Relative Lean Body Mass and Waist Circumference for the Identification of Metabolic Syndrome in the Korean General Population

Lean body mass (LBM) comprises organs and muscle, which are the primary determinants of energy expenditure and regulation of glucose and lipid metabolism. Excessive abdominal fat is associated with metabolic abnormality. Little is known about the relationship between metabolic abnormality and LBM and waist circumference (WC), especially in the Asian general population. The aim of this study was to clarify this relationship. We performed a cross-sectional study with 499,648 subjects who received health check-ups at 16 health promotion centers in 13 Korean cities between January 2018 and October 2019. The subjects were categorized into four groups: (a) High (H)-RLBM (relative lean body mass)/Normal (N)-WC, (b) High-RLBM/Abnormal (A)-WC, (c) Low (L)-RLBM/Normal-WC, and (d) Low-RLBM/Abnormal-WC. RLBM was calculated using fat mass data that were estimated via bioelectrical impedance analysis. L-RLBM/A-WC was significantly associated with metabolically unhealthy status (OR: 4.40, 95% CI: 4.326–4.475) compared to H-RLBM/N-WC. L-RLBM/N-WC (OR: 2.170, 95% CI: 2.122–2.218) and H-RLBM/A-WC (OR: 2.713, 95% CI: 2.659–2.769) were also significantly related to metabolic unhealthy status. The cut-offs of RLBM for predicting metabolic syndrome (MetS) were 74.9 in males and 66.4 in females (p < 0.001). L-RLBM and A-WC are associated with metabolic abnormality in the Korean general population. RLBM is an anthropometric index that can be used to predict MetS in primary health care.

Change in Metabolic Health Status Over Time and Risk of Chronic Kidney Disease: A Prospective Study

Objective: Metabolically healthy obesity (MHO) is a dynamic condition and is known to increase the risk for chronic kidney disease (CKD). In this study, we aimed to examine the association between metabolic health status and its change over time and CKD risk.Methods: A total of 39463 participants from Kailuan Study were collected body mass index and metabolic health status at 2006/07 and 2010/11 examination. Metabolic abnormality was diagnosed by the presence of any 2 of 4 components (elevated blood pressure, elevated fasting blood glucose, elevated triglyceride and decreased high-density lipoprotein cholesterol). We classified participants into six groups according to metabolic health status and obesity. The changes in obesity and metabolic health status were considered from 2006/07 to 2010/11. Results: Of the participants classified as MHNW or MHO at baseline, 17.25% and 39.64% were classified as MUNW or MUO in 2010/11, respectively. During a mean follow-up of 9.7 years, 5351 participants developed CKD from 2010/11. Compared with participants in the stable MHNW group, the stable MHO group had a significantly higher risk of incident CKD (HR: 1.16; 95% CI: 1.02-1.33), but was lower than that in individuals with MUO. Individuals with metabolic healthy at baseline who changed to metabolic abnormality during follow-up had higher risk of CKD. Conclusions: MHO phenotype or its transition to a metabolically unhealthy phenotype were associated with increased risk of CKD. Stable metabolic health individuals had lower risk of CKD than those with metabolically unhealthy phenotype.

Association between the triglyceride glucose index and coronary collateralization in coronary artery disease patients with chronic total occlusion lesions

Background Recent studies have substantiated the role of the triglyceride glucose (TyG) index in predicting the prognosis of coronary artery disease (CAD) patients, while no relevant studies have revealed the association between the TyG index and coronary collateralization in the event of coronary chronic total occlusion (CTO). The current study intends to explore whether, or to what extent, the TyG index is associated with impaired collateralization in CAD patients with CTO lesions. Methods The study enrolled 1093 CAD patients undergoing cardiac catheterization for at least one CTO lesion. Data were collected from the Beijing Anzhen Hospital record system. The degree of collaterals was determined according to the Rentrop classification system. The correlation between the TyG index and coronary collateralization was assessed. Results Overall, 318 patients were included in a less developed collateralization (Rentrop classification 0-1) group. The TyG index was significantly higher in patients with impaired collateralization (9.3±0.65 vs. 8.8±0.53, P<0.001). After adjusting for various confounding factors, the TyG index remained correlated with the occurrence of impaired collateralization, with odds ratios (ORs) of 1.59 and 5.72 in the T2 and T3 group compared with the first tertile group (P<0.001). In addition, subgroup analysis showed that higher TyG index values remained strongly associated with increased risk of less developed collateralization. To compare the risk assessment efficacy for the formation of collateralization between the TyG index and other metabolic abnormality indicators, an area under the receiver-operating characteristic (ROC) curve (AUC) was obtained. A significant improvement in the risk assessment performance for impaired collateralization emerged when adding the TyG index into a baseline model. Conclusions The increased TyG index is strongly associated with less developed collateralization in CAD patients with CTO lesions and its risk assessment performance is better than single metabolic abnormality indicators.

Persistent Purine Metabolic Abnormality Induces the Aggravation of Visceral Inflammation and Intestinal Microbiota Dysbiosis in Magang Goose

Gout is a disease involving abnormal purine metabolism that is widespread in mammals and birds. Goose is especially susceptible for gout in early stage. However, a few studies investigated the ontogenetic pattern of goslings with purine metabolic abnormality. Our studies were conducted to investigate whether persistent purine metabolic abnormality would lead to aggravation of visceral inflammation and intestinal microbiota dysbiosis in goose. A total of 132 1-day-old Magang geese were randomly divided into six replicates and fed a high-calcium and protein meal-based diet from 1 to 28 days. The experiment lasted for 28 days. Liver and kidney damages were observed in 14- and 28-day-old Magang geese, and liver inflammation increased with increasing age. In 28-day-old Magang geese, serum CAT and liver GSH-Px activity were significantly reduced. Furthermore, jejunum intestinal barrier was impaired and the abundance of Bacteroides was significantly reduced at the genus level. Collectively, the high-calcium and high-protein (HCP) meal-based diet caused liver and kidney damage in 28-day-old Magang geese, leading to hyperuricemia and gout symptoms, and the intestinal barrier is impaired and the intestinal flora is disrupted.

Association between deposit of abdominal adipose tissues and metabolic abnormality in a Chinese population

BackgroundPrevious studies indicated that deposit of abdominal adipose tissue associated with the abnormalities of cardiometabolic components. However, the results were inconsistent on the effects of subcutaneous adipose tissue (SAT) and difference between men and women. The aim of this study was to examine the associations of VAT, SAT with metabolic status and the different effects between male and female. Methods1388 eligible subjects were recruited from the baseline investigation of metabolic syndrome investigation in China. Areas of abdominal VAT and SAT were determined by nuclear magnetic resonance imaging (MRI). Total triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) were measured by biochemical auto-analyzer. Metabolic abnormality (MA) was defined more than one of abnormally metabolic components, which were based on the definition of metabolic syndrome (IDF 2005). Multiple logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (95%CI). The predictive values were assessed with area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI), respectively. ResultsSubjects with MA had higher levels of VAT in both of men and women, and higher levels of SAT in men than those with metabolic normality (MN) (P< 0.05). Different associations of SAT in women depended of levels of BMI. Higher levels of VAT were significantly correlated with higher risks for MA (p for trend <0.05). Comparing with the subjects of the first quartile (Q1) of VAT, OR in fourth quartile (Q4) was 6.537 (95% CI= 3.394 -12.591) in men and 3.364 (95% CI=1.898-5.962) in women. However, no significance was found in SAT. In men, VAT improved the predictive value of MA with the AUC of 0.727 (95% CI= 0.687-0.767), and NRI of 0.139 (95%CI=0.070-0.208) and 0.106 (95%CI=0.038-0.173), IDI of 0.074 (95%CI = 0.053-0.095) and 0.046 (95%CI=0.026-0.066) comparing with BMI and WC, respectively. Similar results were found in women.Conclusions VAT and SAT linked increased risks for metabolic abnormality in men no matter in the BMI＜24kg/m2 or in BMI≥24kg/m2, but in women, SAT only increased the risk of MA in BMI≥24kg/m2.Deposit of abdominal adipose tissue associated with the metabolic abnormalities. VAT improved the predictive ability of MA.

Combined Effects of Metabolic Abnormalities and Obesity on Cardiovascular Diseases among Korean Postmenopausal Women

Combined effects of metabolic abnormalities, including metabolic syndrome and obesity, should be identified to screen postmenopausal women at risk of developing cardiovascular diseases. The purpose of this study was to identify the combined effects of metabolic abnormalities and obesity on cardiovascular diseases among postmenopausal Korean women (aged 40–83 years). Data of 5959 postmenopausal women from the Korean National Health and Nutrition Examination Survey (2015–2018) were secondarily analyzed. Using complex simple analysis procedures, logistic regression analysis was performed to identify the combined effect of metabolic abnormalities and obesity on cardiovascular diseases among postmenopausal Korean women. In combination, metabolic syndrome (more than three metabolic abnormalities) and obesity (overweight [≥23 kg/m2 and <25 kg/m2 in body mass index] and obese [>25 kg/m2 in body mass index]) increased the likelihood of developing cardiovascular diseases but combining more than one metabolic abnormality and obesity did not. Combining metabolic syndrome and non-obesity (underweight and normal weight) increased the likelihood of the prevalence of cardiovascular diseases but combining more than one metabolic abnormality and non-obesity did not. Increased cardiovascular diseases in postmenopausal women may be more commonly associated with metabolic syndrome having multiple metabolic abnormalities, but not obesity. Thus, instead of simple weight control, early management of metabolic syndrome is recommended to prevent cardiovascular disease among postmenopausal Korean women.

The Influence of Varicocele and Microsurgical Varicocelectomy on Semen Quality, as Determined by Metabolic Analysis

The influence of varicocele and microsurgical varicocelectomy on semen quality remains unclear. No previous study has investigated the relationship between semen metabolism and the abnormalities in reproductive function caused by varicocele. Here, we used the non-targeted and targeted metabolic analysis to investigate the different metabolites in seminal plasma within normal, varicocele, and varicocelectomy groups. We clearly showed that varicocele significantly affects sperm metabolism, and microsurgical varicocelectomy can reverse this metabolic abnormality. Moreover, we characterized the landscape of three dipeptides in the seminal plasma of patients with varicocele that have not been identified previously in human tissues or biofluids. Interestingly, the levels of these three dipeptides decreased after microsurgical varicocelectomy coincident with an improvement in semen quality. Western blotting confirmed the downregulation of DPEP3 (dipeptidase 3) in the varicocele group and the upregulation of DPEP3 in the varicocelectomy group. Furthermore, we found that eight metabolites may be helpful to distinguish varicocele patients from normal subjects. Our results can be applied to earlier diagnosis or to predict the outcome of microsurgery for varicocele.

Evaluation of medical treatment in Iranian children with nephrolithiasis

Introduction: Nephrolithiasis has been increasingly recognized in recent years. Urine metabolic abnormality is the main cause of renal stone in children. Therefore, identification and medical treatment of metabolic abnormalities have been suggested as an alternative approach to surgical treatments. Objectives: This study was performed to evaluate the therapeutic effect of urine alkalinization and metabolic management in children with renal stone. Patients and Methods: A total of 300 children (from 408 renal clinics) with nephrolithiasis were enrolled in this study. All of them were treated by supportive managements, including urine alkalinization and specific medical treatment of underlying metabolic abnormality. Improvement was defined as stone resolution, stone passage or decrease of stone dimension. Results: Mean age at diagnosis was 28.7 ± 2.6 months (1-150 months). About 78.8% of patients had metabolic abnormality, of which, hypercalciuria (51.7%) and hypocitraturia (33.4%) were the most common causes, respectively. Resolution of renal stone occurred in 89.7% of patients after one year follow up, more in children less than 5 years (P=0.003), and stones smaller than 5 mm (P<0.001). However, 87.5% of large stones (5-12 mm) improved by medical treatment. Conclusion: Pharmacologic treatment is recommended in young children with small nephrolithiasis. Pharmacologic treatment also suggested as a primary intervention in children with uncomplicated large renal stones, and prior to invasive surgical management.