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1.
Revista Digital de Postgrado ; 9(2): 227, ago. 2020. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1103383

RESUMO

Evaluar los efectos de la terapia hormonal (TH) con Drospírenona (DRSP)/17 ß -estradiol (E2), sobre los parámetros del Síndrome Metabólico (SM) en pacientes postmenopáusicas. Métodos: Investigación comparativa y aplicada, con diseño cuasi experimental, de casos y controles a simple ciego, prospectivo y de campo; realizada en la Consulta de Ginecología. Hospital "Dr. Manuel Noriega Trigo". San Francisco, Estado Zulia. Venezuela. Participaron 120 mujeres separadas al azar para recibir la combinación DRSP/E2 (Grupo A) o un placebo (Grupo B). Se evaluaron los componentes del SM antes y posterior a 6 meses de haber recibido la TH. Resultados: Se encontró una alta prevalencia de SM en ambos grupos antes de recibir el tratamiento (53,3% y 48%; grupo A y B respectivamente). Posterior al tratamiento, DRSP/E2 al compararse con un placebo, redujo significativamente tanto la prevalencia del SM como el riesgo de padecerlo (21,7% versus 48,3%, OR [IC95%]= 0,29 [0,13-0,65]; p < 0.001), con reducción significativa (p< 0.001) de la hipertensión arterial, glicemia basal alterada, hipertrigliceridemia y obesidad central; además de una reducción significativa de los síntomas vasomotores, síntomas psicológicos e incontinencia urinaria (p< 0.001). En el grupo B la prevalencia del SM se mantuvo sin cambios, salvo para la glicemia basal alterada y los síntomas vasomotores y psicológicos que mostraron una reducción significativa (p< 0.001). Conclusión: DRSP/E2 (2mg/1 mg) demostró ser eficaz luego de 6 meses de tratamiento tanto para el control de los parámetros que definen al SM; con pocos y leves efectos indeseados(AU)


To assess the effects of hormone therapy (HT) with drospirenone (DRSP)/17 ß -estradiol (E2) on the parameters of the metabolic syndrome (MS) in postmenopausal patients. Methods: We performed a comparative and applied research, with quasiexperimental, case-control, single-blind, prospective and field design. The study was realized in the Gynecology consultation. Hospital "Dr. Manuel Noriega Trigo". San Francisco, Estado Zulia. Venezuela. 120 women were included, they were separated to receive either the combination DRSP/E2 (Group A) or placebo (Group B). We assess MS components before and ather 6 months of receiving HT. Results: We found a high prevalence in both groups before receiving treatment (53.3% and 48%, group A and B respectively). A ther treatment, DRSP/E2 when compared to placebo, significantly reduced both the prevalence of MS as the risk of setting it (21.7% versus 48.3%, OR [95%] = 0.29 [0.13-0.65] p <0.001), with a significant reduction (p <0.001) of hypertension, impaired fasting glucose, hypertriglyceridemia, central obesity; and a significant reduction in vasomotor symptoms, psychological symptoms and urinary incontinence (p <0.001). In group B the prevalence of MS was unchanged, except for impaired fasting glycemia and vasomotor and psychological symptoms showed a significant reduction (p <0.001). Conclusion: DRSP/E2 (2mg /1mg), proved to be effective a ther 6 months of treatment both for the control of the parameters that define the SM, with few and mild side effects(AU)


Assuntos
Humanos , Feminino , Progestinas/uso terapêutico , Terapia de Reposição Hormonal , Síndrome Metabólica/fisiopatologia , Estradiol/uso terapêutico , Pós-Menopausa , Endocrinologia , Ginecologia
2.
Endocrinology ; 161(10)2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32603424

RESUMO

The ongoing coronavirus disease 2019 (COVID-19) pandemic is caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Individuals with metabolic syndrome are at increased risk for poor disease outcomes and mortality from COVID-19. The pathophysiologic mechanisms for these observations have not been fully elucidated. A critical interaction between SARS-CoV-2 and the angiotensin-converting enzyme 2 (ACE2) facilitates viral entry into the host cell. ACE2 is expressed in pancreatic islets, vascular endothelium, and adipose tissue, and the SARS-CoV-2 -ACE2 interaction in these tissues, along with other factors, governs the spectrum and the severity of clinical manifestations among COVID-19 patients with metabolic syndrome. Moreover, the pro-inflammatory milieu observed in patients with metabolic syndrome may contribute toward COVID-19-mediated host immune dysregulation, including suboptimal immune responses, hyperinflammation, microvascular dysfunction, and thrombosis. This review describes the spectrum of clinical features, the likely pathophysiologic mechanisms, and potential implications for the management of metabolic syndrome in COVID-19 patients.


Assuntos
Infecções por Coronavirus/fisiopatologia , Síndrome Metabólica/fisiopatologia , Pneumonia Viral/fisiopatologia , Animais , Betacoronavirus/fisiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/metabolismo , Infecções por Coronavirus/virologia , Sistema Endócrino/metabolismo , Sistema Endócrino/fisiopatologia , Humanos , Sistema Imunitário/imunologia , Sistema Imunitário/fisiopatologia , Síndrome Metabólica/imunologia , Síndrome Metabólica/metabolismo , Microvasos/fisiopatologia , Pandemias , Peptidil Dipeptidase A/genética , Peptidil Dipeptidase A/imunologia , Pneumonia Viral/imunologia , Pneumonia Viral/metabolismo , Pneumonia Viral/virologia
3.
J Int Med Res ; 48(7): 300060520939746, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32722979

RESUMO

The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 infection is a serious global concern. Increased morbidity and mortality is associated with older age, male gender, cardiovascular disease, diabetes, and smoking. As COVID-19 spreads from coastal borders, both state to state and country to country, our understanding of its pathophysiology has evolved. Age and type 2 diabetes mellitus (T2DM) play especially important roles in COVID-19 progression. T2DM is an age-related disease associated with metabolic syndrome, obesity, insulin resistance (hyperinsulinemia), hyperlipidemia, hypertension, hyperglycemia, and endothelial activation and dysfunction. This review evaluates the relationships and intersection between endothelial cell activation and dysfunction in T2DM and COVID-19. COVID-19 induces multiple injuries of the terminal bronchioles and alveolar blood-gas barrier and associated ultrastructural tissue remodeling. COVID-19 may unmask multiple vulnerabilities associated with T2DM including damage to the endothelial glycocalyx and multiple end-organ macro and microvascular diseases. Unmasking existing vulnerabilities in diabetic patients with COVID-19 is important. Globally, we must come together to better understand why T2DM is associated with increased COVID-19 morbidity and mortality.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/fisiopatologia , Células Endoteliais/fisiologia , Síndrome Metabólica/complicações , Síndrome Metabólica/fisiopatologia , Pneumonia Viral/complicações , Pneumonia Viral/fisiopatologia , Animais , Barreira Alveolocapilar/patologia , Barreira Alveolocapilar/fisiopatologia , Bronquíolos/patologia , Bronquíolos/fisiopatologia , Comorbidade , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Reposicionamento de Medicamentos , Células Endoteliais/patologia , Humanos , Síndrome Metabólica/epidemiologia , Modelos Biológicos , Pandemias , Pneumonia Viral/epidemiologia , Alvéolos Pulmonares/fisiologia , Alvéolos Pulmonares/fisiopatologia , Ratos , Cicatrização/fisiologia
4.
PLoS One ; 15(7): e0236526, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32722703

RESUMO

Metabolic syndrome (MetS) is a worldwide health concern related to cardiovascular disease. Stress at work increases the risk for MetS, whereas physical activity and cardiorespiratory fitness (CF) have been shown to be potential buffers against stress. The aim of this study was to test the stress-buffering effects of physical activity and CF on the relationship between work stress and MetS. In a prospective study, we followed 97 police officers (mean age = 39.7 years; mean body mass index = 25.74 kg/m2) over one year and assessed MetS, as defined by the National Cholesterol Education Program Adult Treatment Panel III. Stress at work was measured with the Job Content Questionnaire, as well as the Effort-Reward Imbalance Questionnaire. Physical activity was assessed objectively via 7-day accelerometry. CF was assessed with the Åstrand bicycle ergometer test. Hierarchical linear regression models were carried out to predict MetS at follow-up (mean overall MetS score = 1.22), after controlling for baseline levels and sociodemographic background (mean overall MetS score = 1.19). Higher CF levels were significantly associated with lower MetS risk at follow-up (ß = -.38). By contrast, no main effects were found for physical activity and work stress. However, high effort and demand were significantly correlated with increased blood pressure (effort: r = .23 for systolic blood pressure; r = .21 for diastolic blood pressure) and waist circumference (effort: r = .26; demand: r = .23). Moreover, no significant interaction effects occurred between work stress and CF/physical activity. The results emphasize the importance of high levels of CF in the prevention of MetS in police officers. Accordingly, provision of regular training opportunities and repeated CF testing should be considered as a strategy in overall corporate health promotion.


Assuntos
Aptidão Cardiorrespiratória/psicologia , Exercício Físico , Síndrome Metabólica/fisiopatologia , Síndrome Metabólica/psicologia , Estresse Ocupacional/complicações , Polícia/psicologia , Adulto , Feminino , Humanos , Masculino , Síndrome Metabólica/complicações , Estresse Ocupacional/fisiopatologia , Estresse Ocupacional/psicologia , Fatores de Risco
5.
Am J Physiol Heart Circ Physiol ; 319(2): H481-H487, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32678706

RESUMO

Modifiable cardiometabolic risk factors induce the release of proinflammatory cytokines and reactive oxygen species from circulating peripheral blood mononuclear cells (PBMCs), resulting in increased cardiovascular disease risk and compromised immune health. These changes may be driven by metabolic reprogramming of PBMCs, resulting in reduced mitochondrial respiration; however, this has not been fully tested. We aimed to determine the independent associations between cardiometabolic risk factors including BMI, blood pressure, fasting glucose, and plasma lipids with mitochondrial respiration in PBMCs isolated from generally healthy individuals (n = 21) across the adult lifespan (12 men/9 women; age, 56 ± 21 yr; age range, 22-78 yr; body mass index, 27.9 ± 5.7 kg/m2; blood pressure, 123 ± 16/72 ± 10 mmHg; glucose, 90 ± 14 mg/dL; low-density lipoprotein cholesterol (LDL-C), 111 ± 22 mg/dL; and high-density lipoprotein cholesterol (HDL-C), 62 ± 16 mg/dL). PBMCs were isolated from whole blood by density-dependent centrifugation and used to assess mitochondrial function by respirometry. Primary outcomes included basal and maximal oxygen consumption rate (OCR), which were subsequently used to determine spare respiratory capacity and OCR metabolic potential. After we corrected for systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood glucose, LDL-C was negatively associated with maximal respiration (r = -0.56, P = 0.016), spare respiratory capacity (r = -0.58, P = 0.012), and OCR metabolic potential (r = -0.71, P = 0.0011). In addition, SBP was negatively associated with OCR metabolic potential (r = -0.62, P = 0.0056) after we corrected for DBP, blood glucose, and LDL-C. These data suggest a link between blood cholesterol, SBP, and mitochondrial health that may provide insight into how cardiometabolic risk factors contribute to impaired immune cell function.NEW & NOTEWORTHY Independent of other cardiometabolic risk factors, low-density lipoprotein cholesterol, and systolic blood pressure were found to be negatively associated with several parameters of mitochondrial respiration in peripheral blood mononuclear cells of healthy adults. These data suggest that low-density lipoprotein cholesterol and systolic blood pressure may induce metabolic reprogramming of immune cells, contributing to increased cardiovascular disease risk and impaired immune health.


Assuntos
Pressão Sanguínea , Respiração Celular , LDL-Colesterol/sangue , Leucócitos Mononucleares/metabolismo , Síndrome Metabólica/metabolismo , Mitocôndrias/metabolismo , Adulto , Idoso , Biomarcadores/sangue , Glicemia/análise , Índice de Massa Corporal , Jejum/sangue , Feminino , Humanos , Leucócitos Mononucleares/imunologia , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/imunologia , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Mitocôndrias/imunologia , Consumo de Oxigênio , Fatores de Risco , Adulto Jovem
6.
PLoS One ; 15(6): e0234516, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32559253

RESUMO

The prevalence of metabolic syndrome is increased worldwide. Tobacco smoking increases the risk of developing metabolic syndrome. Waterpipe tobacco smoking has become a global trend of tobacco consumption and is as common as cigarette smoking. In this study, the effect of waterpipe tobacco smoke (WTS) on the development of metabolic syndrome in rats was evaluated. Adult Wistar rats were exposed for 19 weeks to either fresh air (control) or WTS for 1 hour daily/ 5 days per week (WTS). Central obesity, systolic blood pressure, lipid profile, glucose hemostasis and levels of leptin and adiponectin were evaluated. The WTS exposure increased body weight, abdominal circumference, systolic blood pressure and fasting glucose compared to control animals (P<0.05), consistent with inducing metabolic syndrome. The retroperitoneal fat, lipid profile and levels of insulin, leptin and adiponectin were not affected by WTS exposure (P>0.05). In conclusion, exposure to WTS has detrimental health effects leading to the development of metabolic syndrome in experimental animals.


Assuntos
Síndrome Metabólica/metabolismo , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Fumar Tabaco/efeitos adversos , Tabaco para Cachimbos de Água/efeitos adversos , Animais , Modelos Animais de Doenças , Feminino , Humanos , Síndrome Metabólica/induzido quimicamente , Síndrome Metabólica/fisiopatologia , Estresse Oxidativo/efeitos dos fármacos , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Ratos , Cachimbos de Água
7.
PLoS One ; 15(6): e0234035, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584834

RESUMO

Understanding gender differences in health-related behaviors and their impacts is a crucial aspect of effective primary care. We studied gender-based differences in predictors of metabolic syndrome (MetS) resolution among newly diagnosed MetS patients. This study was a secondary analysis of a prospective clinical trial study comprising of 637 middle-aged and older adults (226 men and 411 women) who underwent a regular health checkup and were newly diagnosed with MetS at 16 different health clinics of 14 metropolitan cities and provinces. We conducted Cox proportional hazard analysis to estimate cumulative probability of MetS resolution within a 12-month observation period. Among the 637 patients, 47.6% of participants achieved MetS resolution. The resolution rate was similar among men and women (44.7% and 49.1%, respectively, P = 0.320). Low household income (Hazard ratio = 2.62, 95% confidence interval: 1.13-6.08) and current employment (2.29, 1.26-4.13) were associated with a higher cumulative probability of MetS resolution in men than in women. For women, however, longer sleeping hours (1.18, 1.04-1.34) and living with a partner (1.58, 1.06-2.35) were positive predictors of MetS resolution. Being overweight (0.63, 0.44-0.89) was associated with lower cumulative probability of MetS resolution in women than in men. The factors associated with cumulative probability of MetS resolution within the 12-month follow-up were different between men and women. These findings facilitate further exploration on gender-based differences in risk factors for less optimal improvements in MetS.


Assuntos
Síndrome Metabólica/fisiopatologia , Caracteres Sexuais , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Probabilidade
8.
Ann Epidemiol ; 46: 5-11, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32532371

RESUMO

PURPOSE: Metabolic syndrome has a high prevalence in the United States. P-wave duration is a valuable indicator for atrial electrical conduction. Abnormalities in atrial electrical conduction can predispose to atrial fibrillation. Our objective was to estimate the effect of metabolic syndrome on P-wave duration in a nationally representative sample. METHODS: We included 6499 adults who participated in the National Health and Nutrition Examination Survey III (1988-1994). We estimated the effect of metabolic syndrome and its components on P-wave duration after adjusting for confounders such as demographic and lifestyle variables. We stratified the analyses by gender. RESULTS: Irrespective of gender, participants with metabolic syndrome had a longer P-wave duration than that of those without it. In addition, we observed a positive linear dose-response relation between metabolic syndrome components and P-wave duration. CONCLUSIONS: Patients with metabolic syndrome had a longer P-wave duration. They might have been at a higher risk for atrial fibrillation and mortality; they need to be periodically checked by their health care providers. However, the results of this study should be confirmed in prospective studies.


Assuntos
Eletrocardiografia/métodos , Sistema de Condução Cardíaco/fisiopatologia , Síndrome Metabólica/epidemiologia , Obesidade/epidemiologia , Adulto , Idoso , Fibrilação Atrial/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Inquéritos Nutricionais , Obesidade/complicações , Obesidade/fisiopatologia , Prevalência , Estados Unidos/epidemiologia
9.
Am J Clin Nutr ; 112(2): 373-380, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32511694

RESUMO

BACKGROUND: Evidence suggests low-grade inflammation as the cause of metabolic syndrome and suggests diet as a promoter of chronic inflammation. OBJECTIVE: We evaluated the association between inflammatory diets and the development of metabolic syndrome in Mexican adults. METHODS: A total of 399 participants of the Health Workers Cohort Study were included in this study. The follow-up period was 13 y. Metabolic syndrome definition was the presence of ≥3 of the following components: waist circumference ≥102 cm for males or ≥88 cm for females, blood pressure ≥130 mmHg for systolic or ≥85 mmHg for diastolic, HDL cholesterol <40 mg/dL for males and <50 mg/dL for females; triglycerides ≥150 mg/dL, and glucose ≥100 mg/dL. To evaluate the inflammatory potential of the diet we used the Dietary Inflammatory Index (DII), which was divided into quartiles. To assess the risk of metabolic syndrome we estimated HRs and 95% CIs using Cox proportional hazards models. RESULTS: After adjustment for potential confounders, we found a positive association between participants in the highest quartile (Q) of DII and the incidence of metabolic syndrome (HRQ4vsQ1 = 1.99; 95% CI: 1.03, 3.85; P-trend = 0.04) over a period of 13 y. When we divided the metabolic syndrome by its components, we found that participants in the highest quartile of DII were associated with hypertriglyceridemia (HRQ4vsQ1 = 2.28; 95% CI: 1.13, 4.57; P-trend = 0.01), hypertension (HRQ4vsQ1 = 2.22; 95% CI: 1.03, 4.77; P-trend = 0.032), and abdominal obesity (HRQ4vsQ1 = 2.68; 95% CI: 1.06, 6.79; P-trend = 0.02). CONCLUSIONS: A highly inflammatory diet is associated with metabolic syndrome, hypertension, abdominal obesity, and hypertriglyceridemia. Further studies are needed to corroborate the role of inflammation and diet in the development of metabolic syndrome; yet, a reduction in dietary components that have been linked to inflammation is desirable.


Assuntos
Dieta/efeitos adversos , Síndrome Metabólica/etnologia , Síndrome Metabólica/imunologia , Adulto , Glicemia/metabolismo , Pressão Sanguínea , HDL-Colesterol/metabolismo , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Síndrome Metabólica/genética , Síndrome Metabólica/fisiopatologia , Americanos Mexicanos , Pessoa de Meia-Idade , Triglicerídeos/metabolismo
10.
Nutrients ; 12(6)2020 May 26.
Artigo em Inglês | MEDLINE | ID: covidwho-378035

RESUMO

While the detrimental effects of a chronic positive energy balance due to a sedentary lifestyle have been well established, the impacts of a short period of abruptly reduced physical activity and overeating arising from strict confinement due to the COVID-19 pandemic will soon start to emerge. To reasonably anticipate major consequences according to the available evidence, we hereby review the literature for studies that have explored the health impacts of several weeks of a reduction in physical activity and daily step-count combined with modified eating habits. These studies identify as main metabolic consequences increases in insulin resistance, total body fat, abdominal fat and inflammatory cytokines. All these factors have been strongly associated with the development of metabolic syndrome, which in turn increases the risk of multiple chronic diseases. A plausible mechanism involved in these impacts could be a positive energy balance promoted by maintaining usual dietary intake while reducing energy expenditure. This means that just as calorie intake restriction could help mitigate the deleterious impacts of a bout of physical inactivity, overeating under conditions of home confinement is very likely to exacerbate these consequences. Moreover, hypertension, diabetes, and cardiovascular disease have been identified as potential risk factors for more severely ill patients with COVID-19. Thus, adequate control of metabolic disorders could be important to reduce the risk of severe COVID-19.


Assuntos
Infecções por Coronavirus/prevenção & controle , Dieta/efeitos adversos , Síndrome Metabólica/etiologia , Síndrome Metabólica/fisiopatologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena , Comportamento Sedentário , Betacoronavirus , Espaços Confinados , Dieta/métodos , Ingestão de Energia , Metabolismo Energético , Humanos , Resistência à Insulina , Síndrome Metabólica/virologia , Fatores de Risco
11.
Nutrients ; 12(6)2020 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-32466598

RESUMO

While the detrimental effects of a chronic positive energy balance due to a sedentary lifestyle have been well established, the impacts of a short period of abruptly reduced physical activity and overeating arising from strict confinement due to the COVID-19 pandemic will soon start to emerge. To reasonably anticipate major consequences according to the available evidence, we hereby review the literature for studies that have explored the health impacts of several weeks of a reduction in physical activity and daily step-count combined with modified eating habits. These studies identify as main metabolic consequences increases in insulin resistance, total body fat, abdominal fat and inflammatory cytokines. All these factors have been strongly associated with the development of metabolic syndrome, which in turn increases the risk of multiple chronic diseases. A plausible mechanism involved in these impacts could be a positive energy balance promoted by maintaining usual dietary intake while reducing energy expenditure. This means that just as calorie intake restriction could help mitigate the deleterious impacts of a bout of physical inactivity, overeating under conditions of home confinement is very likely to exacerbate these consequences. Moreover, hypertension, diabetes, and cardiovascular disease have been identified as potential risk factors for more severely ill patients with COVID-19. Thus, adequate control of metabolic disorders could be important to reduce the risk of severe COVID-19.


Assuntos
Infecções por Coronavirus/prevenção & controle , Dieta/efeitos adversos , Síndrome Metabólica/etiologia , Síndrome Metabólica/fisiopatologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena , Comportamento Sedentário , Betacoronavirus , Espaços Confinados , Dieta/métodos , Ingestão de Energia , Metabolismo Energético , Humanos , Resistência à Insulina , Síndrome Metabólica/virologia , Fatores de Risco
12.
Eur J Endocrinol ; 183(2): 211-220, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32460236

RESUMO

Background: Data suggest that metabolic health status, incorporating components of metabolic syndrome (MetS), predicts cardiovascular disease (CVD) risk better than BMI. This study explored the association of MetS and obesity with endothelial function, a prognostic risk factor for incident CVD. Methods: Forty-four participants were phenotyped according to BMI as non-obese vs obese (<30 or >30 kg/m2) and according to the International Diabetes Federation criteria of MetS: ≤2 criteria MetS (MetS-) vs ≥3 criteria MetS (MetS+); (1.)non-obese MetS- vs (2.) non-obese MetS+ and (3.) obese MetS- vs (4.) obese MetS+. Flow-mediated dilation (FMD), body composition including liver fat (MRI and spectroscopy), dietary intake, intensities of habitual physical activity and cardio-respiratory fitness were determined. Variables were analysed using a one-factor between-groups ANOVA and linear regression; mean (95% CI) are presented. Results: Individuals with MetS+ displayed lower FMD than those with MetS-. For non-obese individuals mean difference between MetS+ and MetS- was 4.1% ((1.0, 7.3); P = 0.004) and obese individuals had a mean difference between MetS+ and MetS- of 6.2% ((3.1, 9.2); P < 0.001). Although there was no association between BMI and FMD (P = 0.27), an increased number of MetS components was associated with a lower FMD (P = 0.005), and after adjustment for age and sex, 19.7% of the variance of FMD was explained by MetS, whereas only 1.1% was explained by BMI. Conclusions: In this study cohort, components of MetS, rather than obesity per se, contribute to reduced FMD, which suggests a reduced bioavailability of nitric oxide and thus increased risk of CVD.


Assuntos
Síndrome Metabólica/fisiopatologia , Obesidade/fisiopatologia , Vasodilatação , Adiposidade , Adulto , Composição Corporal , Índice de Massa Corporal , Artéria Braquial/fisiopatologia , Doenças Cardiovasculares/fisiopatologia , Estudos de Coortes , Ingestão de Alimentos , Endotélio Vascular/fisiopatologia , Exercício Físico , Feminino , Humanos , Fígado/metabolismo , Masculino , Pessoa de Meia-Idade , Aptidão Física , Fatores de Risco
13.
Nutr Metab Cardiovasc Dis ; 30(7): 1161-1168, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32448718

RESUMO

BACKGROUND AND AIMS: The metabolic syndrome has been reported by cross-sectional studies to have an association with skeletal muscle quality and quantity. Using a longitudinal study design, this study aimed to explicate the association between muscle characteristics assessed with computed tomography (CT) and the incidence and progression of metabolic syndrome. METHODS AND RESULTS: In this retrospective study on a cohort of employees undergoing annual physical examinations, we evaluated data from 554 participants without metabolic syndrome. The cross-sectional skeletal muscle area was determined based on CT data at the level of the third lumbar vertebra, and the skeletal muscle density (SMD) and skeletal muscle index (SMI) were measured. The participants were divided into four study groups according to the sex-specific median values for SMI and SMD. We followed the participants for a mean period of 3.1 years. In the sex- and age-adjusted model, SMI and SMD had an interaction effect on the longitudinal change in number of metabolic syndrome components (ß = -0.074, p = 0.0727). Multiple regression analyses revealed that both low SMI and SMD was significantly associated with the change (ß = 0.131, p = 0.0281), whereas the low SMI and high SMD, and high SMI and low SMD were not. Both low SMI and SMD (hazard ratio (HR), 2.42; 95% confidence interval, 1.28-4.78) showed an increased adjusted HR for incident metabolic syndrome. CONCLUSION: The participants with both low quality and quantity of skeletal muscles were associated with the incidence and progression of metabolic syndrome, whereas those with only low quantity or quality of skeletal muscles were not.


Assuntos
Composição Corporal , Síndrome Metabólica/epidemiologia , Músculo Esquelético/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Progressão da Doença , Feminino , Nível de Saúde , Humanos , Incidência , Japão/epidemiologia , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Tronco
14.
Diabetes Metab Syndr ; 14(4): 671-677, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32438331

RESUMO

BACKGROUND AND AIMS: Clinical evidence exists that patients with diabetes are at higher risk for Coronavirus disease 2019 (COVID-19). We investigated the physiological origins of this clinical observation linking diabetes with severity and adverse outcome of COVID-19. METHODS: Publication mining was applied to reveal common physiological contexts in which diabetes and COVID-19 have been investigated simultaneously. Overall, we have acquired 1,121,078 publications from PubMed in the time span between 01-01-2000 and 17-04-2020, and extracted knowledge graphs interconnecting the topics related to diabetes and COVID-19. RESULTS: The Data Mining revealed three pathophysiological pathways linking diabetes and COVID-19. The first pathway indicates a higher risk for COVID-19 because of a dysregulation of Angiotensin-converting enzyme 2. The other two important physiological links between diabetes and COVID-19 are liver dysfunction and chronic systemic inflammation. A deep network analysis has suggested clinical biomarkers predicting the higher risk: Hypertension, elevated serum Alanine aminotransferase, high Interleukin-6, and low Lymphocytes count. CONCLUSIONS: The revealed biomarkers can be applied directly in clinical practice. For newly infected patients, the medical history needs to be checked for evidence of a long-term, chronic dysregulation of these biomarkers. In particular, patients with diabetes, but also those with prediabetic state, deserve special attention.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Diabetes Mellitus/imunologia , Síndrome Metabólica/imunologia , Peptidil Dipeptidase A/imunologia , Pneumonia Viral/imunologia , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/fisiopatologia , Diabetes Mellitus/mortalidade , Diabetes Mellitus/fisiopatologia , Humanos , Síndrome Metabólica/mortalidade , Síndrome Metabólica/fisiopatologia , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/fisiopatologia
15.
Medicine (Baltimore) ; 99(17): e19959, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332681

RESUMO

This study aimed to investigate the association between Serum Uric Acid (UA) to Creatinine (Cr) Ratio (UA/Cr) and metabolic syndrome (MetS) in postmenopausal women.A total of 455 patients with MetS and 457 age- and gender- matched controls were included in the present retrospective study. Serum levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), Cr, and UA were measured. We employed logistic regression analysis to investigate the association between serum UA/Cr and MetS in postmenopausal women.Serum UA/Cr levels were significantly higher in patients with MetS than that in control subjects (P < .05). In the correlation analysis, serum UA/Cr showed a significantly positive correlation with age, hypertension, systolic pressure (SBP), diastolic pressure (DBP), Waist, body mass index (BMI), TG, UA and negative correlation with type 2 diabetes mellitus (T2DM) and Cr (P all < .001). Moreover, multivariate analysis revealed that serum UA/Cr was still an independent risk factor for MetS (OR = 2.928, 95% CI = 2.385-3.596, P < .001) after adjustments for other confounders.Serum UA/Cr are strongly associated with the risk of MetS in postmenopausal Chinese women.


Assuntos
Creatinina/análise , Síndrome Metabólica/sangue , Ácido Úrico/análise , Idoso , Índice de Massa Corporal , China , Creatinina/sangue , Feminino , Humanos , Modelos Logísticos , Masculino , Síndrome Metabólica/induzido quimicamente , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Pós-Menopausa/sangue , Estudos Retrospectivos , Fatores de Risco , Ácido Úrico/sangue , Circunferência da Cintura
16.
Medicine (Baltimore) ; 99(17): e19865, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332649

RESUMO

The aim of this study was to evaluate the relationship between educational attainment and cardiorespiratory fitness (CRF) as a predictor of metabolic syndrome in a Korean population.In this single-center, retrospective cross-sectional study, 988 healthy adults (601 men and 387 women) who underwent regular health check-up in Seoul St. Mary's Hospital were analyzed. Educational attainment was categorized into 3 groups according to their final grade of educational course: middle or high school (≤12 years of education), college or university (12-16 years of education), and postgraduate (≥16 years of education). CRF was assessed by cardiopulmonary exercise testing, biceps strength, hand grip strength, bioelectrical impedance analysis, and echocardiography. Metabolic syndrome was diagnosed according to the 3rd report of the National Cholesterol Education Program.Among the subjects, 357 (36.1%) had metabolic syndrome. The postgraduate group had significantly higher peak oxygen consumption (VO2), biceps strength, hand grip strength, and peak expiratory flow than other groups (all P < .001). This group showed better left ventricular diastolic function, in terms of deceleration time of mitral inflow, maximal tricuspid valve regurgitation velocity, and left atrial volume index than other groups. Peak VO2 (%) was significantly correlated with all the parameters of metabolic syndrome, including insulin resistance (r = -0.106, P = .002), waist circumference (r = -0.387, P < .001), triglyceride (r = -0.109, P = .001), high density lipoprotein-cholesterol (r = 0.219, P < .001), systolic blood pressure (r = -0.143, P < .001), and diastolic blood pressure (r = -0.177, P < .001). And Peak VO2 (%) was found to be a predictor of metabolic syndrome (adjusted ß = .988, P < .001). However, the level of education was not able to predict metabolic syndrome (postgraduate group; ß = .955, P = .801).Although the postgraduate group had better CRF than other groups, the educational attainment could not exclusively predict metabolic syndrome in this study. Further research is needed to reveal the socioeconomic mechanism of developing metabolic syndrome.


Assuntos
Aptidão Cardiorrespiratória , Escolaridade , Síndrome Metabólica/epidemiologia , Idoso , Fenômenos Fisiológicos Cardiovasculares , Estudos Transversais , Status Econômico , Teste de Esforço , Feminino , Humanos , Masculino , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Consumo de Oxigênio , Pico do Fluxo Expiratório , República da Coreia/epidemiologia , Estudos Retrospectivos
17.
Nutr Metab Cardiovasc Dis ; 30(5): 749-757, 2020 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-32249139

RESUMO

BACKGROUND AND AIMS: Metabolic unhealthiness and obesity are both associated with an increased risk of cardiovascular disease. We aimed to investigate the significance of metabolic unhealthiness and obesity in organ damages in a community-based elderly cohort. METHODS AND RESULTS: A total of 3325 elderly participants (>65 years old) were recruited in northern Shanghai. Associations of metabolic status and obesity with organ damages were investigated. In all, 1317 (39.6%) participants were metabolically unhealthy and 481 (14.5%) were obese. Compared with metabolically healthy nonobese (MH-nonobese) individuals, metabolically healthy obese subjects had a greater left ventricular mass index (LVMI) and pulse wave velocity (PWV). Metabolically unhealthy subjects, regardless of their obesity status, had greater organ damage parameters including E/Ea, LVMI, PWV, and urine albumin-creatinine ratio (UACR) than MH-nonobese subjects (all P < 0.05). After multivariate adjustments, both metabolic unhealthiness and obesity increased the risk of left ventricular hypertrophy (LVH) (OR 1.31, 95% CI 1.10-1.57 and OR 1.63, 95% CI 1.30-2.04), diastolic dysfunction (OR 1.33, 95% CI 1.06-1.67 and OR 1.51, 95% CI 1.14-1.99), and lower extremity atherosclerosis (OR 1.44, 95% CI 1.11-1.85 and OR 2.01, 95% CI 1.49-2.70). Metabolic unhealthiness was also associated with arterial stiffness, microalbuminuria and chronic kidney disease (all P < 0.05). In a subgroup analysis, metabolic unhealthiness was associated with more organ damages in nonobese subjects, and obesity was associated with LVH and lower extremity atherosclerosis regardless of metabolic status. CONCLUSION: Both obesity and metabolic unhealthiness were associated with organ damages. Metabolic unhealthiness was associated with more organ damages, especially in nonobese individuals. Even healthy obesity was significantly associated with cardiac and vascular impairment. REGISTRATION NUMBER FOR CLINICAL TRIALS: NCT02368938.


Assuntos
Metabolismo Energético , Hipertrofia Ventricular Esquerda/epidemiologia , Síndrome Metabólica/epidemiologia , Obesidade Metabolicamente Benigna/epidemiologia , Doença Arterial Periférica/epidemiologia , Disfunção Ventricular Esquerda/epidemiologia , Fatores Etários , Idoso , Albuminúria/epidemiologia , Biomarcadores/sangue , Biomarcadores/urina , China/epidemiologia , Estudos Transversais , Feminino , Avaliação Geriátrica , Humanos , Hipertrofia Ventricular Esquerda/diagnóstico , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Obesidade Metabolicamente Benigna/diagnóstico , Obesidade Metabolicamente Benigna/fisiopatologia , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/fisiopatologia , Prevalência , Estudos Prospectivos , Insuficiência Renal Crônica/epidemiologia , Medição de Risco , Fatores de Risco , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/fisiopatologia
18.
Nutr Metab Cardiovasc Dis ; 30(5): 822-828, 2020 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-32278607

RESUMO

BACKGROUND AND AIM: This study aimed to: i) examine the differences in insulin resistance (IR) across adiposity levels; and ii) ascertain whether high levels of adiponectin attenuate the detrimental association of adiposity with IR in adolescents. METHODS AND RESULTS: A total of 529 adolescents aged 12-18 years participated in this cross-sectional study (267 girls). Anthropometry and body adiposity parameters [body mass index (BMI), sum of skinfolds, body fat percentage (BF %) by bio-impedance analysis and waist circumference (WC)], were measured according to standardized procedures and categorized into age- and sex-specific quartiles. Socioeconomic status, pubertal stage and lifestyle determinants (Mediterranean diet adherence and cardiorespiratory fitness) were gathered and used as confounders. Serum adiponectin and IR (homeostasis model assessment of insulin resistance [HOMA-IR] estimated from fasting serum insulin and glucose were assessed. Analysis of covariance (ANCOVA) showed that HOMA-IR increased in a linear fashion throughout the quartiles of all adiposity measures (p < 0.001 for all), independently of age, sex, pubertal stage, socioeconomic status, adherence to the Mediterranean diet and cardiorespiratory fitness. Two-way ANCOVA showed that adolescents in the higher quartile of adiposity for BF%, BMI, WC and skinfolds sum (Q4) presented the highest adiponectin levels, and had 0.77 Standard Deviation (SD), 0.8 SD, 0.85 SD and 0.8 SD lower HOMA-IR, respectively (p < 0.01) than their low adiponectin group counterparts, after adjustments for potential confounders. CONCLUSION: Higher adiponectin levels may attenuate the detrimental association between adiposity and IR, particularly in subjects with higher adiposity.


Assuntos
Adiponectina/sangue , Adiposidade , Resistência à Insulina , Síndrome Metabólica/sangue , Obesidade Pediátrica/sangue , Adolescente , Fatores Etários , Biomarcadores/sangue , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/fisiopatologia , Portugal/epidemiologia , Medição de Risco , Fatores de Risco , Regulação para Cima
19.
Curr Diab Rep ; 20(6): 17, 2020 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-32232577

RESUMO

PURPOSE OF REVIEW: Individuals with metabolically unhealthy normal weight (MUNW) have an adverse cardiometabolic risk factor profile in the absence of excess body weight, and increased risk for diabetes and heart disease. We critically review some physiological traits and lifestyle characteristics of the MUNW phenotype. RECENT FINDINGS: The prevalence of MUNW varies considerably around the world and among ethnicities, partly because of different definitions; on average, this phenotype affects about ~ 30% of normal weight persons globally. Most studies have recruited MUNW subjects who, although within the normal weight range, are significantly "more obese" than their metabolically healthy lean peers (greater body mass index or total body fat); hence one cannot ascertain whether observed differences are true traits of the MUNW phenotype of simply secondary to greater relative adiposity within the normal range. Carefully matched studies have indicated that MUNW can exist in the absence of excess total body fat. These subjects have a preferential accumulation of fat in the upper body (abdominal subcutaneous and visceral adipose tissues) and the liver, but not skeletal muscle; perhaps surprisingly, this predominantly "android" fat distribution does not translate into increased waist circumference. The MUNW phenotype is associated with lower aerobic fitness and muscle mass and strength, but whether this is simply due to inadequate regular physical activity is not entirely clear. Likewise, no consistent associations have been found between any dietary factors and the development of MUNW phenotype, but diet-induced modest weight loss facilitates its resolution. Delineating the mechanisms leading to metabolic dysfunction in the absence of increased body weight and body fat will likely reveal important targets for improving metabolic health and eventually for reducing the burden of cardiometabolic disease, not only in individuals with normal body weight but also in people with obesity.


Assuntos
Peso Corporal/fisiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Estilo de Vida , Síndrome Metabólica/fisiopatologia , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/etiologia , Humanos , Obesidade , Fenótipo , Fatores de Risco , Circunferência da Cintura
20.
Nutr Metab Cardiovasc Dis ; 30(4): 701-708, 2020 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-32131988

RESUMO

BACKGROUND AND AIMS: Higher cardiorespiratory fitness (CRF) has been suggested to reduce the risk of metabolic syndrome (MetS). We aimed to longitudinally examine the changes of CRF on MetS and its risk factors from adolescence to adulthood. METHODS AND RESULTS: At the age of 15 years, 1076 subjects were recruited from 2 cohorts. CRF was measured on a cycle ergometer. MetS was classified as having at least 3 of the following parameters above the threshold of risk factors: waist circumference, triglycerides, high-density lipoprotein cholesterol (HDL), high blood pressure (BP) and fasting glucose. In addition, insulin, total cholesterol and low-density lipoprotein cholesterol were measured and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Persistently high, increasing, decreasing and persistently low CRF groups were formed according to change in CRF from adolescence to adulthood. Longitudinal increase in CRF was positively associated with change in HDL and negatively associated with change in insulin, HOMA-IR, triglycerides, BP and prevalence of MetS after adjustment for potential confounders. Subjects with persistently low CRF had 11.5- to 34.4-times higher risk of MetS at the age of 25 and 33 years compared to subjects with persistently high CRF and 14.6- to 15.9-times higher risk compared to the increasing CRF group. CONCLUSION: Higher CRF is strongly related to lower values of MetS risk factors. Increasing CRF from adolescence to adulthood reduces the risk to have MetS later in adulthood. High CRF in adolescence that decreases during adulthood has similar risks to MetS compared to individuals with persistently low CRF.


Assuntos
Aptidão Cardiorrespiratória , Síndrome Metabólica/prevenção & controle , Adolescente , Adulto , Fatores Etários , Estônia , Feminino , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Prevalência , Prognóstico , Fatores de Proteção , Medição de Risco , Fatores de Risco , Fatores de Tempo
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