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1.
Medicine (Baltimore) ; 98(43): e17537, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651856

RESUMO

Neutrophil-to-lymphocyte ratio (NLR) serves as a strong prognostic indicator for patients suffering from various diseases. Neutrophil activation promotes the recruitment of a number of different cell types that are involved in acute and chronic inflammation and are associated with cancer treatment outcome. Measurement of NLR, an established inflammation marker, is cost-effective, and it is likely that NLR can be used to predict the development of metabolic syndrome (MS) at an early stage. MS scores range from 1 to 5, and an elevated MS score indicates a greater risk for MS. Monitoring NLR can prevent the risk of MS.A total of 34,013 subjects were enrolled in this study. The subjects (score 0-5) within the 6 groups were classified according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and all anthropometrics, laboratory biomarkers, and hematological measurements were recorded. For the 6 groups, statistical analysis and receiver operating characteristic (ROC) curves were used to identify the development of MS.Analysis of the ROC curve indicated that NLR served as a good predictor for MS. An MS score of 1 to 2 yielded an acceptable discrimination rate, and these rates were even higher for MS scores of 3 to 5 (P < .001), where the prevalence of MS was 30.8%.NLR can be used as a prognostic marker for several diseases, including those associated with MS.


Assuntos
Linfócitos/metabolismo , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Neutrófilos/metabolismo , Medição de Risco/métodos , Adulto , Biomarcadores/sangue , Feminino , Humanos , Contagem de Linfócitos , Masculino , Síndrome Metabólica/etiologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Estudos Retrospectivos , Fatores de Risco
2.
Medicine (Baltimore) ; 98(42): e17620, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626142

RESUMO

Anthropometric measurements are simple and useful methods for predicting metabolic syndrome (MetS) because obesity is a predominant feature of MetS. Although carotid intima-medial thickness (IMT) is generally used to evaluate subclinical atherosclerosis, the relationship between the optimal cut-off anthropometric values for predicting MetS and carotid IMT has not been analyzed in a Korean population.Anthropometric measurements including waist circumference (WC), waist hip ratio (WHR), waist height ratio (WHtR), body mass index (BMI), and carotid IMT were assessed in 2560 Korean subjects without previous history of cardiovascular disease, cerebrovascular disease, neurological abnormalities, or malignancy who participated in baseline health examinations in a self-referral setting in the Seoul area between April 2010 and November 2012. MetS was defined using the National Cholesterol Education Program-Adult Treatment Panel III criteria.In both men and women, the levels of all anthropometric indices were significantly higher in subjects with MetS than in those without MetS. According to the receiver operating characteristic curve, the values of 80.8 cm for WC, 0.87 for WHR, 0.52 for WHtR, and 24.6 kg/m for BMI were the optimal cut-offs for predicting MetS in women. The values of 89.3 cm for WC, 0.90 for WHR, 0.52 for WHtR, and 25.1 kg/m for BMI were the optimal cut-offs for predicting MetS in men. After adjusting for confounding factors, the WC optimal cut-off values for predicting MetS were independently associated with carotid IMT in both women and men (women: ß = 0.016, P = .008; men: ß = 0.033, P = .009). The optimal BMI cut-off value was independently associated with carotid IMT in men only (ß = 0.027, P = .032).Among anthropometric indices including WC, WHR, WHtR, and BMI, the WC optimal cut-off values for MetS were independently associated with an increased carotid IMT in both women and men in a Korean population.


Assuntos
Antropometria/métodos , Aterosclerose/epidemiologia , Espessura Intima-Media Carotídea , Síndrome Metabólica/epidemiologia , Medição de Risco/métodos , Aterosclerose/diagnóstico , Aterosclerose/etiologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Incidência , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , República da Coreia/epidemiologia , Estudos Retrospectivos
3.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(7): 402-409, ago.-sept. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-182859

RESUMO

Background: This study was designed to detect the potential association of a nonfunctional adrenal incidentaloma (NFAI) with insulin resistance and associated metabolic disturbances, with a subsequent increase in cardiovascular risk factors. Methods: Eighty-three NFAI patients and 56 volunteers (controls) without any adrenal abnormalities on computed tomography (CT) were included. Fasting blood glucose (FBG), fasting insulin, lipid profiles, uric acid, homocysteine, fibrinogen, high sensitivity C-reactive protein (hs-CRP), and adiponectin levels were measured in both groups. Blood pressure (BP), waist circumference, body mass index (BMI), and carotid intima media thickness (CIMT) were evaluated in both the patients and volunteers. Results: There were no significant difference between the NFAI and control groups with respect to age, sex, BMI, waist circumference, systolic and diastolic BP, smoking, concomitant disease, and medications. Fasting insulin and glucose levels and homeostasis model of assessment-insulin resistance (HOMA-IR) scores were significantly higher in the NFAI group as compared with those in the control group (p<0.01). The frequency of metabolic syndrome in the NFAI group was higher than that in the control group (p<0.01). All the lipid fractions, except triglyceride (TG), (p<0.05), homocysteine (p=0.01), and fibrinogen levels (p<0.001), were significantly higher in the NFAI group as compared with the levels in the control group. There were no significant differences between the NFAI and control groups in terms of uric acid, hs-CRP, and adiponectin levels. The CIMT values in the NFAI group were significantly higher than those in the control group (0.74±0.14 vs. 0.53±0.09, p<0.001). The mean CIMT value showed a statistically positive correlation with age (r=0.245, p=0.004); the HOMA-IR score (r=0.490, p<0.001); and FBG (r=0.521, p<0.001), fasting insulin (r=0.432, p<0.001), total cholesterol (TC) (r=0.267, p=0.002), and fibrinogen (r=0.398, p<0.001) levels in the NFAI group. Conclusions: The results indicated that the NFAI patients had an elevated risk of insulin resistance, with metabolic syndrome and increased CIMT values. Long-term follow-up studies should be designed to evaluate postsurgical alterations in metabolic parameters and cardiovascular risk factors in NFAI patients


Antecedentes: Este estudio se diseñó para detectar la posible asociación del incidentaloma suprarrenal no funcionante (ISNF) con resistencia a la insulina y trastornos metabólicos asociados, con un incremento subsecuente en los factores de riesgo cardiovascular. Métodos: Se incluyó a 83 pacientes con ISNF y a 56 voluntarios (controles) sin anomalías suprarrenales en la tomografía computarizada (TC). Se determinaron en ambos grupos los valores de glucemia en ayunas (GA), insulina en ayunas, perfiles lipídicos, ácido úrico, homocisteína, fibrinógeno, proteína C reactiva de alta sensibilidad (PCRas) y adiponectina. Se evaluaron la presión arterial (PA), el perímetro de la cintura, el índice de masa corporal (IMC) y el grosor íntima-media carotídea (GIMC) tanto en los pacientes como en los voluntarios. Resultados: No había una diferencia significativa entre los grupos con ISNF y de control en cuanto a edad, sexo, IMC, perímetro de la cintura, PA sistólica y diastólica, tabaquismo, enfermedades concomitantes y medicamentos. Las concentraciones de insulina y glucosa en ayunas y las puntuaciones del modelo homeostático de evaluación de la resistencia a la insulina (HOMA-IR) fueron significativamente mayores en el grupo con ISNF que en el de control (p<0,01). La frecuencia de síndrome metabólico fue mayor en el grupo con ISNF que en el de control (p<0,01). Los valores de todas las fracciones lipídicas, excepto los de triglicéridos (TG) (p<0,05), homocisteína (p=0,01) y fibrinógeno (p<0,001), fueron significativamente mayores en el grupo con ISNF que en el de control. No hubo diferencias significativas entre los grupos con ISNF y de control en las concentraciones de ácido úrico, PCRas y adiponectina. Los valores del GIMC en el grupo con ISNF fueron significativamente mayores que los del grupo de control (0,74±0,14 frente a 0,53±0,09; p<0,001). El valor medio del GIMC mostró una correlación estadísticamente positiva con la edad (r=0,245; p=0,004); la puntuación del HOMA-IR (r=0,490; p<0,001), y la GA (r=0,521; p<0,001), la insulina en ayunas (r=0,432; p<0,001), el colesterol total (CT) (r=0,267; p=0,002) y el fibrinógeno (r=0,398; p<0,001) en el grupo con ISNF. Conclusión: Los resultados indicaban que los pacientes con ISNF tenían un riesgo elevado de resistencia a la insulina, con síndrome metabólico y aumento de los valores del GIMC. Deben diseñarse estudios de seguimiento a largo plazo para evaluar los cambios posquirúrgicos de los parámetros metabólicos y los factores de riesgo cardiovascular en pacientes con ISFN


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Achados Incidentais , Fatores de Risco , Neoplasias das Glândulas Suprarrenais/complicações , Doenças Cardiovasculares/metabolismo , Espessura Intima-Media Carotídea , Síndrome Metabólica/complicações , Resistência à Insulina , Glândulas Suprarrenais/patologia , Síndrome Metabólica/diagnóstico , Neoplasias das Glândulas Suprarrenais/diagnóstico , Doenças Cardiovasculares/complicações , Síndrome Metabólica/fisiopatologia , Voluntários Saudáveis , Pressão Arterial , Índice de Massa Corporal , Relação Cintura-Quadril
4.
High Blood Press Cardiovasc Prev ; 26(4): 305-319, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31264084

RESUMO

INTRODUCTION: There are current trials investigating the effect of resveratrol supplementation on endothelial function and blood pressures among patients with metabolic syndrome (MetS); however, the findings are controversial. AIM: This systematic review and meta-analysis of randomized controlled trials (RCTs) were carried out to summarize the effects of resveratrol supplementation on endothelial activation and blood pressures among patients with MetS and related disorders. METHODS: We searched systematically online databases including: PubMed-Medline, Embase, ISI Web of Science and Cochrane Central Register of Controlled Trials until October, 2018. Two independent authors extracted data and assessed the quality of included articles. Data were pooled using the fixed- or random-effects model and considered as standardized mean difference (SMD) with 95% confidence intervals (95% CI). RESULTS: Out of 831 electronic citations, 28 RCTs (with 33 findings reported) were included in the meta-analyses. The findings showed that resveratrol intervention significantly increased flow-mediated dilatation (FMD) levels (SMD 1.77; 95% CI 0.25, 3.29; P = 0.02; I2: 96.5). However, resveratrol supplements did not affect systolic blood pressure (SBP) (SMD - 0.27; 95% CI - 0.57, 0.03; P = 0.07; I2: 88.9) and diastolic blood pressure (DBP) (SMD - 0.21; 95% CI - 0.52, 0.11; P = 0.19; I2: 89.8). CONCLUSIONS: Resveratrol supplementation significantly increased FMD among patients with MetS and related disorders, but did not affect SBP and DBP. Additional prospective studies are needed to investigate the effect of resveratrol supplementation on endothelial function and blood pressures, using higher-dose of resveratrol with longer durations.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Suplementos Nutricionais , Endotélio Vascular/efeitos dos fármacos , Síndrome Metabólica/tratamento farmacológico , Resveratrol/uso terapêutico , Vasodilatação/efeitos dos fármacos , Vasodilatadores/uso terapêutico , Adulto , Idoso , Suplementos Nutricionais/efeitos adversos , Endotélio Vascular/fisiopatologia , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Resveratrol/efeitos adversos , Resultado do Tratamento , Vasodilatadores/efeitos adversos
5.
BMC Med Genet ; 20(1): 99, 2019 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170924

RESUMO

BACKGROUND: Metabolic syndrome (MetS), defined as a cluster of metabolic risk factors including dyslipidemia, insulin-resistance, and elevated blood pressure, has been known as partly heritable. MetS effects the lives of many people worldwide, yet females have been reported to be more vulnerable to this cluster of risks. METHODS: To elucidate genetic variants underlying MetS specifically in females, we performed a genome-wide association study (GWAS) for MetS as well as its component traits in a total of 9932 Korean female subjects (including 2276 MetS cases and 1692 controls). To facilitate the prediction of MetS in females, we calculated a genetic risk score (GRS) combining 14 SNPs detected in our GWA analyses specific for MetS. RESULTS: GWA analyses identified 14 moderate signals (Pmeta < 5X10- 5) specific to females for MetS. In addition, two genome-wide significant female-specific associations (Pmeta < 5X10- 8) were detected for rs455489 in DSCAM for fasting plasma glucose (FPG) and for rs7115583 in SIK3 for high-density lipoprotein cholesterol (HDLC). Logistic regression analyses (adjusted for area and age) between the GRS and MetS in females indicated that the GRS was associated with increased prevalence of MetS in females (P = 5.28 × 10- 14), but not in males (P = 3.27 × 10- 1). Furthermore, in the MetS prediction models using GRS, the area under the curve (AUC) of the receiver operating characteristics (ROC) curve was higher in females (AUC = 0.85) than in males (AUC = 0.57). CONCLUSION: This study highlights new female-specific genetic variants associated with MetS and its component traits and suggests that the GRS of MetS variants is a likely useful predictor of MetS in females.


Assuntos
Predisposição Genética para Doença/genética , Estudo de Associação Genômica Ampla/métodos , Síndrome Metabólica/genética , Polimorfismo de Nucleotídeo Único , Adulto , Idoso , Alelos , Grupo com Ancestrais do Continente Asiático/genética , Feminino , Predisposição Genética para Doença/etnologia , Genótipo , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/etnologia , Pessoa de Meia-Idade , Fenótipo , República da Coreia , Fatores de Risco , Fatores Sexuais
6.
BMC Public Health ; 19(1): 613, 2019 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-31113427

RESUMO

BACKGROUND: Several epidemiological studies have suggested that optimal obesity and visceral adiposity indicators and their cut-off values to predict cardio-metabolic risks varied among different ethnic groups. However, few studies have investigated the associations of anthropometric indices with cardio-metabolic risks in Chinese Uyghur adults, and the results were inconsistent. METHODS: Between May and September 2016, a total of 4664 subjects aged ≥18 years old were recruited from Northwest China. Anthropometric indices and cardio-metabolic risk factors were measured by trained personnel. Partial correlation analyses and logistic regression analyses were used to evaluate the associations of anthropometric indices with cardio-metabolic risk factors. Receiver operating characteristic analysis was used to compare the abilities of different anthropometric indices to predict cardio-metabolic risk factors, and to determine the optimal cut-off values. RESULTS: The prevalence of metabolic syndrome was 39.41% in Uyghur adults from Xinjiang Uyghur Autonomous Region. Waist circumference (WC) performed better than other obesity indices in predicting the cardio-metabolic risk factors, and the optimal cut-off value of WC to diagnose metabolic syndrome risk factors was 86.50 cm for women and 90.50 cm for men. CONCLUSIONS: Our study suggests that WC had the strongest predictive power for identifying cardio-metabolic risks in Xinjiang Uyghur adults. Further well-designed longitudinal studies are needed to confirm our findings.


Assuntos
Doenças Cardiovasculares/diagnóstico , Síndrome Metabólica/diagnóstico , Circunferência da Cintura , Adulto , Antropometria , Doenças Cardiovasculares/epidemiologia , China/epidemiologia , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Valores de Referência , Fatores de Risco
7.
Health Psychol ; 38(7): 586-595, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31120270

RESUMO

OBJECTIVE: To investigate the separate and combined associations of obesity and metabolic syndrome (MetS) with depression and the role of inflammation. METHOD: Depression was assessed with the Patient Health Questionnaire-9 (PHQ-9) and was defined with a cutpoint of ≥10. Obesity was defined as body mass index (BMI) ≥30 kg/m2 from measured height and weight. MetS was defined based on the American Heart Association consensus definition. Participants were divided into four groups: healthy normal weight (MHN), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUN), and metabolic unhealthy obese (MUO). C-Reactive protein was assessed in a subsample. RESULTS: A total of 18,025 subjects were included in the analysis. Participants with MUO had the highest prevalence of depression compared with the MHN group (14.8% vs. 6.8, p < .001). While both obesity and MetS were independently associated with depression, there was a significant interaction between the two (p < .001), indicating that the associations of obesity and MetS with depression were synergistic. After adjusting for baseline characteristics, compared with the MHN group, the MUO group had the highest odds of depression (odds ratio [OR] = 2.30, 95% CI [2.03, 2.61]), followed by MHO group (OR = 1.51, 95% CI [1.30, 1.74]) and the MUN group (OR = 1.39, 95% CI [1.18, 1.64]). The MUO group also showed the highest level of C-reactive protein, and the latter partially mediated the effect between MUO and depressive symptoms (20.5% of the total effect). CONCLUSION: Both obesity and MetS are associated with depression independent of each other, but when present together, these conditions have a synergistic association with depression. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Depressão/epidemiologia , Depressão/psicologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/psicologia , Obesidade/epidemiologia , Obesidade/psicologia , Adulto , Idoso , Antropometria/métodos , Índice de Massa Corporal , Peso Corporal/fisiologia , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Inflamação/diagnóstico , Inflamação/epidemiologia , Inflamação/psicologia , Masculino , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Inquéritos Nutricionais/métodos , Obesidade/diagnóstico , Reprodutibilidade dos Testes , Circunferência da Cintura/fisiologia
8.
Trials ; 20(1): 202, 2019 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-30961631

RESUMO

BACKGROUND: To date, surgeons and physicians have found positive results treating metabolic syndrome with surgical and non-surgical weight loss therapies. The purpose of this study was to evaluate changes in telomere length in patients with metabolic syndrome after weight loss. METHODS/DESIGN: This study is a three-arm randomized controlled trial. The first group is composed of patients who have undergone stapleless bypass surgery (one anastomosis gastric bypass with an obstructive stapleless pouch and anastomosis (LOAGB-OSPAN)). The second group of patients underwent standard gastric bypass surgery (laparoscopic mini-gastric bypass-one anastomosis gastric bypass (LMGB-OAGB). The patients in the third group received non-surgical weight loss therapy, including a hypocaloric diet with energy restriction (- 500 kcal/day). The aim is to compare changes-telomere length, body mass index, comorbidities, and quality of life-in patients with metabolic syndrome after weight loss. DISCUSSION: To the best of our knowledge, this is the first randomized study to simultaneously compare the effects of surgical and non-surgical weight loss on changes in telomere length. It could provide a solution to the growing problem of metabolic syndrome. Normalization of the body mass index results in improvements in the health of patients with metabolic syndrome. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03667469 . Registered on 11 September 2018.


Assuntos
Restrição Calórica , Dieta Redutora , Derivação Gástrica/métodos , Laparoscopia , Expectativa de Vida , Síndrome Metabólica/terapia , Obesidade/terapia , Perda de Peso , Adolescente , Adulto , Índice de Massa Corporal , Restrição Calórica/efeitos adversos , Comorbidade , Dieta Redutora/efeitos adversos , Feminino , Derivação Gástrica/efeitos adversos , Humanos , Cazaquistão , Laparoscopia/efeitos adversos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/fisiopatologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Homeostase do Telômero , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
10.
Medicine (Baltimore) ; 98(9): e14712, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30817613

RESUMO

The aim of the study was to assess whether body mass index (BMI) can be used as a simple and reliable survey test for metabolic syndrome.The study is an observational cohort study among patients who visited the Rambam Periodic Examinations Institute (RPEI). We analyzed the correlation between obesity indices and presence of metabolic syndrome. We identified the ideal value of BMI for identification of patients at risk for metabolic syndrome. We also described the correlation between different BMI values and its negative predictive value (NPV) for metabolic syndrome.During the study years, 23,993 patients visited the RPEI, and 12.5% of them fulfilled the criteria for metabolic syndrome. Women with metabolic syndrome had higher proportion of obesity, when compared with men (89.9% vs 52.6%; P < .0001). Normal BMI had very high NPV to rule out metabolic syndrome among men and women (98% and 96%, respectively). Using receiver-operating characteristic curve, we found BMI 27 to be the ideal value for identification of metabolic syndrome for the entire cohort (area under the curve [AUC] 0.767, 95% confidence interval [CI] 0.758-0.775, P < .0001), for men (AUC 0.726, 95% CI 0.715-0.738, P < .0001), and for women (AUC 0.843, 95% CI 0.831-0.855, P < .0001). BMI below 30 provided NPV of 91.1% to rule out metabolic syndrome.The BMI as single survey measurement of obesity offers high NPV for metabolic syndrome and can be used by physician and patients for this purpose.


Assuntos
Índice de Massa Corporal , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Adulto , Fatores Etários , Idoso , Pressão Sanguínea , Pesos e Medidas Corporais , Feminino , Humanos , Israel , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
11.
Kaohsiung J Med Sci ; 35(5): 303-309, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30887645

RESUMO

Raised triglycerides (TG) and reduced high density lipoprotein cholesterol (HDL-c) are components of metabolic syndrome. Both high TG and metabolic syndrome have been reported to be risk factors of endometrial cancer. Therefore, triglycerides-to-high density lipoprotein cholesterol ratio (TG/HDL-c ratio) may be a useful biological indicator in managing endometrial cancer. We aimed to explore the association between pretreatment TG/HDL-c ratio and endometrial cancer in postmenopausal women, and to evaluate its potential role in the disease. Pretreatment serum lipid profile and TG/HDL-c ratio were retrospectively analyzed for 167 postmenopausal women with endometrial cancer and 464 matched noncancer controls. Compared with controls, pretreatment TG/HDL-c ratio in endometrial cancer patients significantly elevated regardless of whether patients had diabetes or overweight/obesity (P < 0.05). Further analyses showed that pretreatment TG/HDL-c ratio increased significantly with advanced tumor stage. Interestingly, TG/HDL-c ratio of type I endometrial cancer patients was higher than those with type II endometrial cancer. A positive association was found between pretreatment TG/HDL-c ratio and tumor stage (adjusted r = 0.176, P = 0.027) in endometrial cancer group. Receiver operating characteristic curve analysis yielded the cut-off value of 1.52 for TG/HDL-c ratio to discriminate patients with cancer from controls (area under the curve, 0.689; sensitivity, 51.5%; specificity, 84.1%). Multivariate logistic regression model identified TG/HDL-c ratio ≥ 1.52 (odds ratio = 4.123; P < 0.001) as an independent predictor of endometrial cancer. TG/HDL-c ratio was positively associated with endometrial cancer clinical features, such as tumor stage and pathogenetic type. Accordingly, pretreatment TG/HDL-c ratio might be a potential marker for endometrial cancer.


Assuntos
Biomarcadores Tumorais/sangue , Carcinoma Endometrioide/sangue , HDL-Colesterol/sangue , Diabetes Mellitus/sangue , Neoplasias do Endométrio/sangue , Síndrome Metabólica/sangue , Obesidade/sangue , Triglicerídeos/sangue , Idoso , Área Sob a Curva , Carcinoma Endometrioide/complicações , Carcinoma Endometrioide/diagnóstico , Carcinoma Endometrioide/patologia , Estudos de Casos e Controles , Complicações do Diabetes , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/patologia , Neoplasias do Endométrio/complicações , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/patologia , Feminino , Humanos , Síndrome Metabólica/complicações , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/patologia , Pós-Menopausa/sangue , Curva ROC , Estudos Retrospectivos , Fatores de Risco
12.
Int J Mol Sci ; 20(5)2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-30836679

RESUMO

In clinical practice, there are patients with a combination of metabolic syndrome (MS) and chronic obstructive pulmonary disease (COPD). The pathological mechanisms linking MS and COPD are largely unknown. It remains unclear whether the effect of MS (possible obesity) has a major impact on the progression of COPD. This complicates the development of effective approaches for the treatment of patients with a diagnosis of MS and COPD. Experiments were performed on female C57BL/6 mice. Introduction of monosodium glutamate and extract of cigarette smoke was modeled to simulate the combined pathology of lipid disorders and emphysema. Biological effects of glucagon-like peptide 1 (GLP-1) and GLP-1 on endothelial progenitor cells (EPC) in vitro and in vivo were evaluated. Histological, immunohistochemical methods, biochemical methods, cytometric analysis of markers identifying EPC were used in the study. The CD31⁺ endothelial cells in vitro evaluation was produced by Flow Cytometry and Image Processing of each well with a Cytation™ 3. GLP-1 reduces the area of emphysema and increases the number of CD31⁺ endothelial cells in the lungs of mice in conditions of dyslipidemia and damage to alveolar tissue of cigarette smoke extract. The regenerative effects of GLP-1 are caused by a decrease in inflammation, a positive effect on lipid metabolism and glucose metabolism. EPC are proposed as pathogenetic and diagnostic markers of endothelial disorders in combination of MS with COPD. Based on GLP-1, it is proposed to create a drug to stimulate the regeneration of endothelium damaged in MS and COPD.


Assuntos
Peptídeo 1 Semelhante ao Glucagon/genética , Síndrome Metabólica/genética , Doença Pulmonar Obstrutiva Crônica/genética , Enfisema Pulmonar/genética , Animais , Fumar Cigarros/efeitos adversos , Modelos Animais de Doenças , Progressão da Doença , Células Progenitoras Endoteliais/metabolismo , Citometria de Fluxo , Glucose/metabolismo , Humanos , Metabolismo dos Lipídeos/genética , Pulmão/efeitos dos fármacos , Pulmão/patologia , Síndrome Metabólica/induzido quimicamente , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/tratamento farmacológico , Camundongos , Molécula-1 de Adesão Celular Endotelial a Plaquetas/genética , Doença Pulmonar Obstrutiva Crônica/induzido quimicamente , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Enfisema Pulmonar/diagnóstico , Enfisema Pulmonar/tratamento farmacológico , Enfisema Pulmonar/patologia , Glutamato de Sódio/toxicidade
13.
J Pediatr Endocrinol Metab ; 32(4): 383-389, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-30862761

RESUMO

Background The aim of this study was to compare the validity of various approaches to pediatric continuous metabolic syndrome (cMetS) scores including siMS scores (2 waist/height + fasting blood glucose [FBG]/5.6 + triglycerides [TG]/1.7 + systolic blood pressure [BP]/130 + high-density lipoprotein [HDL]/1.02), Z-scores, principal component analysis (PCA) and confirmatory factor analysis (CFA) for predicting metabolic syndrome (MetS). Methods This nationwide cross-sectional study was conducted on 4200 Iranian children and adolescents aged 7-18 years. The cMetS was computed using data on HDL, cholesterol, TGs, FBG, mean arterial pressure (MAP) and waist circumference (WC). The areas under the receiver operating characteristic curves (AUCs) were used to compare the performances of different cMetS scores. Results Data of 3843 participants (52.4% boys) were available for the current study. The mean (standard deviation [SD]) age was 12.6 (3) and 12.3 (3.1) years for boys and girls, respectively. The differences in AUC values of cMetS scores were significant based on the Delong method. The AUCs (95% confidence interval [CI]) were for Z-scores, 0.94 (0.93, 0.95); first PCA, 0.91 (0.89, 0.93); sum PCA, 0.90 (0.88, 0.92), CFA, 0.79 (0.76, 0.3) and also for siMS scores 1 to 3 as 0.93 (0.91, 0.94), 0.92 (0.90, 0.93), and 0.91 (0.90, 0.93), respectively. Conclusions The results of our study indicated that the validity of all approaches for cMetS scores for predicting MetS was high. Given that the siMS scores are simple and practical, it might be used in clinical and research practice.


Assuntos
Biomarcadores/análise , Índice de Massa Corporal , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/etiologia , Triglicerídeos/sangue , Circunferência da Cintura , Adolescente , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Curva ROC , Reprodutibilidade dos Testes , Fatores de Risco
14.
Arch Endocrinol Metab ; 63(1): 30-39, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30864629

RESUMO

OBJECTIVE: To identify which anthropometric measurement would be the best predictor of metabolic syndrome (MetS) in Brazilian adolescents. SUBJECTS AND METHODS: Cross-sectional study conducted on 222 adolescents (15-17 years) from a city in southern Brazil. Anthropometric, physical activity, blood pressure and biochemical parameters were investigated. MetS criteria were transformed into a continuous variable (MetS score). Linear regression analyses were performed to assess the associations of BMI, hip circumference, neck circumference (NC), triceps skinfold, subscapular skinfold and body fat percentage with MetS score. ROC curves were constructed to determine the cutoff for each anthropometric measurement. RESULTS: The prevalence of MetS was 7.2%. Each anthropometric measurement was significantly (p < 0.001) associated with MetS score. After adjusting for potential confounding variables (age, sex, physical activity, and maternal education), the standardized coefficients of NC and body fat percentage appeared to have the strongest association (beta = 0.69 standard deviation) with MetS score. The regression of BMI provided the best model fit (adjusted R2 = 0.31). BMI predicted MetS with high sensitivity (100.0%) and specificity (86.4%). CONCLUSIONS: Our results suggest that BMI and NC are effective screening tools for MetS in adolescents. The early diagnosis of MetS combined with targeted lifestyle interventions in adolescence may help reduce the burden of cardiovascular diseases and diabetes in adulthood.


Assuntos
Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Síndrome Metabólica/diagnóstico , Circunferência da Cintura , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/fisiopatologia , Prevalência , Fatores de Risco , Sensibilidade e Especificidade
15.
Biomarkers ; 24(4): 394-400, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30907677

RESUMO

Purpose: Oxidative stress (OS) has been implicated in the pathogenesis of metabolic syndrome (MetS). The acute change in OS biomarkers due to exercise, known as exercise-induced OS (EIOS), is postulated to be a more appropriate marker of OS compared to spot OS measures. These studies objectives were to investigate EIOS in participants with MetS and compare the associations between EIOS, spot OS measures and MetS severity. Methods: Sixty-three participants with MetS had MetS severity assessed using the MetS Z-score. Participants undertook a cardiorespiratory fitness test ( V O2peak) to volitional exhaustion (∼8-12 minutes). Plasma OS (total F2-isoprostanes (IsoP), protein carbonyls (PCs)) and antioxidant (glutathione peroxidase (GPx), total antioxidant status (TAS)) biomarkers were measured from samples obtained before and five minutes post- V O2peak test. Wilcoxon's signed-rank tests were used to determine changes in OS markers. Results: There were no significant (p > 0.05) changes in OS or antioxidant biomarkers from pre- to post-exercise (median (interquartile range): IsoP -15.5 (-71.8 to 47.8) pg/mL; PC -0.01 (-0.16 to 0.13) nmol/mg protein; GPx 0.76 (-4.94 to 9.82) U/L, TAS 0.03 (0.00-0.05) mmol/L). Conclusions: A V O2peak test to exhaustion failed to induce OS in participants with MetS. There were no associations between MetS severity and spot OS or EIOS biomarkers.


Assuntos
Aptidão Cardiorrespiratória , Glutationa Peroxidase/sangue , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Esforço Físico , Idoso , Biomarcadores/sangue , Glicemia/metabolismo , Estudos Transversais , Teste de Esforço/métodos , F2-Isoprostanos/sangue , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Resistência à Insulina , Masculino , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Estresse Oxidativo , Carbonilação Proteica , Índice de Gravidade de Doença
16.
Turk J Med Sci ; 49(1): 110-115, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30762319

RESUMO

Background/aim: Adropin is a peptide-structure hormone that plays a role in preventing the development of insulin resistance, which has been linked to obesity and metabolic regulation. The purpose of this study is to assess serum adropin levels and their relationship with metabolic parameters in psoriasis vulgaris patients both with and without metabolic syndrome (MetS). Materials and methods: Fifty-three patients and 26 healthy controls were included in this study. Serum adropin levels, fasting blood glucose, fasting serum insulin, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, and triglyceride levels of all participants were analyzed. Enzyme-linked immunosorbent assay was used to measure serum adropin levels. Results: Serum adropin levels were 2.94 ± 0.56 ng/mL in psoriatic patients without MetS, 2.49 ± 0.77 ng/mL in psoriasis patients with MetS, and 3.37 ± 0.71 ng/mL in the control group. Multivariate logistic regression analysis was used to evaluate adropin decreases in psoriasis patients as an independent predictor of the presence of MetS. Conclusion: The serum levels of adropin in psoriasis patients were significantly lower in the presence of MetS, and this decrease was more prominent than in those without MetS. Adropin may be a contributing factor for metabolic disorders and the development of MetS in psoriasis patients.


Assuntos
Glicemia/análise , Metabolismo Energético , Resistência à Insulina , Insulina/sangue , Síndrome Metabólica , Peptídeos/sangue , Psoríase , Adulto , Proteínas Sanguíneas , Estudos de Casos e Controles , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Correlação de Dados , Feminino , Humanos , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Psoríase/sangue , Psoríase/diagnóstico , Psoríase/metabolismo , Reprodutibilidade dos Testes , Triglicerídeos/sangue , Turquia
17.
J Korean Med Sci ; 34(6): e49, 2019 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-30787682

RESUMO

Background: We assessed the association between metabolic health status and incidence of prostate cancer using the National Health Check-ups (NHC) database of Korea. Methods: A total of 11,771,252 men who participated in the NHC between 2009 and 2012 and 56,552 men who were newly diagnosed with prostate cancer were analyzed. Normal-weight and obesity were defined as body mass index (BMI) < 25 kg/m2 and ≥ 25 kg/m2, respectively. Metabolic obesity was defined as the presence ≥ 3 components of the metabolic syndrome. Participants were stratified into 4 groups: metabolically healthy, normal-weight; metabolically obese, normal-weight (MONW); metabolically healthy, obese (MHO); and metabolically obese, obese. Multivariate Cox regression analysis was performed to examine the relationship between metabolic health status and incidence of prostate cancer. Results: During a mean 5.4 ± 1.1 years of follow-up, 56,552 patients were registered with a diagnosis of prostate cancer. When analyzed according to metabolic health status classification, the multivariable-adjusted hazard ratio (HR) was 1.143 for the MONW group, 1.097 for the MHO group, showing the HR for the MONW group was higher than that for the MHO group. As the number of metabolic syndrome components increased, HR increased significantly. When stratified based on BMI, metabolically obese patients showed significantly higher HR than metabolically healthy patients in all BMI groups. Conclusion: This population-based nationwide study revealed an association between metabolic health status and the incidence of prostate cancer, and the risk increased according to the number of components of the metabolic syndrome.


Assuntos
Síndrome Metabólica/diagnóstico , Neoplasias da Próstata/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Estudos de Coortes , Bases de Dados Factuais , Seguimentos , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/diagnóstico , Modelos de Riscos Proporcionais , Neoplasias da Próstata/complicações , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/mortalidade , República da Coreia/epidemiologia , Fatores de Risco
18.
Medicine (Baltimore) ; 98(7): e14601, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30762814

RESUMO

There has been a marked increase in the use of low-dose computed tomography (LDCT) for lung cancer screening. However, the potential of LDCT to predict metabolic syndrome (MetS) has not been well-documented in this risk-sharing population. We assessed the reliability of epicardial fat volume (EFV) and epicardial fat area (EFA) measurements on chest LDCT for prediction of MetS.A total of 130 (mean age, 50.2 ±â€Š10.77 years) asymptomatic male who underwent nonelectrocardiography (ECG)-gated LDCT were divided into 2 groups for the main analysis (n = 75) and validation (n = 55). Each group was further divided into subgroups with or without MetS. EFV and EFA were calculated semiautomatically using commercially available software with manual assistance. The area under the curve (AUC) on receiver operating characteristic (ROC) analysis and cutoff values to predict MetS on LDCT were then calculated and validated. Female data were not available for analysis due to small sample size in this self-referred lung cancer screening program.In the analysis group, the mean EFV was 123.12 ±â€Š42.29 and 67.30 ±â€Š20.68 cm for the MetS and non-MetS subgroups, respectively (P < .001), and the mean EFA was 7.95 ±â€Š3.10 and 4.04 ±â€Š1.73 cm, respectively (P < .001). Using 93.65 and 4.94 as the cutoffs for EFV and EFA, respectively, the sensitivity, specificity, positive and negative predictive values, and accuracy for predicting MetS were 84.2% and 84.2%, and 92.9% and 64.3% (P < .001); 80% and 44.4% (P = .01); 94.5% and 92.3%; and 90.7% and 69.3% (P < .001), respectively. The AUC for EFV and EFA for predicting MetS was 0.909 and 0.808 (95% confidence interval, 0.819-1.000 and 0.702-0.914, respectively) (P = .02). Using the same cutoff values in the analysis group, there was no significant difference in diagnostic performance using EFV and EFA between the analysis and validation sets.Although quantification of both EFA and EFV is feasible on non-ECG-gated LDCT, EFV may be used to reliably predict MetS with fairly high and better diagnostic performance in selected population.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Coração/diagnóstico por imagem , Programas de Rastreamento/métodos , Síndrome Metabólica/diagnóstico , Adulto , Idoso , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico por imagem , Pessoa de Meia-Idade , Variações Dependentes do Observador , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
19.
PLoS One ; 14(1): e0211483, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30703147

RESUMO

BACKGROUND: Glycated haemoglobin (HbA1c) test has been increasingly promoted as an alternative to fasting plasma glucose (FPG) or oral glucose tolerance test (OGTT) to diagnose dysglycaemia but its performance in HIV-infected Africans has yet to be established. This study aimed to assess the diagnostic accuracy of HbA1c for dysglycaemia including FPG-defined and OGTT-defined dysglycaemia, and OGTT-defined diabetes in HIV-infected Africans, and the effect of HbA1c-predicted dysglycaemia on Joint Interim Statement (JIS)-based prevalent metabolic syndrome (MS). METHODS: A cross-sectional study included HIV-positive patients recruited across public healthcare facilities in the Western Cape. The recommended HbA1c cut-points were tested alongside the optimal cut-points obtained from receiver operating characteristic curve analyses, while the agreement between the MS criteria were assessed using kappa statistic. RESULTS: 748 participants (157 men), median age 38 years, 93% on anti-retroviral drugs were included. The optimal HbA1c cut-points of 5.75% (39.3 mmol/mol) showed 54% sensitivity, 84% specificity for FPG-defined dysglycaemia, and 52% sensitivity, 85% specificity for OGTT-defined dysglycaemia. The HbA1c value of 5.85% (40.4 mmol/mol) (63% sensitivity, 99% specificity) was optimal for diabetes. The internationally advocated cut-point of 6.5% (48 mmol/mol) had 37% sensitivity and 99% specificity for diabetes, while HbA1c ≥5.7% (≥39 mmol/mol) yielded similar performance with the study-specific cut-point for any dysglycaemia. MS prevalence by the JIS criteria (28.2%) increased to 29.7% when using HbA1c ≥5.75% (≥39.3 mmol/mol) and to 32.9% with HbA1c ≥5.7% (≥39 mmol/mol); agreement between the original and modified criteria was generally good. CONCLUSIONS: This study agrees with the internationally recommended HbA1c cut-point for detecting dysglycaemia, but not for diabetes in HIV-infected Africans. In line with previous studies in general African populations, our findings suggest that similar factors interfere with HbA1c values regardless of HIV infection status. Replacing FPG-based with HbA1c-predicted dysglycaemia in the JIS criteria to diagnose MS is feasible in HIV-infected Africans.


Assuntos
Biomarcadores/sangue , Diabetes Mellitus/fisiopatologia , Intolerância à Glucose/diagnóstico , Hemoglobina A Glicada/análise , Infecções por HIV/complicações , Programas de Rastreamento/métodos , Síndrome Metabólica/diagnóstico , Adulto , África/epidemiologia , Estudos Transversais , Feminino , Intolerância à Glucose/sangue , Intolerância à Glucose/etiologia , Teste de Tolerância a Glucose , HIV/isolamento & purificação , Infecções por HIV/virologia , Humanos , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/etiologia , Pessoa de Meia-Idade , Prevalência , Curva ROC
20.
Cir Cir ; 87(2): 196-204, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30768074

RESUMO

Introduction: Primary hyperparathyroidism (PHPT) is the leading cause of outpatient hypercalcemia associated with increased cardiovascular risk. The flow-mediated vasodilation (FMV) has been proposed as a non-invasive method for assessing endothelial function. Objective: To compare the endothelial dysfunction measured by FMV and diastolic dysfunction in patients with PHPT before and after parathyroidectomy. Method: We performed a quasi-experimental (before-after) study to evaluate diastolic function and FMV in patients with PHPT before and six months after parathyroidectomy. Results: Fifteen patients completed study: 12 women and 3 men; 73% presented lithiasis, 27% osteoporosis and 53% metabolic syndrome; 73% presented diastolic dysfunction before the surgery and 60% after the surgery (p = 0.09). Post-isquemia brachial diameter improved from 41 mm (before surgery) to 46 mm (after surgery; p = 0.020). After surgery, we also observed an increase in the brachial diameter pre vs. post-ischemia from 41 to 46 mm (p = 0.005). Before surgery, the change in the delta of brachial diameter pre and post-ischemia was 1 mm and up to 4 mm after surgery (p = 0.03). Conclusions: There is a minor endothelial dysfunction measured by FMV in patients who underwent surgery for PHPT at 6 months after surgery, as well as a trend towards improvement in diastolic dysfunction. Echocardiography can be useful in the preoperative evaluation in patients with asymptomatic PHPT.


Assuntos
Endotélio Vascular/fisiopatologia , Hiperparatireoidismo Primário/fisiopatologia , Hiperparatireoidismo Primário/cirurgia , Síndrome Metabólica/fisiopatologia , Paratireoidectomia , Vasodilatação/fisiologia , Idoso , Diástole/fisiologia , Ecocardiografia , Feminino , Humanos , Hiperparatireoidismo Primário/complicações , Masculino , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Período Pós-Operatório , Período Pré-Operatório , Estudos Prospectivos , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia
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