The metabolic syndrome: setting the scene. The cons

2007 ◽  
Vol 4 (2_suppl) ◽  
pp. S4-S6 ◽  
Author(s):  
Naveed Sattar
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Metabolic Syndrome ◽  
Elevated Blood ◽  
Diabetes Screening ◽  
Cvd Risk ◽  
Treatment Benefit ◽  
The Metabolic Syndrome

Conclusion: Metabolic syndrome is conceptually useful. It has encouraged thought about the pathology of diabetes and cardiovascular disease, has facilitated research and has brought together cardiologists and diabetologists. But the criteria are neither needed nor additive for CVD risk assessment or diabetes screening or prediction. Neither are they needed to determine treatment benefit. Better options would be to measure and target established risk factors such as lipids, smoking and elevated blood pressure. We should also be thinking about obesity and its prevention, and to do this we need changes in food, activity and fiscal environments.

scholarly journals Early vascular aging risk assessment in patients with metabolic syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Salasyuk ◽  
S Nedogoda ◽  
I Barykina ◽  
V Lutova ◽  
E Popova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Assessment ◽  
Metabolic Syndrome ◽  
Vascular Aging ◽  
Clinical Markers ◽  
Cvd Risk ◽  
Vascular Age

Abstract Background Metabolic syndrome (MetS) and abdominal obesity are one of the most common CVD risk factors among young and mature patients. However, the currently used CVD risk assessment scales may underestimate the CV risk in people with obesity and MS. Early vascular aging rather than chronological aging can conceptually offer better risk prediction. MetS, as accumulation of classical risk factors, leads to acceleration of early vascular aging. Since an important feature of MetS is its reversibility, an adequate risk assessment and early start of therapy is important in relation to the possibilities of preventing related complications. Purpose To derive a new score for calculation vascular age and predicting EVA in patients with MetS. Methods Prospective open cohort study using routinely collected data from general practice. The derivation cohort consisted of 1000 patients, aged 35–80 years with MetS (IDF,2005 criteria). The validation cohort consisted of 484 patients with MetS and carotid-femoral pulse wave velocity (cfPWV) values exceeding expected for average age values by 2 or more SD (EVA syndrome). Results In univariate analysis, EVA was significantly correlated with the presence of type 2 diabetes and clinical markers of insulin resistance (IR), body mass index (BMI), metabolic syndrome severity score (MetS z-score), uric acid (UA) level, hsCRP, HOMA-IR, total cholesterol (TC), triglycerides (TG), heart rate (HR), central aortic blood pressure (CBP), diastolic blood pressure (DBP). Multiple logistic regression shown, that presence of type 2 diabetes and IR were associated with greater risk of EVA; the odds ratios were 2.75 (95% CI: 2.34, 3.35) and 1.57 (95% CI: 1.16, 2.00), respectively. In addition, the risk of having EVA increased by 76% with an increase in HOMA-IR by 1 unit, by 17% with an increase in hsCRP by 1 mg/l, by 4% with an increase in DBP by 1 mm Hg, and by 1% with each 1 μmol / L increase in the level of UA. The area under the curve for predicting EVA in patients with MetS was 0,949 (95% CI 0,936 to 0,963), 0,630 (95% CI 0,589 to 0,671), 0,697 (95% CI 0,659 to 0,736) and 0,686 (95% CI 0,647 to 0,726), for vascular age, calculated from cfPWV, SCORE scale, QRISK-3 scale and Framingham scale, respectively. Diabetes mellitus and clinical markers of IR (yes/no), HOMA-IR and UA level were used to develop a new VAmets score for EVA prediction providing a total accuracy of 0.830 (95% CI 0,799 to 0,860). Conclusion cfPWV at present the most widely studied index of arterial stiffness, fulfills most of the stringent criteria for a clinically useful biomarker of EVA in patients with MetS. Although, parallel efforts for effective integration simple clinical score into clinical practice have been offered. Our score (VAmets) may accurately identify patients with MetS and EVA on the basis of widely available clinical variables and classic cardiovascular risk factors can prioritize using of vascular age in routine care. ROC-curves for predicting EVA in MetS Funding Acknowledgement Type of funding source: None

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 Reversal Rate of Clustering of Cardiovascular Disease Risk Factors of Metabolic Syndrome in the General Population: The Niigata Preventive Medicine Study

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Shinsuke Okada ◽  
Akiko Suzuki ◽  
Hiroshi Watanabe ◽  
Toru Watanabe ◽  
Yoshifusa Aizawa
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Risk Factor ◽  
Disease Risk ◽  
Fasting Blood Glucose ◽  
Reversal Rate ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Metabolic Syndrome

The reversal rate from clustering of cardiovascular disease (CVD) risk factors—components of the metabolic syndrome (MetS) is not known.Methods and Results. Among 35,534 subjects who received the annual health examinations at the NiigataHealth Foundation (Niigata, Japan), 4,911 subjects had clustering of 3 or more of the following CVD risk factors: (1) body mass index (BMI) ≥25 Kg/m2, (2) blood pressure ≥130 mm Hg in systolic and/or ≥85 mm Hg in diastolic, (3) triglycerides ≥150 mg/dL, (4) high-density lipoprotein cholesterol ≤40 mg/dL in men, ≤50 mg/dL in women, and (5) fasting blood glucose ≥100 mg/dL. After 5 years 1,929 subjects had a reversal of clustering (39.4%). A reversal occurred more often in males. The subjects with a reversal of clustering had milder level of each risk factor and a smaller number of risk factors, while BMI was associated with the least chance of a reversal.Conclusion. We concluded that a reversal of clustering CVD risk factors is possible in 4/10 subjects over a 5-year period by habitual or medical interventions. Gender and each CVD risk factor affected the reversal rate adversely, and BMI was associated with the least chance of a reversal.

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.

Metabolic health in patients with schizophrenia – CVD risk in a Norwegian outpatient population

2017 ◽  
Vol 41 (S1) ◽  
pp. s810-s810
Author(s):  
J. Engh ◽  
E. Andersen ◽  
E. Martinsen ◽  
J. Egeland ◽  
T.L. Holmen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
General Population ◽  
Normal Population ◽  
High Density Lipoproteins ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Metabolic Characteristics ◽  
The Metabolic Syndrome

The mortality of schizophrenia patients is approximately twice that of the general population and there is a 20% reduction in life expectancy in this patient group. Cardiovascular disease (CVD) is responsible for as much as 50% of the excess mortality associated with schizophrenia. One important source of the high CVD prevalence is the cluster of metabolic characteristics defining the metabolic syndrome (MetS: 3 or more of the following features: abdominal obesity, high blood pressure, elevated levels of triglycerides and fasting glucose and low levels of high-density lipoproteins). Patients with schizophrenia seem to be undertreated for these vascular risk factors relative to the general population. More knowledge is needed concerning broadened risk factors of cardiovascular disease in a representative sample of schizophrenia patients. We conducted preliminary cross sectional analyses in a sample of 64 consecutive outpatients with schizophrenia with a mean age of 37 years consisting of 59% men, who were enrolled in a treatment study. All used antipsychotics, and 71% were smokers. We found that (percentage of patients under treatment for the respective somatic condition in parenthesis) 82% were overweight, 49% had hypertonia (17%), 24% hyperglycemia (3%), 48% hypertriglyceridemia and 13% hyperlipidemia (10% triglycerid or cholesterol lowering medication). Forty percent had metabolic syndrome compared to 11% in the normal population (Norway, age corrected). Additionally, estimates of insulin resistance will be conducted. We found that the prevalence of MetS components was high in outpatient schizophrenia. A substantial discrepancy was found between metabolic ill health and medication treatment of such conditions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals There is No Distinctive Gut Microbiota Signature in the Metabolic Syndrome: Contribution of Cardiovascular Disease Risk Factors and Associated Medication

2020 ◽  
Vol 8 (3) ◽  
pp. 416 ◽  
Author(s):  
Adrián Cortés-Martín ◽  
Carlos E. Iglesias-Aguirre ◽  
Amparo Meoro ◽  
María Victoria Selma ◽  
Juan Carlos Espín
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Gut Microbiota ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Metabolic Syndrome ◽  
Drug Treatments

The gut microbiota (GM) has attracted attention as a new target to combat several diseases, including metabolic syndrome (MetS), a pathological condition with many factors (diabetes, obesity, dyslipidemia, hypertension, etc.) that increase cardiovascular disease (CVD) risk. However, the existence of a characteristic taxonomic signature associated with obesity-related metabolic dysfunctions is under debate. To investigate the contribution of the CVD risk factors and(or) their associated drug treatments in the composition and functionality of GM in MetS patients, we compared the GM of obese individuals (n = 69) vs. MetS patients (n = 50), as well as within patients, depending on their treatments. We also explored associations between medication, GM, clinical variables, endotoxemia, and short-chain fatty acids. Poly-drug treatments, conventional in MetS patients, prevented the accurate association between medication and GM profiles. Our results highlight the heterogeneity of taxonomic signatures in MetS patients, which mainly depend on the CVD risk factors. Hypertension and(or) its associated medication was the primary trait involved in the shaping of GM, with an overabundance of lipopolysaccharide-producing microbial groups from the Proteobacteria phylum. In the context of precision medicine, our results highlight that targeting GM to prevent and(or) treat MetS should consider MetS patients more individually, according to their CVD risk factors and associated medication.

scholarly journals Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 10 (4) ◽  
pp. 634-646 ◽  
Author(s):  
Ehsan Ghaedi ◽  
Mohammad Mohammadi ◽  
Hamed Mohammadi ◽  
Nahid Ramezani-Jolfaie ◽  
Janmohamad Malekzadeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Lipid Profile ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Paleolithic Diet ◽  
Cvd Risk ◽  
Randomized Controlled

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.

scholarly journals Effects of Cranberry Juice Supplementation on Cardiovascular Disease Risk Factors in Adults with Elevated Blood Pressure: A Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2618
Author(s):  
Chesney K. Richter ◽  
Ann C. Skulas-Ray ◽  
Trent L. Gaugler ◽  
Stacey Meily ◽  
Kristina S. Petersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Systolic Blood Pressure ◽  
Vascular Function ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Lipoprotein Profile ◽  
Cranberry Juice ◽  
Central Systolic Blood Pressure

Emerging cardiovascular disease (CVD) risk factors, including central vascular function and HDL efflux, may be modifiable with food-based interventions such as cranberry juice. A randomized, placebo-controlled, crossover trial was conducted in middle-aged adults with overweight/obesity (n = 40; mean BMI: 28.7 ± 0.8 kg/m2; mean age: 47 ± 2 years) and elevated brachial blood pressure (mean systolic/diastolic BP: 124 ± 2/81 ± 1 mm Hg). Study participants consumed 500 mL/d of cranberry juice (~16 fl oz; 27% cranberry juice) or a matched placebo juice in a randomized order (8-week supplementation periods; 8-week compliance break), with blood samples and vascular measurements obtained at study entry and following each supplementation period. There was no significant treatment effect of cranberry juice supplementation on the primary endpoint of central systolic blood pressure or central or brachial diastolic pressure. Cranberry juice significantly reduced 24-h diastolic ambulatory BP by ~2 mm Hg compared to the placebo (p = 0.05) during daytime hours. Cranberry juice supplementation did not alter LDL-C but significantly changed the composition of the lipoprotein profile compared to the placebo, increasing the concentration of large LDL-C particles (+29.5 vs. −6.7 nmol/L; p = 0.02) and LDL size (+0.073 vs. −0.068 nm; p = 0.001). There was no effect of treatment on ex vivo HDL efflux in the total population, but exploratory subgroup analyses identified an interaction between BMI and global HDL efflux (p = 0.02), with greater effect of cranberry juice in participants who were overweight. Exploratory analyses indicate that baseline C-reactive protein (CRP) values may moderate treatment effects. In this population of adults with elevated blood pressure, cranberry juice supplementation had no significant effect on central systolic blood pressure but did have modest effects on 24-hr diastolic ambulatory BP and the lipoprotein profile. Future studies are needed to verify these findings and the results of our exploratory analyses related to baseline health moderators.

scholarly journals Anthropometric cut-points for discriminating diabetes and the metabolic syndrome among Arabs and Asians: the Kuwait Diabetes Epidemiology Program

2021 ◽  
pp. 1-11
Author(s):  
Victor M. Oguoma ◽  
Neil T. Coffee ◽  
Saad Alsharrah ◽  
Mohamed Abu-Farha ◽  
Faisal H. Al-Refaei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Ethnic Groups ◽  
South Asian ◽  
International Diabetes Federation ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Data Set ◽  
Cut Points ◽  
The Metabolic Syndrome

Abstract This study aimed to determine anthropometric cut-points for screening diabetes and the metabolic syndrome (MetS) in Arab and South Asian ethnic groups in Kuwait and to compare the prevalence of the MetS based on the ethnic-specific waist circumference (WC) cut-point and the International Diabetes Federation (IDF) and American Heart Association/National Heart, Lung, and Blood Institute WC criteria. The national population-based survey data set of diabetes and obesity in Kuwait adults aged 18–60 years was analysed. Age-adjusted logistic regression and receiver operating characteristic (ROC) analyses were conducted to evaluate for 3589 individuals the utility of WC, waist:height ratio (WHtR) and BMI to discriminate both diabetes and ≥3 CVD risk factors. Areas under the ROC curve were similar for WC, WHtR and BMI. In Arab men, WC, WHtR and BMI cut-offs for diabetes were 106 cm, 0·55 and 28 kg/m2 and for ≥3 CVD risk factors, 97 cm, 0·55 and 28 kg/m2, respectively. In Arab women, cut-offs for diabetes were 107 cm, 0·65 and 33 kg/m2 and for ≥3 CVD risk factors, 93 cm, 0·60 and 30 kg/m2, respectively. WC cut-offs were higher for South Asian women than men. IDF-based WC cut-offs corresponded to a higher prevalence of the MetS across sex and ethnic groups, compared with Kuwait-specific cut-offs. Any of the assessed anthropometric indices can be used in screening of diabetes and ≥3 CVD risk factors in Kuwaiti Arab and Asian populations. ROC values were similar. The WC threshold for screening the MetS in Kuwaiti Arabs and South Asians is higher for women.

Association between Patients with Metabolic Syndrome and Other Various Factors Defining Metabolic Syndrome: A Cross-Sectional Study

2021 ◽  
Vol 8 (4) ◽  
pp. 12-17
Author(s):  
Basavaraj PG ◽  
Ashok P Yenkanchi ◽  
Chidanand Galagali
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Cardiovascular Diseases ◽  
Abdominal Obesity ◽  
Positive History ◽  
The Metabolic Syndrome ◽  
Study Results ◽  
History Of ◽  
The Mean

Background: Risk factors can lead to clinical conditions, like metabolic syndrome, that predisposes the development of cardiovascular diseases. Objective: The goal of this population-based, prospective and non-randomised cohort study was to study the association between patients with metabolic syndrome and other various factors defining metabolic syndrome. Methods: All the patients referred to the department of Medicine, Al-Ameen Medical college hospital and District Hospital, Vijayapur, Karnataka, India over a period of twenty-two months extending from December 2013 to September 2015 were considered in this study. Results: In the current study, out of 100 patients, 62.9% patients had metabolic syndrome with positive family history of hypertension, diabetes mellitus. 70.8% patients had metabolic syndrome with positive history of smoking. 64.3% patients had metabolic syndrome with positive history of alcohol .73.9% patients had metabolic syndrome with positive history of IHD. 87% of the patients with metabolic syndrome had SBP> 130 mmHg, and 78.85% patients had DBP>85 mmHg. And metabolic syndrome was observed in 71.8% patients on anti hypertensive drugs. The mean level of total cholesterol, LDL cholesterol, triglyceride is increased whereas the mean level of anti-atherogenic HDL cholesterol is low in subjects with MS. At least one lipid abnormality was present in > 95 % of cases. Around 81% subjects with BMI <25 (out of 38) had metabolic syndrome and 58% subjects with BMI>25(out of 62) had metabolic syndrome. Conclusion: All the components defining the metabolic syndrome correlated positively with the abdominal obesity. Systolic blood pressure values were significantly higher than diastolic blood pressure in subjects with abdominal obesity. Metabolic syndrome has multiple risk factors determined by various aspects like the race, the life style, geographical factors larger study is needed to understand the correlation between various components defining it. A healthy lifestyle, that includes avoiding tobacco exposure and proper weight control, must be encouraged in this high-risk population. Keywords: Cardiovascular diseases; Overweight; Risk factors; Smoking.

Sign in / Sign up

Export Citation Format

Share Document