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1.
Wiad Lek ; 74(2): 313-316, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33813493

RESUMEN

OBJECTIVE: The aim: To evaluate anthropometric, hemodynamic parameters, as well as changes in blood and leptin lipid spectrum in children and adults with overweight and obesity. PATIENTS AND METHODS: Materials and methods: We examined 68 overweight children and 90 patients with obesity in combination with stage 2, grade 2 AH who were electively inpatient. The control group consisted of practically healthy individuals - 20 adults and 55 children. RESULTS: Results: Obesity in childhood isaccompanied by the development of dyslipidemia, hypercholesterolemia, hyperleptinemia and hypertension, and in adulthood may be an additional risk factor for cardiovascular disease, in particular AH. According to the study, total leptin level in overweight children was significantly higher compared to the control group (p<0.01). The concentration of leptin in patients with hypertension in combination with obesity was 3 times higher compared to the control group (p<0.01). CONCLUSION: Conclusions: Thus, obesity or overweight, accompanied by hyperleptinemia and an increase in the proatherogenic fractions of the blood lipid spectrum, is an important problem that needs to be addressed in childhood to prevent cardiovascular disease in adulthood.


Asunto(s)
Hipertensión , Síndrome Metabólico , Obesidad Pediátrica , Adulto , Índice de Masa Corporal , Niño , Humanos , Hipertensión/epidemiología , Leptina , Síndrome Metabólico/complicaciones , Síndrome Metabólico/epidemiología , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Obesidad Pediátrica/complicaciones , Obesidad Pediátrica/epidemiología , Factores de Riesgo
2.
Kardiologiia ; 61(3): 36-41, 2021 Mar 30.
Artículo en Ruso, Inglés | MEDLINE | ID: mdl-33849417

RESUMEN

Aim        To study the psychological continuum in elderly patients with arterial hypertension associated with metabolic syndrome during the chronotherapy with a fixed combination (FC) of amlodipine, lisinopril, and rosuvastatin.Material and methods        In the inpatient conditions, 63 patients aged 60-74 years with arterial hypertension associated with metabolic syndrome were treated with chronotherapy with a FC of amlodipine, lisinopril, and rosuvastatin (5 / 10 / 10 mg/day in the evening). These patients composed the main group. The control group (58 patients aged 60-74 years with arterial hypertension associated with metabolic syndrome) was treated with the FC of amlodipine, lisinopril, and rosuvastatin at the same dose of 5 / 10 / 10 mg/day in the morning.Results   At one year, the disorders of psychological continuum were significantly decreased with the chronotherapy (evening dosing) with the antihypertensive FC of amlodipine, lisinopril, and rosuvastatin compared to the traditional treatment (morning dosing) at the same dose of 5 / 10 / 10 mg/day in both groups. With the chronotherapeutic approach, the dynamic of cognitive disorders in patients aged 60-74 years with arterial hypertension associated with metabolic syndrome was characterized by a significant increase in the Mini-Mental-State-Examination scale score from 17.8±0.3 at baseline to 23.5±0.4 with the evening dosing (р<0.001) vs. the increase from 16.9±0.3 to 20.4±0.4 (р<0.001) with the morning dosing. The situational anxiety score decreased from 40.0±2.2 to 30.6±1.8 (р<0.05) and from 40.8±2.5 to 33.5±1.9  (р<0.05), and the trait anxiety score decreased from 48.8±2.0 to 26.4±1.9 (р<0.001) and from 44.9±1.9 to 30.7±1.7  (р<0.01) with the evening and morning dosing, respectively. Depressive disorders slightly decreased with the chronotherapy by 14.1 % vs. 7.7 % with the traditional regimen; nevertheless, they were consistent with depressive spectrum disorders in both groups.Conclusion            The study results showed a higher effectiveness of the chronotherapeutic treatment compared to the traditional treatment with FC of amlodipine, lisinopril, and rosuvastatin in arterial hypertension with metabolic syndrome.


Asunto(s)
Hipertensión , Síndrome Metabólico , Anciano , Amlodipino/farmacología , Antihipertensivos/uso terapéutico , Ansiedad , Presión Sanguínea , Cronoterapia , Humanos , Hipertensión/tratamiento farmacológico , Lisinopril , Síndrome Metabólico/complicaciones , Síndrome Metabólico/tratamiento farmacológico , Persona de Mediana Edad , Rosuvastatina Cálcica
3.
Klin Lab Diagn ; 66(2): 75-79, 2021 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-33734639

RESUMEN

The presence of metabolic syndrome (MS) significantly increases the risk of developing cardiovascular diseases that lead to chronic heart failure (CHF). The values of NT-proBNP, ST-2, and CRP markers and their mutual correlations were studied in 37 patients with chronic heart failure (CHF) without metabolic syndrome (MS) (group 1) and 37 patients with CHF with MS (group 2). The aim of the study was to determine the features of their changes in patients with CHF complicated by MS, and to rank patients by assigning a rank value to the values of NTproBNP, ST2, and CRP concentrations. The average ST2 level was 51±24 ng/ml in group 1 and 62±27 ng/ml in group 2. The average values of CRP in group 1 were 23.1±5.3 mg/l, in group 2-33.0±4.4 mg/l (p<0.05). The NTproBNP level was 2413±1586 PG/ml and 2721±1635 PG/ml in groups 1 and 2, respectively. Correlations between the values of NTproBNP and ST2, NTproBNP and CRP were demonstrated. In the group of CHF with MS, compared with the group of CHF, there were significantly more patients with the most pronounced pathological levels of damage markers: the number of patients with a General rank of 6-9 in the group of CHF with MS was 59%, in the group of CHF without MS-38% (p<0.05). Of the 18 patients who died, 17 were among those who had an overall rank of 6 to 9, only 1 patient who died after hospitalization had an overall rank of 5. At the same time, among 22 patients who had improved CHF in the outcome of hospitalization, 18 patients had a total rank from 0 to 5, and in 4 patients of this category, the clinical manifestations of CHF remained virtually unchanged. The results of ranking the level of the studied laboratory markers indicate that they can be used as a predictor of various outcomes of CHF.


Asunto(s)
Insuficiencia Cardíaca , Síndrome Metabólico , Biomarcadores , Enfermedad Crónica , Humanos , Laboratorios , Síndrome Metabólico/complicaciones , Péptido Natriurético Encefálico , Fragmentos de Péptidos , Pronóstico
4.
Nat Commun ; 12(1): 1970, 2021 03 30.
Artículo en Inglés | MEDLINE | ID: mdl-33785752

RESUMEN

Periods of fasting and refeeding may reduce cardiometabolic risk elevated by Western diet. Here we show in the substudy of NCT02099968, investigating the clinical parameters, the immunome and gut microbiome exploratory endpoints, that in hypertensive metabolic syndrome patients, a 5-day fast followed by a modified Dietary Approach to Stop Hypertension diet reduces systolic blood pressure, need for antihypertensive medications, body-mass index at three months post intervention compared to a modified Dietary Approach to Stop Hypertension diet alone. Fasting alters the gut microbiome, impacting bacterial taxa and gene modules associated with short-chain fatty acid production. Cross-system analyses reveal a positive correlation of circulating mucosa-associated invariant T cells, non-classical monocytes and CD4+ effector T cells with systolic blood pressure. Furthermore, regulatory T cells positively correlate with body-mass index and weight. Machine learning analysis of baseline immunome or microbiome data predicts sustained systolic blood pressure response within the fasting group, identifying CD8+ effector T cells, Th17 cells and regulatory T cells or Desulfovibrionaceae, Hydrogenoanaerobacterium, Akkermansia, and Ruminococcaceae as important contributors to the model. Here we report that the high-resolution multi-omics data highlight fasting as a promising non-pharmacological intervention for the treatment of high blood pressure in metabolic syndrome patients.


Asunto(s)
Presión Sanguínea/fisiología , Peso Corporal/fisiología , Ayuno/fisiología , Microbioma Gastrointestinal/fisiología , Síndrome Metabólico/fisiopatología , Anciano , Índice de Masa Corporal , Desulfovibrionaceae/fisiología , Dieta , Heces/microbiología , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/microbiología , Hipertensión/fisiopatología , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/microbiología , Persona de Mediana Edad , Ruminococcus/fisiología , Subgrupos de Linfocitos T/inmunología , Subgrupos de Linfocitos T/fisiología
5.
Pol Merkur Lekarski ; 49(289): 32-34, 2021 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-33713090

RESUMEN

Obesity is one of the most serious and common risk factors for cardiovascular disease that increases the risk of type 2 diabetes. AIM: The aim of the study was to analyze the features of disorders of diastolic function of the left ventricle and the oxygenation of arterial and venous blood in patients with diabetic foot syndrome and metabolic syndrome with diastolic dysfunction of the left ventricle in its complex treatment with the using a course of hyperbaric oxygen therapy. MATERIALS AND METHODS: An examination of 32 patients with diabetic foot syndrome, neuro-ischemic form (I stage - 8 patients, II stage - 24 patients) and metabolic syndrome, to determine an assessment was made of diastolic function of the left ventricle, determination of saturation of arterial and venous blood, oxygen content in arterial and venous blood, arterio-venous difference in oxygen. The control group consisted of 20 healthy individuals. These indicators were determined before starting the course of hyperbaric oxygen therapy and after completing the full course used 100 % oxygen, with the following parameters: working pressure of 1.7-1.8 at, with periods of compression and decompression of 10 minutes, isopression - 40-60 minutes. The total number of sessions was 8-10. RESULTS: The ratio peak rates of early- and late diastolic filling of the patients in the study group was significantly lower by 24.48 % (p <0.05) compared to the control group. Iso-volumetric relaxation and slowing of early diastolic filling also increased: by 21.02 % and by 7.26 % (p <0.05), respectively. Saturation of arterial blood after hyperbaric oxygenation sessions was 4.1% higher than the initial data. Saturation of venous blood before and after oxygen therapy was 52.64 ± 0.08 % and 58.25 ± 0.02 %, respectively. Oxygen content in arterial and venous blood before the start of the course was 121.57 ± 0.85 ml· L-1 and 127.20 ± 3.5 ml·L-1, respectively, and after treatment respectively 135.61 ± 0.06 ml·L-1 and 82.13 ± 0.01 ml·L-1. In addition, the volume of oxygen consumed by body tissues increased from 46.85 ± 0.84 ml·L-1 to 57.83 ± 4.3 ml·L-1. CONCLUSIONS: The use of the course of the hyperbaric oxygen therapy contributed to the reduction of signs of diastolic heart failure and increased oxygenation rates of arterial and venous blood, the alignment of oxygen metabolism, contributed to the elimination of both systemic oxygen deficiency and local tissue hypoxia, due to which a complex therapeutic effect revealed.


Asunto(s)
Diabetes Mellitus Tipo 2 , Pie Diabético , Síndrome Metabólico , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/terapia , Pie Diabético/terapia , Diástole , Ventrículos Cardíacos , Humanos , Síndrome Metabólico/complicaciones , Síndrome Metabólico/terapia
6.
Nutrients ; 13(3)2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33652715

RESUMEN

The purpose of this study is to assess the effects of an alternative approach to type 2 diabetes prevention. Ninety-six patients with prediabetes (age 52 (10) years; 80% female; BMI 39.2 (7.1) kg/m2) received a continuous remote care intervention focused on reducing hyperglycemia through carbohydrate restricted nutrition therapy for two years in a single arm, prospective, longitudinal pilot study. Two-year retention was 75% (72 of 96 participants). Fifty-one percent of participants (49 of 96) met carbohydrate restriction goals as assessed by blood beta-hydroxybutyrate concentrations for more than one-third of reported measurements. Estimated cumulative incidence of normoglycemia (HbA1c <5.7% without medication) and type 2 diabetes (HbA1c ≥6.5% or <6.5% with medication other than metformin) at two years were 52.3% and 3%, respectively. Prevalence of metabolic syndrome, class II or greater obesity, and suspected hepatic steatosis significantly decreased at two years. These results demonstrate the potential utility of an alternate approach to type 2 diabetes prevention, carbohydrate restricted nutrition therapy delivered through a continuous remote care model, for normalization of glycemia and improvement in related comorbidities.


Asunto(s)
Diabetes Mellitus Tipo 2/prevención & control , Dieta Baja en Carbohidratos/métodos , Hiperglucemia/dietoterapia , Estado Prediabético/dietoterapia , Telemedicina/métodos , Ácido 3-Hidroxibutírico/sangre , Adulto , Anciano , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/etiología , Hígado Graso/epidemiología , Hígado Graso/etiología , Hígado Graso/prevención & control , Femenino , Hemoglobina A Glucada/metabolismo , Humanos , Hiperglucemia/sangre , Hiperglucemia/complicaciones , Estudios Longitudinales , Masculino , Síndrome Metabólico/sangre , Síndrome Metabólico/complicaciones , Síndrome Metabólico/dietoterapia , Síndrome Metabólico/etiología , Persona de Mediana Edad , Obesidad/epidemiología , Obesidad/etiología , Obesidad/prevención & control , Educación del Paciente como Asunto , Proyectos Piloto , Estado Prediabético/sangre , Estado Prediabético/complicaciones , Prevalencia , Estudios Prospectivos , Resultado del Tratamiento , Adulto Joven
7.
Nutrients ; 13(3)2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33652751

RESUMEN

This study aimed to investigate the effects of two commercially available fish oils (FOs) containing different proportions of two omega-3 fatty acids (FA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on the metabolic and endocrine dysfunctions of white adipose tissue resulting from obesity. Male C57BL/6J mice, 8 weeks old, received a control or high-fat diet (CO and HF groups, with 9% and 59% energy from fat, respectively) for 8 weeks. The next 8 weeks, the HF group was subdivided into HF, HF+FO/E (HF+5:1 EPA:DHA), and HF+FO/D (HF+5:1 DHA:EPA). Supplementation was performed by gavage, three times a week. All groups that received the HF diet had lower food and caloric intake, but a higher fat intake, body weight (BW) gain, glucose intolerance, and a significant increase in inguinal (ING), retroperitoneal (RP), and epididymal (EPI) adipose tissues when compared to the CO group. Additionally, HF and HF+FO/D groups showed insulin resistance, adipocyte hypertrophy, increased lipolysis and secretion of TNF-α, resistin and IL-10 adipokines by ING and RP adipocytes, and adiponectin only by the HF+FO/D group in ING adipocytes. All of these effects were completely reversed in the HF+FO/E group, which also showed partial reversion in BW gain and glucose intolerance. Both the HF+FO/E and HF+FO/D groups showed a reduction in ING and RP adipose depots when compared to the HF group, but only HF+FO/E in the EPI depot. HF+FO/E, but not HF+FO/D, was able to prevent the changes triggered by obesity in TNF-α, Il-10, and resistin secretion in ING and RP depots. These results strongly suggest that different EPA:DHA ratios have different impacts on the adipose tissue metabolism, FO being rich in EPA, but not in DHA, and effective in reversing the changes induced by obesity.


Asunto(s)
Ácido Eicosapentaenoico/farmacología , Aceites de Pescado/farmacología , Alimentos Fortificados , Síndrome Metabólico/terapia , Obesidad/terapia , Adipocitos/efectos de los fármacos , Tejido Adiposo/metabolismo , Animales , Dieta Alta en Grasa/efectos adversos , Modelos Animales de Enfermedad , Ácidos Docosahexaenoicos/farmacología , Resistencia a la Insulina/fisiología , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/fisiopatología , Ratones , Ratones Endogámicos C57BL , Ratones Obesos , Obesidad/complicaciones , Obesidad/fisiopatología , Aumento de Peso/efectos de los fármacos
8.
Int J Mol Sci ; 22(4)2021 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-33671459

RESUMEN

Metabolic syndrome (MetS) and infertility are two afflictions with a high prevalence in the general population. MetS is a global health problem increasing worldwide, while infertility affects up to 12% of men. Despite the high prevalence of these conditions, the possible impact of MetS on male fertility has been investigated by a few authors only in the last decade. In addition, underlying mechanism(s) connecting the two conditions have been investigated in few preclinical studies. The aim of this review is to summarize and critically discuss available clinical and preclinical studies on the role of MetS (and its treatment) in male fertility. An extensive Medline search was performed identifying studies in the English language. While several studies support an association between MetS and hypogonadism, contrasting results have been reported on the relationship between MetS and semen parameters/male infertility, and the available studies considered heterogeneous MetS definitions and populations. So far, only two meta-analyses in clinical and preclinical studies, respectively, evaluated this topic, reporting a negative association between MetS and sperm parameters, testosterone and FSH levels, advocating, however, larger prospective investigations. In conclusion, a possible negative impact of MetS on male reproductive potential was reported; however, larger studies are needed.


Asunto(s)
Síndrome Metabólico/fisiopatología , Reproducción/fisiología , Animales , Dieta Alta en Grasa , Humanos , Infertilidad Masculina/complicaciones , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/epidemiología , Prevalencia , Semen
9.
World J Gastroenterol ; 27(5): 377-390, 2021 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-33584070

RESUMEN

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has undoubtedly revolutionized the whole globe and given a new point of view on respiratory tract infections. Nevertheless, coronavirus disease 2019 (COVID-19) cannot be perceived as a disease limited only to pneumonia with diverse severity. More and more reports have demonstrated a wide range of possible systemic symptoms, including hepatic complications. Liver injury has been observed in a significant proportion of patients, especially in those with a severe or critical illness. COVID-19 might provoke a deterioration of liver function in patients with already diagnosed chronic liver diseases and without pre-existing liver disorders. The deterioration of liver function worsens the prognosis, increases the risk of a severe course of SARS-CoV-2 infection and prolongs the hospital stay. In general, patients who develop liver dysfunction in COVID-19 are mainly males, elderly people, and those with higher body mass index. The underlying mechanisms for hepatic failure in patients infected with SARS-CoV-2 are still unclear, nevertheless liver damage appears to be directly connected with virus-induced cytopathic effects. A liver injury observed during hospitalization might be simultaneously caused by the use of potentially hepatotoxic drugs, mainly antiviral agents. This minireview focuses on a possible relationship between COVID-19 and the liver, potential molecular mechanisms of liver damage, the characteristics of liver injury and suggested factors predisposing to hepatic manifestations in COVID-19 patients.


Asunto(s)
/complicaciones , Fallo Hepático/virología , Antivirales/efectos adversos , /patología , Tracto Gastrointestinal/fisiopatología , Interacciones Huésped-Patógeno , Humanos , Inflamación/complicaciones , Hígado/patología , Fallo Hepático/inducido químicamente , Síndrome Metabólico/complicaciones , Pronóstico , /fisiología
10.
Adv Ther ; 38(4): 1776-1790, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33630277

RESUMEN

INTRODUCTION: To assess real-life effectiveness of a perindopril/indapamide (Per/Ind) single-pill combination (SPC) in patients with hypertension (HT) and type 2 diabetes mellitus (T2DM), obesity and/or metabolic syndrome (MetS). METHODS: This post hoc analysis pooled raw data from four large observational studies (FORTISSIMO, FORSAGE, ACES, PICASSO). Patients, most with uncontrolled blood pressure (BP) on previous treatments were switched to Per/Ind (10 mg/2.5 mg) SPC at study entry. Office systolic and diastolic blood pressures (SBP and DBP) were measured at baseline, 1 month and 3 months. RESULTS: In the overall pooled population (N = 16,763), mean age was 61 ± 12 years, HT duration 11 ± 8 years, and baseline SBP/DBP 162/94 mmHg. T2DM, obesity and MetS were present in 21%, 49% and 27% of patients, respectively. Subgroups had similar mean age and HT duration to the overall population; patients with T2DM were slightly older (64 ± 10 years) with a longer HT duration (13 ± 8 years). Mean BP was approximately 160/95 mmHg in each subgroup. At 1 month, mean SBP decreased by approximately 20 mmHg in the overall population, and by a further 10 mmHg at 3 months. Similar results were observed in the three subgroups, with mean changes from baseline at 3 months of - 28 ± 15/- 13 ± 10 in T2DM; - 30 ± 15/- 14 ± 10 in obesity; and - 31 ± 15/- 15 ± 9 mmHg in MetS. BP decreases were greatest in patients with grade II or grade III HT. BP control rates (< 140/90 mmHg or 140/85 mmHg for T2DM) at 3 months were 59% in T2DM, 67% in obese, and 66% in MetS. No specific safety concerns were raised, particularly concerning ionic (Na, K) or metabolic profiles. CONCLUSIONS: Switching to Per/Ind SPC led to rapid and effective BP decreases in patients with T2DM, obesity, or MetS. BP control was achieved in 6-7 out of 10 previously treated but uncontrolled patients. Treatment was well tolerated. The results confirm the beneficial effects of a Per/Ind SPC for difficult-to-control patient populations.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hipertensión , Indapamida , Síndrome Metabólico , Anciano , Antihipertensivos/uso terapéutico , Presión Sanguínea , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Combinación de Medicamentos , Humanos , Hipertensión/complicaciones , Hipertensión/tratamiento farmacológico , Indapamida/uso terapéutico , Síndrome Metabólico/complicaciones , Síndrome Metabólico/tratamiento farmacológico , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/tratamiento farmacológico , Perindopril/uso terapéutico , Resultado del Tratamiento
11.
Arch Gynecol Obstet ; 303(3): 631-643, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33439300

RESUMEN

BACKGROUND: Polycystic ovarian syndrome (PCOS) is the most prevalent metabolic disorder in reproductive-age women. It is indeed a multifactorial condition evidenced by ovarian dysfunction, hyperandrogenaemia, infertility, hormonal imbalance and chronic anovulation. Experimental evidence infers that PCOS women are prone to cardiovascular problems and insulin resistance. PURPOSE: To furnish the details about the association of inflammatory markers in PCOS. DESIGN: An extensive literature search on PubMed, science direct and google scholar has been performed for articles about PCOS and inflammation in PCOS. A comprehensive analysis using original articles, reviews, systemic and meta-analysis was conducted for better understanding the relationship between inflammatory cytokines and PCOS. RESULTS: The inflammatory markers perform a substantial part in managing the functions of the ovary. Any disturbances in their levels can lead to ovarian dysfunction. Inflammatory markers are associated with PCOS pathogenesis. The interplay between inflammatory cytokines in the PCOS ovary strongly implies that inflammation is one of the most potent risk factors of PCOS. CONCLUSION: Inflammatory markers have a significant role in regulating the ovary. This manuscript highlights the significance of metabolic and inflammatory markers with PCOS. Since PCOS is always considered as a metabolic disorder, researchers can also consider focusing on the relationship between the inflammatory markers in PCOS to establish a new treatment or management of the disease and to improve women's health.


Asunto(s)
Citocinas/metabolismo , Hiperandrogenismo/complicaciones , Inflamación/sangre , Síndrome del Ovario Poliquístico/sangre , Factor de Necrosis Tumoral alfa/sangre , Anovulación/complicaciones , Biomarcadores/sangre , Femenino , Humanos , Infertilidad , Inflamación/metabolismo , Insulina/sangre , Resistencia a la Insulina , Interleucina-6 , Síndrome Metabólico/complicaciones , Síndrome del Ovario Poliquístico/metabolismo , Síndrome del Ovario Poliquístico/patología
12.
Nutr. hosp ; 37(6): 1130-1134, nov.-dic. 2020. tab
Artículo en Inglés | IBECS | ID: ibc-198303

RESUMEN

INTRODUCTION: obese patients present an inflammatory and metabolic profile that leads to oxidative stress and cellular damage. Phase angle is an indicator of cellular integrity and has been proposed as a prognostic parameter for changes in the metabolic profile. OBJECTIVE: to investigate the possible association between phase angle and metabolic parameters in obese patients. MATERIAL AND METHOD: this was a cross-sectional study of adult obese patients who attended a specialized clinic between 2014 and 2016. All patients were ≥ 18 years of age, with a body mass index ≥ 35 kg/m2. All data were obtained from medical records and made part of the clinical protocol. Patients were divided into two groups using a cutoff point for phase angle, and the groups were compared using the Kruskal-Wallis or Chi-squared test for quantitative and categorical variables, respectively. Correlations were identified by Spearman's and Pearson's correlation analyses. All between-group differences were considered statistically significant at p ≤ 0.05. RESULTS: a low phase angle was present in 30.5 % of the 141 patients enrolled in the study. We found an association between low phase angle and presence of hyperuricemia (p = 0.018) when adjusted for waist circumference, dysglycemia, arterial hypertension, and hyperuricemia. There was no correlation between phase angle and the components of body composition. CONCLUSIONS: there is an association of phase angle with uric acid levels, but not with other metabolic parameters


INTRODUCCIÓN: los pacientes obesos presentan un perfil inflamatorio y metabólico que provoca estrés oxidativo y daño celular. El ángulo de fase es un indicador de integridad celular que se ha propuesto como parámetro pronóstico de los cambios del perfil metabólico. OBJETIVO: investigar la posible asociación entre el ángulo de fase y los parámetros metabólicos en pacientes obesos. MATERIAL Y MÉTODO: estudio transversal de pacientes obesos adultos que asistieron a una clínica especializada entre 2014 y 2016. Todos los pacientes tenían ≥ 18 años de edad y un índice de masa corporal ≥ 35 kg/m2. Todos los datos se obtuvieron de los registros médicos y formaron parte del protocolo clínico. Los pacientes se dividieron en dos grupos usando un punto de corte para el ángulo de fase, y los grupos se compararon usando la prueba de Kruskal-Wallis o del chi cuadrado para las variables cuantitativas y categóricas, respectivamente. Las correlaciones se identificaron mediante el análisis de correlación de Spearman y el de Pearson. Todas las diferencias entre grupos se consideraron estadísticamente significativas si p ≤ 0.05. RESULTADOS: se observó un ángulo de fase bajo en el 30,5 % de los 141 pacientes incluidos en el estudio. Encontramos una asociación entre el ángulo de fase bajo y la presencia de hiperuricemia (p = 0.018) cuando se ajustó para la circunferencia de la cintura, la disglucemia, la hipertensión arterial y la hiperuricemia. No hubo correlación entre el ángulo de fase y los componentes de la composición corporal. CONCLUSIONES: el ángulo de fase presenta asociación con los niveles plasmáticos de ácido úrico pero no con otros parámetros metabólicos


Asunto(s)
Humanos , Femenino , Adulto , Obesidad/diagnóstico , Síndrome Metabólico/complicaciones , Síndrome Metabólico/fisiopatología , Índice de Severidad de la Enfermedad , Relación Cintura-Cadera/métodos , Composición Corporal , Estudios Transversales , Índice de Masa Corporal , Estadísticas no Paramétricas , Hiperuricemia/complicaciones , Ácido Úrico/análisis
13.
PLoS One ; 15(12): e0243576, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33362213

RESUMEN

BACKGROUND: Cross-sectional studies suggest an association between metabolic syndrome (MetS) and knee osteoarthritis (KOA). We performed a meta-analysis to evaluate whether MetS is an independent risk factor for KOA. METHODS: Prospective cohort studies evaluating the association between MetS and KOA in general population were retrieved from PubMed and Embase. Only studies with multivariate analyses were included. Data were pooled with a random-effect model, which is considered to incorporate heterogeneity among the included studies. RESULTS: Five studies including 94,965 participants were included, with 18,990 people with MetS (20.0%). With a mean follow-up duration of 14.5 years, 2,447 KOA cases occurred. Pooled results showed that MetS was not significant associated with an increased risk of KOA after controlling of factors including body mass index (adjusted risk ratio [RR]: 1.06, 95% CI: 0.92~1.23, p = 0.40; I2 = 33%). Subgroup analysis showed that MetS was independently associated with an increased risk of severe KOA that needed total knee arthroplasty (RR = 1.16, 95% CI: 1.03~1.30, p = 0.02), but not total symptomatic KOA (RR = 0.84, 95% CI: 0.65~1.08, p = 0.18). Stratified analyses suggested that MetS was independently associated with an increased risk of KOA in women (RR = 1.23, 95% CI: 1.03~1.47, p = 0.02), but not in men (RR = 0.90, 95% CI: 0.70~1.14, p = 0.37). CONCLUSIONS: Current evidence from prospective cohort studies did not support MetS was an independent risk factor of overall KOA in general population. However, MetS may be associated with an increased risk of severe KOA in general population, or overall KOA risk in women.


Asunto(s)
Síndrome Metabólico/complicaciones , Osteoartritis de la Rodilla/epidemiología , Osteoartritis de la Rodilla/etiología , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Incidencia , Masculino , Síndrome Metabólico/epidemiología , Síndrome Metabólico/fisiopatología , Persona de Mediana Edad , Osteoartritis de la Rodilla/cirugía , Estudios Prospectivos , Factores de Riesgo
14.
BMJ Open Respir Res ; 7(1)2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33328246

RESUMEN

BACKGROUND: Several characteristics of the metabolic syndrome, such as obesity and hypertension, have emerged as risk factors for a poor clinical outcome in COVID-19. However, most reports lack data on the metabolic syndrome itself. This study investigated prospectively the relationship between respiratory deterioration and the presence of metabolic syndrome or abdominal adiposity in patients with COVID-19. METHODS: A prospective observational cohort study analysing patients with respiratory symptoms who presented at a local emergency department in the Netherlands. The influence of abdominal adiposity-assessed by an increased waist-hip ratio-and metabolic syndrome on respiratory deterioration and the length of hospital stay were analysed with multivariable logistic regressions and Kaplan-Meier analyses. RESULTS: In total, 166 patients were analysed, of whom 86 (52%) tested positive for COVID-19. The prevalence of metabolic syndrome did not differ between patients with COVID-19 with and without the need for intubation or level of supportive care (37.5% vs 48.4%, p=0.338). In contrast, abdominal adiposity is an independent risk factor for respiratory distress in COVID-19, adjusted for metabolic syndrome, age, gender and BMI (OR 1.11, 95% CI 1.02 to 1.20, p=0.014). CONCLUSION: This study shows that abdominal adiposity, and not the presence of metabolic syndrome, is associated with clinical deterioration in COVID-19. This prospective study provides further insight into the risk stratification of patients with COVID-19 based on a simple measurement as the waist and hip circumference. TRIAL REGISTRATION NUMBER: NL8580.


Asunto(s)
/complicaciones , Síndrome Metabólico/complicaciones , Obesidad Abdominal/complicaciones , /etiología , Adiposidad , Adulto , Anciano , /epidemiología , Femenino , Humanos , Hipertensión/complicaciones , Tiempo de Internación/estadística & datos numéricos , Masculino , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/epidemiología , Persona de Mediana Edad , Países Bajos/epidemiología , Obesidad/complicaciones , Obesidad Abdominal/epidemiología , Prevalencia , Estudios Prospectivos , /mortalidad , Factores de Riesgo , Relación Cintura-Cadera/métodos
15.
Nutrients ; 12(12)2020 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-33339255

RESUMEN

Obesity and metabolic syndrome (MetS) are worldwide major health challenges. The Mediterranean diet (MD) is associated with a better cardiometabolic profile, but these beneficial effects may be influenced by genetic variations, modulating the predisposition to obesity or MetS. The aim was to assess whether interaction effects occur between an obesity genetic risk score (obesity-GRS) and the MD on adiposity and MetS in European adolescents. Multiple linear regression models were used to assess the interaction effects of an obesity-GRS and the MD on adiposity and MetS and its components. Interaction effects between the MD on adiposity and MetS were observed in both sex groups (p < 0.05). However, those interaction effects were only expressed in a certain number of adolescents, when a limited number of risk alleles were present. Regarding adiposity, a total of 51.1% males and 98.7% females had lower body mass index (BMI) as a result of higher MD adherence. Concerning MetS, only 9.9% of males with higher MD adherence had lower MetS scores. However, the same effect was observed in 95.2% of females. In conclusion, obesity-related genotypes could modulate the relationship between MD adherence and adiposity and MetS in European adolescents; the interaction effect was higher in females than in males.


Asunto(s)
Adiposidad/genética , Fenómenos Fisiológicos Nutricionales de los Adolescentes/genética , Dieta Mediterránea/estadística & datos numéricos , Síndrome Metabólico/dietoterapia , Obesidad/genética , Adolescente , Niño , Estudios Transversales , Europa (Continente)/epidemiología , Femenino , Predisposición Genética a la Enfermedad , Humanos , Modelos Lineales , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/genética , Obesidad/prevención & control , Factores de Riesgo , Factores Sexuales , Adulto Joven
16.
BMJ Case Rep ; 13(12)2020 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-33370951

RESUMEN

Non-alcoholic fatty liver disease (NAFLD) is nowadays the most common liver disease worldwide. Autoimmune hepatitis (AIH) is a relatively rare disease of the liver characterised by female predominance, circulating autoantibodies, polyclonal hypergammaglobulinaemia, interface hepatitis on histology and favourable response to immunosuppression. The possibility of an additional AIH diagnosis in patients with NAFLD (NAFLD/AIH concurrence) or the presence of AIH alone instead of a supposed NAFLD diagnosis represents a challenge for clinicians. We report herein two adult patients (a 33-year-old woman and a 59-year-old man) with a previous NAFLD diagnosis who proved finally to suffer from AIH alone. These two representative cases indicate how difficult and complicated could be sometimes the diagnosis of patients with AIH highlighting the range of disease manifestations and severity while they also underline that although NAFLD is by far the most frequent chronic liver disease this could not be always the case.


Asunto(s)
Anticuerpos Antinucleares/sangre , Hepatitis Autoinmune/diagnóstico , Síndrome Metabólico/complicaciones , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Obesidad Mórbida/complicaciones , Adulto , Anticuerpos Antinucleares/inmunología , Biopsia , Diagnóstico Diferencial , Errores Diagnósticos , Diagnóstico por Imagen de Elasticidad , Femenino , Hepatitis Autoinmune/tratamiento farmacológico , Hepatitis Autoinmune/inmunología , Hepatitis Autoinmune/patología , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Inmunosupresores/administración & dosificación , Hígado/diagnóstico por imagen , Hígado/inmunología , Hígado/patología , Pruebas de Función Hepática , Masculino , Síndrome Metabólico/inmunología , Persona de Mediana Edad , Ácido Micofenólico/administración & dosificación , Enfermedad del Hígado Graso no Alcohólico/etiología , Obesidad Mórbida/inmunología , Prednisolona/administración & dosificación
17.
Cells ; 9(11)2020 11 13.
Artículo en Inglés | MEDLINE | ID: mdl-33202960

RESUMEN

The novel coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was declared a pandemic by the WHO on 19 March 2020. This pandemic is associated with markedly elevated blood glucose levels and a remarkable degree of insulin resistance, which suggests pancreatic islet ß-cell dysfunction or apoptosis and insulin's inability to dispose of glucose into cellular tissues. Diabetes is known to be one of the top pre-existing co-morbidities associated with the severity of COVID-19 along with hypertension, cardiocerebrovascular disease, advanced age, male gender, and recently obesity. This review focuses on how COVID-19 may be responsible for the accelerated development of type 2 diabetes mellitus (T2DM) as one of its acute and suspected long-term complications. These observations implicate an active role of metabolic syndrome, systemic and tissue islet renin-angiotensin-aldosterone system, redox stress, inflammation, islet fibrosis, amyloid deposition along with ß-cell dysfunction and apoptosis in those who develop T2DM. Utilizing light and electron microscopy in preclinical rodent models and human islets may help to better understand how COVID-19 accelerates islet and ß-cell injury and remodeling to result in the long-term complications of T2DM.


Asunto(s)
Apoptosis , Infecciones por Coronavirus/patología , Diabetes Mellitus Tipo 2/patología , Neumonía Viral/patología , Animales , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/virología , Diabetes Mellitus Tipo 2/complicaciones , Humanos , Células Secretoras de Insulina/citología , Células Secretoras de Insulina/metabolismo , Síndrome Metabólico/complicaciones , Síndrome Metabólico/patología , Estrés Oxidativo , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/virología , Sistema Renina-Angiotensina/fisiología
18.
Kardiologiia ; 60(8): 98-105, 2020 Sep 17.
Artículo en Ruso | MEDLINE | ID: mdl-33155965

RESUMEN

Aim To study the role of inflammation markers and endothelial dysfunction in predicting the risk of cardiovascular event following a percutaneous coronary intervention (PCI) in patients with ischemic heart disease (IHD) and metabolic syndrome (MS).Materials and methods 80 patients (72 men; median age, 56 (50;63) years) with IHD and PCI were evaluated. Based on the presence of MS according to NCEP-ATP III criteria, patients were divided into two groups, group 1 without MS (n=32) and group 2 with MS (n=48). The control age- and sex-matched group included 15 people without cardiovascular diseases. Serum concentrations of tumor necrosis factor α (TNFα), interleukin 6 (IL-6), IL-10, lipoprotein-associated phospholipase A2 (LP-PLA2), and endothelin 1 were measured by enzyme-linked immunosorbent assay (ELISA). Patients were followed up for 12 months after PCI with evaluation of the incidence of adverse cardiovascular events. Statistical analysis was performed with Statistica 10.0 and Medcalc 19.2.6 software. Differences between variables were considered statistically significant at р<0.05. Potential predictors were determined by the ROC analysis with construction of ROC curves, calculation of AUC (area under the curve), identification of COP (cut-off point by the Youden's index), and sensitivity (Se) and specificity corresponding to the COP.Results Patients with MS had statistically significantly higher serum levels of inflammatory markers than patients of the control group. Concentration of the intravascular inflammation marker, PL-PLA2, was 2.7 times higher in group 1 and 5.1 times higher in group 2 than in the control group (р<0.001). Concentrations of endothelin 1 were 1.9 times higher in group 1 and 3.7 times higher in the MS group compared to the control. At one year after PCI, the incidence of adverse outcomes in the form of cardiovascular events was higher for patients with MS: 10 (20.8 %) cases of stent restenosis and 13 (27.1 %) episodes of coronary atherosclerosis progression according to results of repeated coronarography vs. 2 (6.3%) restenosis cases (χ2-10.853; р=0.002) and 2 (6.3%) episodes of atherosclerosis progression (χ2-23.651; р=0.001) for patients without MS. The groups did not differ in rates of myocardial infarction and cardiac death. The most significant predictors of unfavorable prognosis were LP-PLA2 concentration >983.83 ng/ml (area under the ROC curve, 0.867; sensitivity, 80 %; specificity, 100%; р<0.001) and endothelin 1 overexpression >0.852 fmol/ml (area under the ROC curve, 0.885; sensitivity, 85.5 %; specificity, 83.6 %; р<0.001).Conclusion Patients with MS were characterized by more pronounced imbalance of pro- and anti-inflammatory factors. Concentrations of LP-PLA2 >983.83 ng/ml and endothelin 1 >0.852 fmol/ml were shown to be predictors of unfavorable prognosis for patients with IHD and MS after PCI with coronary stenting.


Asunto(s)
Enfermedad de la Arteria Coronaria , Síndrome Metabólico , Intervención Coronaria Percutánea , Enfermedad de la Arteria Coronaria/cirugía , Humanos , Inflamación , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/diagnóstico , Persona de Mediana Edad , Intervención Coronaria Percutánea/efectos adversos , Pronóstico , Factores de Riesgo , Stents
19.
Cir. Esp. (Ed. impr.) ; 98(9): 540-546, nov. 2020. tab
Artículo en Español | IBECS | ID: ibc-198480

RESUMEN

INTRODUCCIÓN: El síndrome metabólico (SM) se asocia con un aumento del riesgo de diabetes mellitus (DM) y cardiopatía coronaria. El SM también puede estar asociado con un aumento del riesgo de algunos cánceres frecuentes. El objetivo de este estudio fue determinar la relación entre el SM y el cáncer de mama en mujeres posmenopáusicas. MÉTODOS: Estudio de cohortes prospectivo de mujeres posmenopáusicas. Dicha cohorte se dividió en dos grupos: el «grupo con un diagnóstico benigno», formado por mujeres a las cuales se les realizó un seguimiento por cribado del cáncer de mama, y el «grupo con un tumor maligno», formado por pacientes con cáncer de mama diagnosticado por biopsia. Se analizaron como variables a estudio la edad, peso, altura, índice de masa corporal (IMC), perímetro abdominal, glucosa sérica, LDL, HDL y niveles de insulina. Se utilizó la fórmula del modelo homeostático HOMA-IR para evaluar la resistencia a la insulina. Las diferencias se consideraron estadísticamente significativas cuando p < 0,05. RESULTADOS: Doscientas mujeres con una media de edad de 61,5 ± 9,6 años (rango: 37-93) se inscribieron en el estudio que consta de 150 (75%) pacientes en el grupo con un diagnóstico benigno y 50 (25%) pacientes en el grupo con un tumor maligno. El IMC y el perímetro abdominal fueron mayores en el grupo con un tumor maligno (p < 0,05). La incidencia de DM y SM fue mayor en el grupo con un tumor maligno (p < 0,005). En el grupo con un tumor maligno se detectaron incidencias mucho más altas en relación con los niveles glucémicos en ayunas > 100 mg/dl, los niveles de insulina > 10 mUI/l y puntuaciones en el HOMA-IR > 2,7 (p < 0,05). CONCLUSIONES: Existe relación entre el SM y el cáncer de mama posmenopáusico. Son necesarios más estudios para establecer métodos de protección para la prevención del cáncer de mama en mujeres con SM


INTRODUCTION: Metabolic syndrome is associated with an increased risk of diabetes mellitus (DM) and coronary heart disease. It may also be associated with a higher risk of some common cancers. The objective of this study was to determine the relationship between metabolic syndrome and breast cancer in postmenopausal women. METHODS: We present a prospective cohort study of postmenopausal women. This cohort was divided into two groups: the «benign diagnosis group», including women who were studied after breast cancer screening; and the «malignant tumor group», including patients with breast cancer that had been diagnosed by biopsy. Age, weight, height, body mass index (BMI), abdominal perimeter, serum glucose, LDL, HDL and insulin levels were analyzed as variables under study. The HOMA-IR homeostatic model formula was used to assess insulin resistance. The differences were considered statistically significant when P < .05. RESULTS: Two hundred women with a mean age of 61.5±9.6 (range: 37-93) were enrolled in the study, consisting of 150 (75%) patients with a benign diagnosis and 50 (25%) patients with a malignant tumor. BMI and abdominal perimeter were higher in the group with a malignant tumor (P < .05). The incidence of DM and metabolic syndrome was higher in the malignant tumor group (P < .005). In the malignant tumor group, much higher incidences correlated with fasting glycemic levels > 100 mg/dL, insulin levels > 10 mIU/L and HOMA-IR scores > 2.7 (P < .05). CONCLUSIONS: There is a relationship between metabolic syndrome and postmenopausal breast cancer. More studies are needed to establish methods for the prevention of breast cancer in women with metabolic syndrome


Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Síndrome Metabólico/complicaciones , Neoplasias de la Mama/etiología , Posmenopausia/metabolismo , Estudios Prospectivos , Neoplasias de la Mama/metabolismo , Factores de Riesgo , Complicaciones de la Diabetes , Dislipidemias/complicaciones , Obesidad Abdominal/complicaciones , Resistencia a la Insulina , Antropometría
20.
J Med Life ; 13(3): 289-292, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33072198

RESUMEN

Metabolic syndrome is one of the actual problems of modern medicine because of its high prevalence in the general population and its essential role in the development and progression of cardiovascular diseases. In the last decade, studying the relationship between metabolic syndrome and periodontal diseases has attracted many scientists' attention. Based on this, the study of the clinical features of periodontal diseases in the early stages of metabolic syndrome is relevant and necessary for timely and successful pathogenetic therapy. The purpose of our study was to investigate and analyze the prevalence and intensity of periodontal disease in people with metabolic syndrome. To solve this goal, we surveyed 190 people with metabolic syndrome who were registered at the endocrinological clinic in Chernivtsi. They formed the main observation group. The comparison observation group included 90 people without metabolic disorders. The age of the patients ranged from 25 to 55 years. Periodontal disease was detected in 155 of 190 patients with metabolic syndrome (81.58 ± 2.82%). In 90 patients without endocrinological pathology, the prevalence of periodontal disease was 1.2 times lower (65.56 ± 5.04%; p <0.01). Generalized periodontitis prevailed in the structure of periodontal diseases in patients with metabolic syndrome: 26.45±3.56% cases were in the second stage of generalized periodontitis (GP), and 21.94±3.33% in the third stage of GP, р<0.01. Therefore, the metabolic syndrome, as a state with a high risk of diabetes development, creates conditions for the formation and rapid progression of inflammatory-destructive periodontal lesions.


Asunto(s)
Síndrome Metabólico/complicaciones , Enfermedades Periodontales/epidemiología , Enfermedades Periodontales/patología , Adulto , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Encuestas y Cuestionarios
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