarly journals Butyrylcholinesterase: Association with the Metabolic Syndrome and Identification of 2 Gene Loci Affecting Activity

2006 ◽  
Vol 52 (6) ◽  
pp. 1014-1020 ◽  
Author(s):  
Anne Valle ◽  
Daniel T O’Connor ◽  
Palmer Taylor ◽  
Gu Zhu ◽  
Grant W Montgomery ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Ldl Cholesterol ◽  
Cholinesterase Activity ◽  
Plasma Cholinesterase ◽  
Plasma Cholinesterase Activity ◽  
The Metabolic Syndrome ◽  
Adult Twins

Abstract Background: Plasma cholinesterase activity is known to be correlated with plasma triglycerides, HDL- and LDL-cholesterol, and other features of the metabolic syndrome. A role in triglyceride metabolism has been proposed. Genetic variants that decrease activity have been studied extensively, but the factors contributing to overall variation in the population are poorly understood. We studied plasma cholinesterase activity in a sample of 2200 adult twins to assess covariation with cardiovascular risk factors and components of the metabolic syndrome, to determine the degree of genetic effects on enzyme activity, and to search for quantitative trait loci affecting activity. Methods and Results: Cholinesterase activity was lower in women than in men before the age of 50, but increased to activity values similar to those in males after that age. There were highly significant correlations with variables associated with the metabolic syndrome: plasma triglyceride, HDL- and LDL-cholesterol, apolipoprotein B and E, urate, and insulin concentrations; γ-glutamyltransferase and aspartate and alanine aminotransferase activities; body mass index; and blood pressure. The heritability of plasma cholinesterase activity was 65%. Linkage analysis with data from the dizygotic twin pairs showed suggestive linkage on chromosome 3 at the location of the cholinesterase (BCHE) gene and also on chromosome 5. Conclusions: Our results confirm and extend the connection between cholinesterase, cardiovascular risk factors, and metabolic syndrome. They establish a substantial heritability for plasma cholinesterase activity that might be attributable to variation near the structural gene and at an independent locus.

scholarly journals Left ventricular hypertrophy and linked cardiovascular risk factors among Congolese licensed civilian aircrew

2020 ◽  
Vol 5 (2) ◽  
pp. 28
Author(s):  
Nathan B Buila ◽  
Georges N Ngoyi ◽  
Yves N Lubenga ◽  
Jean-Marc B Bantu ◽  
Trésor S Mvunzi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Left Ventricular Hypertrophy ◽  
Cardiovascular Risk Factors ◽  
Ventricular Hypertrophy ◽  
Biological Evaluation ◽  
Left Ventricular ◽  
Flight Crew ◽  
The Metabolic Syndrome

Objective: To assess the prevalence of left ventricular hypertrophy (LVH) and linked cardiovascular risk factors in civilian aircrew.Methods: Cardiovascular risk factors were assessed among flight and cabin crew undergoing routine clinical and biological evaluation for initial or renewal of aeromedical license. The evaluation also included a standard 12-lead ECG and echocardiography. Echo-based LVH was LVM ≥ 49 g/m2.7 (men) or ≥ 45 g/m2.7 (women). LVH was categorized as mild (men: 49-55 g/m2.7; women: 45-51 g/m2.7), moderate (men: 56-63 g/m2.7; women: 52-58 g/m2.7), or severe (men: ≥ 64 g/m2.7; women: ≥ 59g/m2.7) according to Lang’s report.Results: Among the 379 aircrew members (70.4% men; 23% Caucasians; 62.5% flight crew; mean age 40.6 ± 12.8 years), LVH was present in 36 individuals (9.5%) with mild, moderate and severe pattern observed respectively in 19.4%, 33.3% and 47.2% of the cases. The rate of LVH amounted to 16.7% in normotensive subjects, 25.0% in those with prehypertension, and 58.3% among hypertensive individuals. In addition to age of 40-59y (OR: 8.48; 95% CI: [2.23-12.23]; p = .002) or more (4.22 [1.57-11.35]; p = .004), hypertension (3.55 [1.50 - 8.41]; p = .004), overweight/obesity (5.33 [1.14 - 25.05]; p = .034) and hyperuricemia (5.05 [2.11 - 12.09]; p = .001), all well-known constituents of the metabolic syndrome, were the main factors significantly associated with LVH.Conclusion: The frequency and link of LVH to the components of the metabolic syndrome highlights the need for a comprehensive approach to the management of cardiovascular risk factors in civilian aircrew.

scholarly journals Metabolic syndrome – a risky combination

2012 ◽  
Vol 18 (4) ◽  
pp. 188-192
Author(s):  
R. S. Şuţa ◽  
Cristina Şuţa
Keyword(s):  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Arterial Hypertension ◽  
Central Obesity ◽  
International Diabetes Federation ◽  
Hard Core ◽  
Common Finding ◽  
The Metabolic Syndrome ◽  
Cardiovascular Morbidity And Mortality ◽  
Study Population

Abstract The metabolic syndrome is characterized by a cluster of related clinical, anthropometric and biochemical features such as central obesity, dysglycaemia, dyslipidaemia and hypertension. It is highly prevalent in the general population (approximately 22%), with differences in relation to race, gender, and age. It carries an increased cardiovascular morbidity and mortality, which makes an early and correct assessment mandatory. The prevalence of the metabolic syndrome is very high in type 2 diabetes patients, in whom it influences the risk of chronic complications. The aim of the present report is to explore the characteristics and the combination types of the metabolic syndrome and to assess the cardiovascular risk in patients presenting this clinical entity. 329 patients consecutively diagnosed with metabolic syndrome were included in the study, both men and women, no limit regarding age. Patient selection was made during the periodic medical visits in the outpatient clinics of Diabetes, Cardiology and Internal Medicine. Metabolic syndrome (MetS) was diagnosed according to 2005 International Diabetes Federation (IDF) Criteria. Women were more frequent than men, mean age was 59.08±888 and they all had central obesity (it is the major criteria of 2005 IDF definition for MetS) .The diagnosis of the metabolic syndrome was fulfilled with only 3 criteria, most of the times. The complete metabolic syndrome was the rarest, less than 25% of the patients presenting all 5 definition criteria and it was more frequent among men (men 39.2% vs women 15.9%: p < 0.0001). Apart from central obesity, which is mandatory for diagnosing MetS and thus present in all patients, arterial hypertension is the most common finding in our study population, with impaired glycaemia and increased triglycerides occupying the second and third place, respectively. Central obesity, arterial hypertension and impaired glycaemia represent the most frequent combination, a real „hard core” of MetS. As expected, the cardiovascular risk was high in the study population. The cardiovascular „score” of our patients increased significantly with the number of components used for the diagnosis of MetS (MetS with 3 elements vs MetS with 4 elements vs MetS with 5 elements: SCORE - 5.36 ± 7.07 vs 7.66 ± 8.63 vs 8.52 ± 8.34, p < 0.01).

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