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Obesity and metabolic syndrome (MetS) share common pathophysiological characteristics with aging. To better understand their interplay, we examined how body mass index (BMI) and MetS jointly associate with physiological age, and if the associations changed from midlife to late-life. We used longitudinal data from 1,825 Swedish twins. Physiological age was measured as frailty index (FI) and functional aging index (FAI) and modeled independently in linear mixed-effects models adjusted for chronological age, sex, education, and smoking. We assessed curvilinear associations of BMI and chronological age with physiological age, and interactions between BMI, MetS, and chronological age. We found a significant three-way interaction between BMI, MetS, and chronological age on FI (p-interaction = 0·006), not FAI. Consequently, we stratified FI analyses by age: < 65, 65–85, and ≥ 85 years, and modeled FAI across ages. Except for FI at ages ≥ 85, BMI had U-shaped associations with FI and FAI, where BMI around 26-28 kg/m2 was associated with the lowest physiological age. MetS was associated with higher FI and FAI, except for FI at ages < 65, and modified the BMI-FI association at ages 65–85 (p-interaction = 0·02), whereby the association between higher BMI levels and FI was stronger in individuals with MetS. Age modified the MetS-FI association in ages ≥ 85, such that it was stronger at higher ages (p-interaction = 0·01). Low BMI, high BMI, and metabolic syndrome were associated with higher physiological age, contributing to overall health status among older individuals and potentially accelerating aging., CC BY 4.0 DEED© 2023, The Author(s)Published: 16 December 2023Correspondence Address: P. Ler; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Nobels väg 12A, Solna, 171 65, Sweden; email: peggy.ler@ki.seOpen access funding provided by Karolinska Institute. This work was supported by the Swedish Research Council for Health, Working Life and Welfare (Forte; 2022-00672); the Strategic Research Program in Epidemiology (SFOepi) at Karolinska Institutet, Karolinska Institutet’s Research Foundation (2022-01718); Loo and Hans Osterman’s Foundation (2022-01222, 2023-01855); the Foundation for Geriatric Diseases at Karolinska Institutet (2022-01296); the National Institutes of Health (NIH; R01 AG060470, AG059329), and the Swedish Research Council (Vetenskaprådet; 2016–03081). SATSA was supported by the NIH (grants AG04563 and AG10175), the MacArthur Foundation Research Network on Successful Aging, the Swedish Research Council for Working Life and Social Research (97:0147:1B, 2009-0795), and the Swedish Research Council (825-2007-7460 and 825-2009-6141). OCTO-Twin was supported by the NIH (R01AG08861). GENDER was supported by the MacArthur Foundation Research Network on Successful Aging, The Axel and Margaret Ax:son Johnson’s Foundation, The Swedish Council for Social Research, and the Swedish Foundation for Health Care Sciences and Allergy Research. The funders had no role in the study design, data collection, data analysis, interpretation, or writing of the manuscript.

Background: Handgrip strength (HGS) is a surrogate marker of whole body strength that has been observed to correlate inversely with the metabolic syndrome (MetS). In this study, we examined whether HGS in young, healthy individuals, was associated with surrogate endpoints of the MetS. A secondary goal was to examine whether absolute HGS (absHGS) or relative HGS (relHGS) was a stronger predictor of MetS. Method: 834 subjects (577 women), aged 18–26, were recruited. Surrogate endpoints for MetS were waist circumference, HDL, fasting glucose, fasting insulin, triglycerides, and systolic and diastolic blood pressure (BP). We also examined the association between HGS and body fat percentage, HOMA-IR, CRP, orosomucoid and apolipoprotein A-1 and apolipoprotein B. The associations were examined using multivariable linear regression. Results: AbsHGS and relHGS were each associated with several surrogate endpoints of the metabolic syndrome, with RelHGS being statistically significantly associated with a greater number of the variables – all except fasting glucose and diastolic BP. Conclusion: RelHGS correlates with components of the MetS even in young, healthy populations. It is a better predictor of MetS components than absHGS. As a cheap and easy to use biomarker, relHGS holds merit as a screening tool for metabolic dysfunction even in preclinical contexts.

Obesity and metabolic syndrome (MetS) share common pathophysiological characteristics with aging. To better understand their interplay, we examined how body mass index (BMI) and MetS jointly associate with physiological age, and if the associations changed from midlife to late-life. We used longitudinal data from 1,825 Swedish twins. Physiological age was measured as frailty index (FI) and functional aging index (FAI) and modeled independently in linear mixed-effects models adjusted for chronological age, sex, education, and smoking. We assessed curvilinear associations of BMI and chronological age with physiological age, and interactions between BMI, MetS, and chronological age. We found a significant three-way interaction between BMI, MetS, and chronological age on FI (p-interaction = 0·006), not FAI. Consequently, we stratified FI analyses by age: < 65, 65–85, and ≥ 85 years, and modeled FAI across ages. Except for FI at ages ≥ 85, BMI had U-shaped associations with FI and FAI, where BMI around 26-28 kg/m2 was associated with the lowest physiological age. MetS was associated with higher FI and FAI, except for FI at ages < 65, and modified the BMI-FI association at ages 65–85 (p-interaction = 0·02), whereby the association between higher BMI levels and FI was stronger in individuals with MetS. Age modified the MetS-FI association in ages ≥ 85, such that it was stronger at higher ages (p-interaction = 0·01). Low BMI, high BMI, and metabolic syndrome were associated with higher physiological age, contributing to overall health status among older individuals and potentially accelerating aging., CC BY 4.0 DEED© 2023, The Author(s)Published: 16 December 2023Correspondence Address: P. Ler; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Nobels väg 12A, Solna, 171 65, Sweden; email: peggy.ler@ki.seOpen access funding provided by Karolinska Institute. This work was supported by the Swedish Research Council for Health, Working Life and Welfare (Forte; 2022-00672); the Strategic Research Program in Epidemiology (SFOepi) at Karolinska Institutet, Karolinska Institutet’s Research Foundation (2022-01718); Loo and Hans Osterman’s Foundation (2022-01222, 2023-01855); the Foundation for Geriatric Diseases at Karolinska Institutet (2022-01296); the National Institutes of Health (NIH; R01 AG060470, AG059329), and the Swedish Research Council (Vetenskaprådet; 2016–03081). SATSA was supported by the NIH (grants AG04563 and AG10175), the MacArthur Foundation Research Network on Successful Aging, the Swedish Research Council for Working Life and Social Research (97:0147:1B, 2009-0795), and the Swedish Research Council (825-2007-7460 and 825-2009-6141). OCTO-Twin was supported by the NIH (R01AG08861). GENDER was supported by the MacArthur Foundation Research Network on Successful Aging, The Axel and Margaret Ax:son Johnson’s Foundation, The Swedish Council for Social Research, and the Swedish Foundation for Health Care Sciences and Allergy Research. The funders had no role in the study design, data collection, data analysis, interpretation, or writing of the manuscript.

Background: Handgrip strength (HGS) is a surrogate marker of whole body strength that has been observed to correlate inversely with the metabolic syndrome (MetS). In this study, we examined whether HGS in young, healthy individuals, was associated with surrogate endpoints of the MetS. A secondary goal was to examine whether absolute HGS (absHGS) or relative HGS (relHGS) was a stronger predictor of MetS. Method: 834 subjects (577 women), aged 18–26, were recruited. Surrogate endpoints for MetS were waist circumference, HDL, fasting glucose, fasting insulin, triglycerides, and systolic and diastolic blood pressure (BP). We also examined the association between HGS and body fat percentage, HOMA-IR, CRP, orosomucoid and apolipoprotein A-1 and apolipoprotein B. The associations were examined using multivariable linear regression. Results: AbsHGS and relHGS were each associated with several surrogate endpoints of the metabolic syndrome, with RelHGS being statistically significantly associated with a greater number of the variables – all except fasting glucose and diastolic BP. Conclusion: RelHGS correlates with components of the MetS even in young, healthy populations. It is a better predictor of MetS components than absHGS. As a cheap and easy to use biomarker, relHGS holds merit as a screening tool for metabolic dysfunction even in preclinical contexts.

Introduction: The relationship between body composition and the metabolically obese, normal weight phenotype (MONW), characterized by metabolic issues in individuals with a normal BMI, is still not well understood. Although BMI is widely used to assess the impact of overweight and obesity on metabolic health, it has limitations in distinguishing between fat and lean mass. The aim of this study was to analyze the association between estimated body fat percentage (%BF) using skinfold thickness and the diagnosis of MONW in the Peruvian population. Methodology: This cross-sectional analytical study used data from the PERU MIGRANT cohort. Participants with a BMI between 18.5 and 24.9 kg/m² with no history of diabetes or hypertension were included. MONW was defined as having ≥2 cardiometabolic risk factors. The optimal cut-off point for %BF was determined using ROC curves and the area under the curve with 95% confidence intervals (CI), stratified by sex, and using the Youden index. A generalized linear model with a log link and Poisson family was used for regression analysis, obtaining crude and adjusted prevalence ratios (PRc and PRa) with 95%CI.Results: A total of 321 participants were included in the study. 54.52% were women, and 9.66% were ≥60 years old. The prevalence of MONW was 32.09% and varied significantly by sex, age group, and %BF. The optimal %BF cutoff points for MONW were 20.70% in men and 32.45% in women. Multiple regression analysis revealed that a high %BF significantly increased the PR by 3.09 (95%CI: 2.04-4.67) times after adjusting for covariates. Conclusions: This study confirms the relationship between the estimated %BF using skinfold thickness and the diagnosis of MONW. It underscores the importance of comprehensively assessing body composition, even in lean individuals, to effectively prevent associated metabolic alterations, Introducción: La relación entre la composición corporal y el fenotipo delgado metabólicamente obeso (DMO), caracterizado por problemas metabólicos en personas con un IMC normal, ha sido poco estudiada en población latina. A pesar de que el IMC se utiliza ampliamente para evaluar las asociaciones entre sobrepeso, obe-sidad y la salud metabólica, presenta limitaciones en la diferenciación entre grasa y masa magra. El objetivo de este estudio fue analizar la asociación entre el porcentaje de grasa corporal (%GC) estimado a través de pliegues cutáneos y el diagnóstico de DMO en la población peruana. Metodología: Estudio analítico transversal con datos de la cohorte PERU MIGRANT. Se incluyeron participan-tes con IMC entre 18,5 a 24,9 kg/m² sin antecedentes de diabetes e hipertensión. El DMO se definió como ≥2 factores de riesgo cardio metabólicos. El punto de corte óptimo del %GC se obtuvo mediante la curva de la característica operativa del receptor (COR) y área bajo la curva con intervalos de confianza (IC) al 95%, estratificado por sexo y utilizando el índice de Youden. Se realizó un modelo lineal generalizado con enlace log y familia Poisson, obteniendo razones de prevalencia crudas y ajustadas (RPc y RPa) con IC95%. Resultados: Se incluyó 321 participantes en el estudio. El 54,52% eran mujeres y 9,66% tenía ≥60 años. La prevalencia del DMO fue 32,09% y varió significativamente según el sexo, grupo de edad y %GC. Los puntos de corte óptimos del %GC para DMO fueron 20,70% en hombres y 32,45% en mujeres. La regresión múltiple reveló que un alto %GC aumentó significativamente la RPa en 3,09 (IC95%: 2,04-4,67) veces, tras ajustar por covariables. Conclusiones: Este estudio confirma la relación entre el %GC estimado mediante pliegues cutáneos y el diagnóstico de DMO. Destaca la importancia de evaluar la composición corporal integralmente, incluso en personas delgadas, para prevenir eficazmente las alteraciones metabólicas asociadas.

Introduction: The main objective of this systematic review was to explore the relationship between people with metabolic syndrome criteria, their dietary patterns and the development of sarcopenia.Methodology: A systematic review was performed in accordance with the standard of the PRISMA guidelines. The inclusion criteria were adult population (18 years and over), both sexes, diagnosed with metabolic syndrome (MS) or one of their components (obesity, dislypemia, hypertension or insulin resistance), cross-sectional, cohort studies or randomized controlled trials and articles in English or Spanish. The protocol registration number in PROSPERO is CRD42022369071.Results: 662 articles were found, after screening and selection, 16 were analyzed. The aforementioned articles were 12 cross-sectional studies, 1 RCT and 3 cohort studies. The total sample studied was 21453 people. Heterogeneity was observed in the gathering of study information methods. The results were divided into three groups according to the data collection methods used in the study: dietary survey, Food Frequency Questionnaire (FFQ) and other methods. An association was found between low intake of fiber or vitamin C and unbalanced diets with the development of sarcopenia in people with MS. Otherwise, it was found an association between a diet rich in carbohydrates, Dietary approaches to stop hypertension (DASH), Mediterranean, ovolactovegetarian and Brazilian traditional diets and a lower risk of development sarcopenia. Conclusions: It was found an association between low-fiber intake and unbalanced diets and a high risk of development sarcopenia while diet while good quality diets with a high content of vegetables, fiber and anti-inflammatory foods reduced the risk, Introducción: El objetivo principal de esta revisión sistemática fue explorar la relación entre los patrones dietéticos y el desarrollo de sarcopenia en personas con criterios diagnósticos de síndrome metabólico.Metodología: Se realizó una revisión sistemática de acuerdo con el estándar de las directrices PRISMA. Los criterios de inclusión fueron población adulta (mayor de 18 años), ambos sexos, diagnosticados de síndrome metabólico (SM) o alguno de sus componentes (obesidad, dislipemia, hipertensión o resistencia a la insulina), estudios transversales, de cohortes o ensayos clínicos aleatorizados y artículos en inglés o español. El número de registro del protocolo en PROSPERO es CRD42022369071.Resultados: Se encontraron 662 artículos, tras el cribado y selección se analizaron 16. Dichos artículos fueron 12 estudios transversales, 1 ECA y 3 estudios de cohortes. La muestra total estudiada fue de 21453 personas. Se observó heterogeneidad en los métodos de recogida de información de los estudios. Los resul-tados se dividieron en tres grupos según los métodos de recogida de datos utilizados en el estudio: encues-ta dietética, Cuestionario de Frecuencia de Alimentos (FFQ) y otros métodos. Se encontró una asociación entre la baja ingesta de fibra o vitamina C y las dietas desequilibradas con el desarrollo de sarcopenia en personas con SM. Sin embargo, se encontró asociación entre una dieta rica en hidratos de carbono, Dietary approaches to stop hypertension (DASH), la dieta mediterránea, ovolactovegetariana y las dietas tradicio-nales brasileñas y un menor riesgo de desarrollo sarcopenia.Conclusiones: Se encontró una asociación entre la baja ingesta de fibra y las dietas desequilibradas y un alto riesgo de desarrollo de sarcopenia, mientras que las dietas de buena calidad con un alto contenido en verduras, fibra y alimentos antiinflamatorios redujeron el riesgo.

OBJECTIVES: Patients with pre-transplant metabolic dysfunction-associated steatohepatitis (MASH) are at high risk of metabolic syndrome (MetS) after liver transplant. While many patients are co-managed by a transplant team, most preventative screening and MetS management may occur in the primary care setting. We aimed to evaluate primary care utilization by MASH liver transplant recipients as well as MetS screening and control. METHODS: We conducted a retrospective chart review that included adults who underwent liver transplant for MASH or cryptogenic cirrhosis at a single institution from January 2010 to December 2016, had available primary care data, and at least 36-months of follow-up post-transplant. Measures included primary care utilization, adherence to screening guidelines, and control of MetS. We used Fischers exact test to explore the association of primary care utilization with screening and control. RESULTS: A total of 37 patients met inclusion criteria with 366 visits reviewed. The median time to first visit was 68 days post-transplant and patients had a median of 9 total visits. Few patients met screening guidelines for diabetes (8.1%) or hyperlipidemia (10.8%). The percentage of patients with control of obesity, hypertension, diabetes, and hyperlipidemia decreased over the 36-month follow-up period. Primary care utilization was not associated with adherence to screening recommendations for diabetes (P = .141) or hyperlipidemia (P = .103). Higher primary care utilization was not associated with control of hypertension (P = .107), diabetes (P = .871), or hyperlipidemia (P = .999). CONCLUSION: More research is needed to investigate barriers to screening and management of MetS conditions in this high-risk patient population in the primary care setting as well as to optimize post-transplant care coordination.

Obesity and metabolic syndrome affect the majority of the US population. Patients with obesity are at increased risk of developing type 2 diabetes (T2DM), obstructive sleep apnea (OSA), and metabolic dysfunction-associated steatotic liver disease (MASLD), each of which carry the risk of further complications if left untreated and lead to adverse outcomes. The rising prevalence of obesity and its comorbidities has led to increased mortality, decreased quality of life, and rising healthcare expenditures. This phenomenon has resulted in the intensive investigation of exciting therapies for obesity over the past decade, including more treatments that are still in the pipeline. In our present report, we aim to solidify the relationships among obesity, T2DM, OSA, and MASLD through a comprehensive review of current research. We also provide an overview of the surgical and pharmacologic treatment classes that target these relationships, namely bariatric surgery, the glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and glucagon receptor agonists.

Introduction: Metabolic syndrome (MetS) has been identified as a significant contributor to increased risk of cardiovascular diseases and numerous adverse health outcomes, placing a considerable financial burden on healthcare systems and societal well-being. With the elderly population experiencing a notable and ongoing rise in MetS prevalence, it becomes crucial to grasp its pathogenesis and explore avenues for mitigating its progression. By understanding and addressing factors that exacerbate MetS, we may potentially hinder the development of chronic diseases and curb the associated escalation in healthcare costs. Recent advancements in aging biomarkers, such as epigenetic clocks, offer promising insights into various health conditions. However, existing research has primarily adopted a cross-sectional approach. Therefore, this dissertation aims to illuminate the prospective association between epigenetic markers and metabolic dysfunction within cohorts comprising racially diverse older adults. Specifically, there are three key objectives of this dissertation: 1) assess the effect of changes in metabolic dysfunction over time on clock accelerations; 2) construct regression models to predict changes in MetS components from initial epigenetic clock accelerations. Additionally, we evaluate the predictive capability of these epigenetic clock accelerations for the onset of MetS. And 3) we investigate the association between baseline DNAm level at CpG sites and subsequent changes in MetS components. Following this, we construct predictive models for incident MetS using baseline DNAm levels at CpG sites through two distinct methods: an epigenome-wide association study approach and a candidate CpG site approach.Methods: To address the first study objective, we used data from 867 participants in the Health and Retirement Study (HRS) who were assessed for demographic characteristics and metabolic biomarkers measured at baseline in 2008. In 2016, using newly collected blood

BACKGROUND & AIMS: Metabolic syndrome (MS) is a growing epidemic and a risk factor for the development of hepatocellular carcinoma (HCC). This study investigated the long-term outcomes of liver resection (LR) for HCC in patients with MS. Rates, timing, patterns, and treatment of recurrences were investigated, and cancer-specific survivals were assessed. METHODS: Between 2001 and 2021, data from 24 clinical centers were collected. Overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival were analyzed as well as recurrence patterns and treatment. The analysis was conducted using a competing-risk framework. The trajectory of the risk of recurrence over time was applied to a competing risk analysis. For post-recurrence survival, death resulting from tumor progression was the primary endpoint, whereas deaths with recurrence relating to other causes were considered as competing events. RESULTS: In total, 813 patients were included in the study. Median OS was 81.4 months (range 28.1-157.0 months), and recurrence occurred in 48.3% of patients, with a median RFS of 39.8 months (range 15.7-174.7 months). Cause-specific hazard of recurrence showed a first peak 6 months (0.027), and a second peak 24 months (0.021) after surgery. The later the recurrence, the higher the chance of receiving curative intent approaches (p = 0.001). Size >5 cm, multiple tumors, microvascular invasion, and cirrhosis were independent predictors of recurrence showing a cause-specific hazard over time. RFS was associated with death for recurrence (hazard ratio: 0.985, 95% CI: 0.977-0.995; p = 0.002). CONCLUSIONS: Patients with MS undergoing LR for HCC have good long-term survival. Recurrence occurs in 48% of patients with a double-peak incidence and time-specific hazards depending on tumor-related factors and underlying disease. The timing of recurrence significantly impacts survival. Surveillance after resection should be adjusted over time depending on

Metabolic Syndrome (MetS) affects one in three adults in the US and is characterized by abdominal obesity, high blood pressure, high blood sugar, high triglycerides, and low HDL cholesterol, increasing the risk of cardiovascular diseases and diabetes. We explored differences in neighborhood conditions and psychosocial factors between men and women across low and high socioeconomic status (SES) groups, and how these differences contribute to the higher risk of MetS in low SES individuals. Our sample included 4,191 individuals aged 45-84 from diverse racial and ethnic backgrounds; 3,005 of them were classified as low or high SES for further analyses. We examined the association of MetS with SES for women and men separately using separate Cox proportional hazards models for each group. The mean age was 61 years, 49.2% were women, 43% were White, 9.4% had no health insurance, and 15.2% had less than a high school education. The overall incidence of MetS was 33% for both low and high SES individuals. After adjusting for confounders, low SES women had a 66% higher risk of developing MetS compared to high SES women (HR 1.66, 95% CI 1.38 to 2.00). Similarly, low SES men had a 66% higher risk of developing MetS compared to high SES men (HR 1.66, 95% CI 1.36 to 2.02). Contrary to expectations, adjusting for these variables did not attenuate the risk, and significant disparities were observed for both men and women across SES groups. More research is needed to understand the mechanisms linking low SES with MetS incidence to address these SES disparities.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) are implicated in the aetiology of non-communicable diseases. Our study aimed to evaluate associations between NAFLD and MetS with overall and cause-specific mortality. METHODS: We used dietary, lifestyle, anthropometric and metabolic biomarker data from a random subsample of 15,784 EPIC cohort participants. NAFLD was assessed using the fatty liver index (FLI) and MetS using the revised definition. Indices for metabolic dysfunction-associated fatty liver disease (MAFLD) were calculated. The individual associations of these indices with overall and cause-specific mortality were assessed using multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs). As a subobjective, risk associations with adaptations of new classifications of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic and alcohol-related liver disease (MetALD) were also assessed. RESULTS: Among the 15,784 sub-cohort participants, a total of 1997 deaths occurred (835 due to cancer, 520 to CVD, 642 to other causes) over a median 15.6 (IQR, 12.3-17.1) years of follow-up. Compared to an FLI < 30, FLI ≥ 60 was associated with increased risks of overall mortality (HR = 1.44, 95%CI = 1.27-1.63), and deaths from cancer (HR = 1.32, 95%CI = 1.09-1.60), CVD (HR = 2.06, 95% CI = 1.61-2.63) or other causes (HR = 1.21, 95%CI = 0.97-1.51). Mortality risk associations were also elevated for individuals with MAFLD compared to those without. Individuals with MetS were at increased risk of all mortality endpoints, except cancer-specific mortality. MASLD and MetALD were associated with higher risk of overall mortality. CONCLUSIONS: Our findings based on a prospective cohort suggest that individuals with hepatic steatosis or metabolic dysfunction have a higher overall and cause-specific mortality risk.

Scope: Higher intake of cruciferous and allium vegetables is associated with lower cardiometabolic risk. Little research has investigated the cardiometabolic effects of S-methyl cysteine sulfoxide (SMCSO), found abundant in these vegetables. This study hypothesizes that SMCSO will blunt development of metabolic syndrome features in mice fed high-fat feed. Methods and results: Fifty C57BL/6 male mice are randomly assigned to standard-chow, high-fat, or high-fat supplemented with low-SMCSO (43 mg kg−1 body weight [BW] day−1), medium-SMCSO (153 mg kg−1 BW day−1), or high-SMCSO (256 mg kg−1 BW day−1) for 12-weeks. High-fat with SMCSO did not prevent diet-induced obesity, glucose intolerance, or hypercholesterolemia. Mice fed high-fat with SMCSO has higher hepatic lipids than mice fed standard-chow or high-fat alone. Urinary SMCSO increases at 6- and 12-weeks in the low-SMCSO group, before reducing 46% and 28% in the medium- and high-SMCSO groups, respectively, at 12-weeks, suggesting possible tissue saturation. Interestingly, two SMCSO-fed groups consume significantly more feed, without significant weight gain. Due to limitations in measuring consumed feed, caution should be taken interpreting these results. Conclusion: SMCSO (43–256 mg kg−1 BW day−1) does not ameliorate metabolic syndrome features in high-fat fed mice. Substantial knowledge gaps remain. Further studies should administer SMCSO separately (i.e., gavage), with metabolic studies exploring tissue levels to better understand its physiological action.

OBJECTIVE: To evaluate the association between GGT/HDL-C ratio and resolution of MetS in adults after sleeve gastrectomy (SG). METHODS: We conducted a retrospective cohort study using secondary data from a Peruvian bariatric center. The study population consisted of adults aged 18 and above who underwent laparoscopic SG and were diagnosed with MetS prior to the surgery. The main outcome measured was MetS resolution 6 months post-surgery and the exposure variable was the GGT/HDL-C ratio. RESULTS: We analyzed 137 patients with a mean age of 38.9 ± 10.9 years; 64.2% were females. The median GGT/HDL-C ratio was 1.1 [0.7 - 1.5], and 83.9% of patients experienced resolution of MetS. Furthermore, both the middle tertile of GGT/HDL-C (aRR: 1.28; 95% CI: 1.04 - 1.58; p = .019) and the lowest tertile (aRR: 1.27; 95% CI: 1.01 - 1.60; p = .038) showed a significant association with the resolution of MetS. CONCLUSION: Eight out of 10 patients undergoing SG experience resolution of MetS within 6 months after surgery. Patients in the middle and lower tertiles of the GGT/HDL-C were more likely to achieve this outcome. Therefore, the GGT/HDL-C ratio should be considered a valuable and efficient biomarker for preoperative assessment of bariatric surgery candidates.

The valorisation of bioactive compounds from seaweeds is of interest due to their abundance and diverse range of bioactive compounds, which are crucial for the development of novel nutraceutical products. Recently, a unique composition of seaweed extracts, consisting of a blend of brown seaweeds Ascophyllum nodosum and Fucus vesiculosus), has emerged as a potential therapeutic solution for immunological and metabolic abnormalities. This thesis sought to investigate the clinical efficacy and safety of these extracts and to determine the optimal dosage for the management of metabolic syndrome components and inflammation. This thesis is divided over five chapters; in Chapter 1, I presented a general introduction to seaweeds, in particular brown seaweeds and their main metabolites, as they are known to contain more bioactive components compared to red and green seaweeds. In Chapter 2, I presented the first comprehensive review of two extensively studied brown seaweed extracts, Ascophyllum nodosum and Fucus vesiculosus, with respect to their efficacy in managing and preventing metabolic syndrome and its associated comorbidities. The findings shed light on the promising potential of these extracts in managing metabolic syndrome and its related disorders. To address the heterogeneity observed in previous study results, I conducted dietary intervention studies to determine the potential benefits of these extracts in the context of metabolic health among a non-habitual seaweed consuming UK population. In Chapter 3, I presented the results of a preliminary pilot study aimed at evaluating the impact of seaweed extracts on fasting blood glucose, insulin, insulin resistance (HOMA-IR), blood lipids, gastrointestinal symptoms, and to assess product tolerability in terms of side effects in overweight and obese adults. The results showed a trend towards a reduction in plasma glucose and low-density lipoprotein cholesterol and an increase in high-density lipoprotein cholesterol after

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) are implicated in the aetiology of non-communicable diseases. Our study aimed to evaluate associations between NAFLD and MetS with overall and cause-specific mortality. METHODS: We used dietary, lifestyle, anthropometric and metabolic biomarker data from a random subsample of 15,784 EPIC cohort participants. NAFLD was assessed using the fatty liver index (FLI) and MetS using the revised definition. Indices for metabolic dysfunction-associated fatty liver disease (MAFLD) were calculated. The individual associations of these indices with overall and cause-specific mortality were assessed using multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs). As a subobjective, risk associations with adaptations of new classifications of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic and alcohol-related liver disease (MetALD) were also assessed. RESULTS: Among the 15,784 sub-cohort participants, a total of 1997 deaths occurred (835 due to cancer, 520 to CVD, 642 to other causes) over a median 15.6 (IQR, 12.3-17.1) years of follow-up. Compared to an FLI < 30, FLI ≥ 60 was associated with increased risks of overall mortality (HR = 1.44, 95%CI = 1.27-1.63), and deaths from cancer (HR = 1.32, 95%CI = 1.09-1.60), CVD (HR = 2.06, 95% CI = 1.61-2.63) or other causes (HR = 1.21, 95%CI = 0.97-1.51). Mortality risk associations were also elevated for individuals with MAFLD compared to those without. Individuals with MetS were at increased risk of all mortality endpoints, except cancer-specific mortality. MASLD and MetALD were associated with higher risk of overall mortality. CONCLUSIONS: Our findings based on a prospective cohort suggest that individuals with hepatic steatosis or metabolic dysfunction have a higher overall and cause-specific mortality risk.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) are implicated in the aetiology of non-communicable diseases. Our study aimed to evaluate associations between NAFLD and MetS with overall and cause-specific mortality. METHODS: We used dietary, lifestyle, anthropometric and metabolic biomarker data from a random subsample of 15,784 EPIC cohort participants. NAFLD was assessed using the fatty liver index (FLI) and MetS using the revised definition. Indices for metabolic dysfunction-associated fatty liver disease (MAFLD) were calculated. The individual associations of these indices with overall and cause-specific mortality were assessed using multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs). As a subobjective, risk associations with adaptations of new classifications of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic and alcohol-related liver disease (MetALD) were also assessed. RESULTS: Among the 15,784 sub-cohort participants, a total of 1997 deaths occurred (835 due to cancer, 520 to CVD, 642 to other causes) over a median 15.6 (IQR, 12.3-17.1) years of follow-up. Compared to an FLI < 30, FLI ≥ 60 was associated with increased risks of overall mortality (HR = 1.44, 95%CI = 1.27-1.63), and deaths from cancer (HR = 1.32, 95%CI = 1.09-1.60), CVD (HR = 2.06, 95% CI = 1.61-2.63) or other causes (HR = 1.21, 95%CI = 0.97-1.51). Mortality risk associations were also elevated for individuals with MAFLD compared to those without. Individuals with MetS were at increased risk of all mortality endpoints, except cancer-specific mortality. MASLD and MetALD were associated with higher risk of overall mortality. CONCLUSIONS: Our findings based on a prospective cohort suggest that individuals with hepatic steatosis or metabolic dysfunction have a higher overall and cause-specific mortality risk.

Background: Associations between metabolic status and metabolic changes with the risk of cardiovascular outcomes have been reported. However, the role of genetic susceptibility underlying these associations remains unexplored. We aimed to examine how metabolic status, metabolic transitions, and genetic susceptibility collectively impact cardiovascular outcomes and all-cause mortality across diverse body mass index (BMI) categories. Methods: In our analysis of the UK Biobank, we included a total of 481,576 participants (mean age: 56.55; male: 45.9%) at baseline. Metabolically healthy (MH) status was defined by the presence of < 3 abnormal components (waist circumstance, blood pressure, blood glucose, triglycerides, and high-density lipoprotein cholesterol). Normal weight, overweight, and obesity were defined as 18.5 ≤ BMI < 25 kg/m2, 25 ≤ BMI < 30 kg/m2, and BMI ≥ 30 kg/m2, respectively. Genetic predisposition was estimated using the polygenic risk score (PRS). Cox regressions were performed to evaluate the associations of metabolic status, metabolic transitions, and PRS with cardiovascular outcomes and all-cause mortality across BMI categories. Results: During a median follow-up of 14.38 years, 31,883 (7.3%) all-cause deaths, 8133 (1.8%) cardiovascular disease (CVD) deaths, and 67,260 (14.8%) CVD cases were documented. Among those with a high PRS, individuals classified as metabolically healthy overweight had the lowest risk of all-cause mortality (hazard ratios [HR] 0.70; 95% confidence interval [CI] 0.65, 0.76) and CVD mortality (HR 0.57; 95% CI 0.50, 0.64) compared to those who were metabolically unhealthy obesity, with the beneficial associations appearing to be greater in the moderate and low PRS groups. Individuals who were metabolically healthy normal weight had the lowest risk of CVD morbidity (HR 0.54; 95% CI 0.51, 0.57). Furthermore, the inverse associations of metabolic status and PRS with cardiovascular outcomes and all-cause mortality across BMI categor

Introduction: Metabolic syndrome (MS), which includes abdominal obesity, hyperglycemia, hypertension, and dyslipidemias, is a significant public health issue, negatively impacting quality of life through its components and associated comorbidities. Methodology: A cross-sectional and observational study in adults over 34 years old attending the Rheumatology service at a health center in Azogues, Ecuador. The study involved a sample of 161, with clinical, anthropometric, and paraclinical data collection. Quality of life (COOP/WONCA) and MS were evaluated according to ALAD (Latin American Diabetes Association) criteria, using statistical analysis with SPSS software. Results: The study found a 48.2% prevalence of MS, predominantly in women and those over 70 years old, mainly urban residents with primary education. Quality of life showed declines in physical form and general health status in patients with MS. There was a significant relationship between hypertension and worse quality of life in terms of general activities. Conclusions: This study reveals a significant prevalence of MS, notably affecting the physical dimension of the patients' quality of life., Introducción: El síndrome metabólico (SM), que incluye obesidad abdominal, hiperglucemia, hipertensión y dislipidemias, es un problema significativo para la salud pública, impactando negativamente en la calidad de vida (CV) a través de sus componentes y las comorbilidades asociadas. Metodología: Estudio transversal y observacional en adultos mayores de 34 años atendidos en el servicio de Reumatología un centro de salud en Azogues, Ecuador. Se contó con una muestra de 161 pacientes, con recolección de datos clínicos, antropométricos y paraclínicos. Se evaluó la CV (COOP/WONCA) y SM según criterios ALAD (Asociación Latinoamericana de Diabetes), usando análisis estadísticos con el programa SPSS. Resultados: El estudio encontró un 48,2% de prevalencia de SM, predominante en mujeres y mayores de 70 años, mayoritariamente urbanos y con educación primaria. La CV mostró disminuciones en la forma física y el estado general de salud en pacientes con SM. Hubo una relación significativa entre hipertensión y mala CV a nivel de las actividades generales. Conclusiones: este estudio revela una prevalencia significativa del SM, afectando notablemente la CV en la dimensión física de los pacientes.

OBJECTIVE: Most mental disorders, when examined individually, are associated with an increased risk of cardiometabolic complications. However, these associations might be attributed to a general liability to psychopathology or confounded by unmeasured familial factors. The authors investigated the association between psychiatric conditions in young adulthood and the risk of cardiometabolic complications in middle adulthood, up to 40 years later. METHODS: This cohort study (N=672,823) identified all individuals and their siblings born in Sweden between 1955 and 1962 and followed the cohort through 2013. Logistic regression models were used to estimate the bivariate associations between 10 psychiatric conditions or criminal convictions and five cardiometabolic complications in individuals. A general factor model was used to identify general, internalizing, externalizing, and psychotic factors based on the comorbidity among psychiatric conditions and criminal convictions. The cardiometabolic complications were then regressed on the latent general factor and three uncorrelated specific factors within a structural equation modeling framework in individuals and across sibling pairs. RESULTS: Each psychiatric condition significantly increased the risk of cardiometabolic complications. These associations appeared nonspecific, as multivariate models indicated that most were attributable to the general factor of psychopathology, rather than to specific psychiatric conditions. There were no or only small associations between individuals' general psychopathology and their siblings' cardiometabolic complications. The same pattern was evident for the specific internalizing and psychotic factors. CONCLUSIONS: Associations between mental disorders in early life and later long-term risk of cardiometabolic complications appeared to be attributable to a general liability to psychopathology. Familial coaggregation analyses suggested that the elevated risk could not be attributed to con, Supported by the Swedish Research Council for Health (grant 2017-01358) , ALF Funding from the Stockholm Region (grant 20190712), and the China Scholarship Council.

Background: Handgrip strength (HGS) is a surrogate marker of whole body strength that has been observed to correlate inversely with the metabolic syndrome (MetS). In this study, we examined whether HGS in young, healthy individuals, was associated with surrogate endpoints of the MetS. A secondary goal was to examine whether absolute HGS (absHGS) or relative HGS (relHGS) was a stronger predictor of MetS. Method: 834 subjects (577 women), aged 18–26, were recruited. Surrogate endpoints for MetS were waist circumference, HDL, fasting glucose, fasting insulin, triglycerides, and systolic and diastolic blood pressure (BP). We also examined the association between HGS and body fat percentage, HOMA-IR, CRP, orosomucoid and apolipoprotein A-1 and apolipoprotein B. The associations were examined using multivariable linear regression. Results: AbsHGS and relHGS were each associated with several surrogate endpoints of the metabolic syndrome, with RelHGS being statistically significantly associated with a greater number of the variables – all except fasting glucose and diastolic BP. Conclusion: RelHGS correlates with components of the MetS even in young, healthy populations. It is a better predictor of MetS components than absHGS. As a cheap and easy to use biomarker, relHGS holds merit as a screening tool for metabolic dysfunction even in preclinical contexts.

Introduction: The use of medicinal plants in the treatment of non-communicable chronic diseases such as type 2 diabetes mellitus, arterial hypertension, and dyslipidemia has been increasing. According to the World Health Organization, 80 % of people have used medicinal plants at some point in their lives. Despite the rich biodiversity of medicinal plants in Colombia, only a small percentage has been approved for medical use, and a lack of understanding of the complexity of these plants can lead to irrational use, toxicity, adverse effects, or pharmacological interactions. Objective: To describe the knowledge and popular wisdom that medicinal plant vendors have and use regarding medicinal plants to treat metabolic syndrome and its associated pathologies. Methods: This is a cross-sectional study using a semi-structured survey applied to merchants and distributors of medicinal plants from the three main marketplaces in Cali, Colombia. Taxonomic identification was conducted on the most cited plant species, which were not reported in the Colombian Vademecum of Medicinal Plants –VCPM–. Additionally, information available in the VCPM was compared with scientific literature extracted from various sources such as ScienceDirect, PubMed, and Google Scholar. Results: The most recommended plants by medicinal plant vendors for treating pathologies associated with metabolic syndrome are walnut, insulin, chaparro rojo, papunga, chicharrón de loma, moringa, mastranto, cáscara de mandarina, dandelion, nettle, zarzaparrilla, cofrei y artichoke. The interviewees demonstrated little knowledge of contraindications and adverse effects, and some of the plants are not listed and/or described in the VCPM. Conclusion: This study highlights the importance of knowledge and use of medicinal plants in the treatment of non-communicable chronic diseases associated with metabolic syndrome. Medicinal plant vendors in Cali, Colombia, offer a wide range of options to address these pathologies, although, Introducción: El uso de plantas medicinales en el tratamiento de enfermedades crónicas no transmisibles como la diabetes mellitus tipo 2, la hipertensión arterial y la dislipidemia ha venido en aumento. Según cifras de la Organización Mundial de la Salud, el 80 % de las personas ha utilizado en algún momento de su vida plantas medicinales. A pesar de la rica biodiversidad de plantas medicinales en Colombia, solo un pequeño porcentaje ha sido aprobado para uso médico y la falta de comprensión sobre la complejidad de estas plantas puede conllevar un uso irracional, toxicidad, efectos adversos o interacciones farmacológicas. Objetivo: Describir los conocimientos y saberes populares que los vendedores de plantas medicinales tienen y utilizan con respecto a las plantas medicinales para tratar el síndrome metabólico y sus patologías asociadas. Métodos: Estudio de corte transversal mediante la aplicación de una encuesta semiestructurada a comerciantes y distribuidores de plantas medicinales de las tres principales plazas de mercado de Cali, Colombia. Se realizó una identificación taxonómica de las especies vegetales más citadas, las cuales no estaban reportadas en el Vademécum colombiano de plantas medicinales –VCPM–. Además, se comparó la información disponible en el VCPM con la literatura científica extraída de diversas fuentes como ScienceDirect, PubMed y Google Scholar. Resultados: Las plantas más recomendadas por los vendedores de plantas medicinales para tratar las patologías asociadas al síndrome metabólico son el nogal, insulina, chaparro rojo, papunga, chicharrón de loma, moringa, mastranto, cáscara de mandarina, diente de león, ortiga, zarzaparrilla, cofrei y alcachofa. Los entrevistados demostraron poco conocimiento de contraindicaciones y los efectos adversos y algunas de las plantas no se encuentran listadas y/o descritas en el VCPM. Conclusión: Este estudio destaca la importancia del conocimiento y uso de plantas medicinales en el tratamiento de enfermedades

Obesity and metabolic syndrome (MetS) share common pathophysiological characteristics with aging. To better understand their interplay, we examined how body mass index (BMI) and MetS jointly associate with physiological age, and if the associations changed from midlife to late-life. We used longitudinal data from 1,825 Swedish twins. Physiological age was measured as frailty index (FI) and functional aging index (FAI) and modeled independently in linear mixed-effects models adjusted for chronological age, sex, education, and smoking. We assessed curvilinear associations of BMI and chronological age with physiological age, and interactions between BMI, MetS, and chronological age. We found a significant three-way interaction between BMI, MetS, and chronological age on FI (p-interaction = 0·006), not FAI. Consequently, we stratified FI analyses by age: < 65, 65–85, and ≥ 85 years, and modeled FAI across ages. Except for FI at ages ≥ 85, BMI had U-shaped associations with FI and FAI, where BMI around 26-28 kg/m2 was associated with the lowest physiological age. MetS was associated with higher FI and FAI, except for FI at ages < 65, and modified the BMI-FI association at ages 65–85 (p-interaction = 0·02), whereby the association between higher BMI levels and FI was stronger in individuals with MetS. Age modified the MetS-FI association in ages ≥ 85, such that it was stronger at higher ages (p-interaction = 0·01). Low BMI, high BMI, and metabolic syndrome were associated with higher physiological age, contributing to overall health status among older individuals and potentially accelerating aging., CC BY 4.0 DEED© 2023, The Author(s)Published: 16 December 2023Correspondence Address: P. Ler; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Nobels väg 12A, Solna, 171 65, Sweden; email: peggy.ler@ki.seOpen access funding provided by Karolinska Institute. This work was supported by the Swedish Research Council for Health, Working Life and Welfare (Forte; 2022-00672); the Strategic Research Program in Epidemiology (SFOepi) at Karolinska Institutet, Karolinska Institutet’s Research Foundation (2022-01718); Loo and Hans Osterman’s Foundation (2022-01222, 2023-01855); the Foundation for Geriatric Diseases at Karolinska Institutet (2022-01296); the National Institutes of Health (NIH; R01 AG060470, AG059329), and the Swedish Research Council (Vetenskaprådet; 2016–03081). SATSA was supported by the NIH (grants AG04563 and AG10175), the MacArthur Foundation Research Network on Successful Aging, the Swedish Research Council for Working Life and Social Research (97:0147:1B, 2009-0795), and the Swedish Research Council (825-2007-7460 and 825-2009-6141). OCTO-Twin was supported by the NIH (R01AG08861). GENDER was supported by the MacArthur Foundation Research Network on Successful Aging, The Axel and Margaret Ax:son Johnson’s Foundation, The Swedish Council for Social Research, and the Swedish Foundation for Health Care Sciences and Allergy Research. The funders had no role in the study design, data collection, data analysis, interpretation, or writing of the manuscript.

Obesity and metabolic syndrome (MetS) share common pathophysiological characteristics with aging. To better understand their interplay, we examined how body mass index (BMI) and MetS jointly associate with physiological age, and if the associations changed from midlife to late-life. We used longitudinal data from 1,825 Swedish twins. Physiological age was measured as frailty index (FI) and functional aging index (FAI) and modeled independently in linear mixed-effects models adjusted for chronological age, sex, education, and smoking. We assessed curvilinear associations of BMI and chronological age with physiological age, and interactions between BMI, MetS, and chronological age. We found a significant three-way interaction between BMI, MetS, and chronological age on FI (p-interaction = 0·006), not FAI. Consequently, we stratified FI analyses by age: < 65, 65–85, and ≥ 85 years, and modeled FAI across ages. Except for FI at ages ≥ 85, BMI had U-shaped associations with FI and FAI, where BMI around 26-28 kg/m2 was associated with the lowest physiological age. MetS was associated with higher FI and FAI, except for FI at ages < 65, and modified the BMI-FI association at ages 65–85 (p-interaction = 0·02), whereby the association between higher BMI levels and FI was stronger in individuals with MetS. Age modified the MetS-FI association in ages ≥ 85, such that it was stronger at higher ages (p-interaction = 0·01). Low BMI, high BMI, and metabolic syndrome were associated with higher physiological age, contributing to overall health status among older individuals and potentially accelerating aging., CC BY 4.0 DEED© 2023, The Author(s)Published: 16 December 2023Correspondence Address: P. Ler; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Nobels väg 12A, Solna, 171 65, Sweden; email: peggy.ler@ki.seOpen access funding provided by Karolinska Institute. This work was supported by the Swedish Research Council for Health, Working Life and Welfare (Forte; 2022-00672); the Strategic Research Program in Epidemiology (SFOepi) at Karolinska Institutet, Karolinska Institutet’s Research Foundation (2022-01718); Loo and Hans Osterman’s Foundation (2022-01222, 2023-01855); the Foundation for Geriatric Diseases at Karolinska Institutet (2022-01296); the National Institutes of Health (NIH; R01 AG060470, AG059329), and the Swedish Research Council (Vetenskaprådet; 2016–03081). SATSA was supported by the NIH (grants AG04563 and AG10175), the MacArthur Foundation Research Network on Successful Aging, the Swedish Research Council for Working Life and Social Research (97:0147:1B, 2009-0795), and the Swedish Research Council (825-2007-7460 and 825-2009-6141). OCTO-Twin was supported by the NIH (R01AG08861). GENDER was supported by the MacArthur Foundation Research Network on Successful Aging, The Axel and Margaret Ax:son Johnson’s Foundation, The Swedish Council for Social Research, and the Swedish Foundation for Health Care Sciences and Allergy Research. The funders had no role in the study design, data collection, data analysis, interpretation, or writing of the manuscript.

Obesity and metabolic syndrome (MetS) share common pathophysiological characteristics with aging. To better understand their interplay, we examined how body mass index (BMI) and MetS jointly associate with physiological age, and if the associations changed from midlife to late-life. We used longitudinal data from 1,825 Swedish twins. Physiological age was measured as frailty index (FI) and functional aging index (FAI) and modeled independently in linear mixed-effects models adjusted for chronological age, sex, education, and smoking. We assessed curvilinear associations of BMI and chronological age with physiological age, and interactions between BMI, MetS, and chronological age. We found a significant three-way interaction between BMI, MetS, and chronological age on FI (p-interaction = 0·006), not FAI. Consequently, we stratified FI analyses by age: < 65, 65–85, and ≥ 85 years, and modeled FAI across ages. Except for FI at ages ≥ 85, BMI had U-shaped associations with FI and FAI, where BMI around 26-28 kg/m2 was associated with the lowest physiological age. MetS was associated with higher FI and FAI, except for FI at ages < 65, and modified the BMI-FI association at ages 65–85 (p-interaction = 0·02), whereby the association between higher BMI levels and FI was stronger in individuals with MetS. Age modified the MetS-FI association in ages ≥ 85, such that it was stronger at higher ages (p-interaction = 0·01). Low BMI, high BMI, and metabolic syndrome were associated with higher physiological age, contributing to overall health status among older individuals and potentially accelerating aging., CC BY 4.0 DEED© 2023, The Author(s)Published: 16 December 2023Correspondence Address: P. Ler; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Nobels väg 12A, Solna, 171 65, Sweden; email: peggy.ler@ki.seOpen access funding provided by Karolinska Institute. This work was supported by the Swedish Research Council for Health, Working Life and Welfare (Forte; 2022-00672); the Strategic Research Program in Epidemiology (SFOepi) at Karolinska Institutet, Karolinska Institutet’s Research Foundation (2022-01718); Loo and Hans Osterman’s Foundation (2022-01222, 2023-01855); the Foundation for Geriatric Diseases at Karolinska Institutet (2022-01296); the National Institutes of Health (NIH; R01 AG060470, AG059329), and the Swedish Research Council (Vetenskaprådet; 2016–03081). SATSA was supported by the NIH (grants AG04563 and AG10175), the MacArthur Foundation Research Network on Successful Aging, the Swedish Research Council for Working Life and Social Research (97:0147:1B, 2009-0795), and the Swedish Research Council (825-2007-7460 and 825-2009-6141). OCTO-Twin was supported by the NIH (R01AG08861). GENDER was supported by the MacArthur Foundation Research Network on Successful Aging, The Axel and Margaret Ax:son Johnson’s Foundation, The Swedish Council for Social Research, and the Swedish Foundation for Health Care Sciences and Allergy Research. The funders had no role in the study design, data collection, data analysis, interpretation, or writing of the manuscript.

BACKGROUND: Handgrip strength (HGS) is a surrogate marker of whole body strength that has been observed correlate inversely with the metabolic syndrome (MetS). In this study, we examined whether HGS in young, healthy individuals, was associated with surrogate endpoints of the MetS. A secondary goal was to examine whether absolute HGS (absHGS) or relative HGS (relHGS) was a stronger predictor of MetS. METHOD: 834 subjects (577 women), aged 18-26, were recruited. Surrogate endpoints for MetS were waist circumference, HDL, fasting glucose, fasting insulin, triglycerides, and systolic and diastolic blood pressure (BP). We also examined the association between HGS and body fat percentage, HOMA-IR, CRP, orosomucoid and apolipoprotein A-1 and apolipoprotein B. The associations were examined using linear regression. RESULTS: AbsHGS and relHGS were each associated with several surrogate endpoints of the metabolic syndrome, with RelHGS being statistically significantly associated with a greater number of the variables - all except fasting glucose and diastolic BP. CONCLUSION: RelHGS correlates with components of the MetS even in young, healthy populations. It is a better predictor of MetS components than absHGS. As a cheap and easy to use biomarker, relHGS holds merit as a screening tool for metabolic dysfunction even in preclinical contexts.

Background: Handgrip strength (HGS) is a surrogate marker of whole body strength that has been observed to correlate inversely with the metabolic syndrome (MetS). In this study, we examined whether HGS in young, healthy individuals, was associated with surrogate endpoints of the MetS. A secondary goal was to examine whether absolute HGS (absHGS) or relative HGS (relHGS) was a stronger predictor of MetS. Method: 834 subjects (577 women), aged 18–26, were recruited. Surrogate endpoints for MetS were waist circumference, HDL, fasting glucose, fasting insulin, triglycerides, and systolic and diastolic blood pressure (BP). We also examined the association between HGS and body fat percentage, HOMA-IR, CRP, orosomucoid and apolipoprotein A-1 and apolipoprotein B. The associations were examined using multivariable linear regression. Results: AbsHGS and relHGS were each associated with several surrogate endpoints of the metabolic syndrome, with RelHGS being statistically significantly associated with a greater number of the variables – all except fasting glucose and diastolic BP. Conclusion: RelHGS correlates with components of the MetS even in young, healthy populations. It is a better predictor of MetS components than absHGS. As a cheap and easy to use biomarker, relHGS holds merit as a screening tool for metabolic dysfunction even in preclinical contexts.

IntroductionOveractive bladder (OAB) and Underactive bladder (UAB) could be associated with metabolic syndrome, affective disorders, sex hormone deficiency, changes in urinary microbiota, functional gastrointestinal disorders, or autonomic nervous system dysfunction.ObjectivesThe aim of this Think Tank was to provide a guide on how to investigate OAB and/or detrusor underactivity (DU) patients to better clarify the underlying pathophysiology and possibly personalize the treatment.MethodsA compendium of discussion based on the current evidence related to phenotyping patients with OAB or DU investigating metabolic, neurogical, psychological and gastrointestinal aspects with the aim to personalize the treatment.Results and ConclusionsThe article emphasizes the critical significance of adopting a comprehensive yet tailored approach to phenotyping patients with lower urinary tract symptoms, such as OAB and UAB. The intricate interplay between the lower urinary tract and various factors, metabolic, neurological, psychological, and gastrointestinal can define unique LUT profiles, enabling personalized therapies to replace the one-size-fits-all approach.

Background: Despite numerous risk factors and serious consequences, little is known about metabolic dysfunction-associated steatotic liver disease (MASLD) at population level in Africa. Aim: The aim of the study was to estimate the prevalence and risk factors of MASLD in people living with and without HIV in Uganda. Methods: We collected data from 37 communities in South Central Uganda between May 2016 and May 2018. We estimated MASLD prevalence using the fatty liver index and advanced liver fibrosis using the dynamic aspartate-to-alanine aminotransferase ratio. We collected additional data on sociodemographics, HIV and cardiovascular disease (CVD) risk factors. We used multivariable logistic regression to determine the association between HIV, CVD risk factors and MASLD. Results: We included 759 people with HIV and 704 HIV-negative participants aged 35–49. MASLD prevalence was 14% in women and 8% in men; advanced liver fibrosis prevalence was estimated to be <1%. MASLD prevalence was more common in women (15% vs. 13%) and men (9% vs. 6%) with HIV. Being female (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.4–3.3) was associated with a higher odds of MASLD after adjustment for confounders; HIV infection was borderline associated with MASLD (OR = 1.4; 95% CI: 1.0–2.0). Conclusions: In a relatively young cohort in Uganda, 14% of women and 8% of men had MASLD. There was an indication of an association between HIV and MASLD in multivariable analysis. These data are the first to describe the population-level burden of MASLD in sub-Saharan Africa using data from a population-based cohort.

Obesity and metabolic syndrome (MetS) share common pathophysiological characteristics with aging. To better understand their interplay, we examined how body mass index (BMI) and MetS jointly associate with physiological age, and if the associations changed from midlife to late-life. We used longitudinal data from 1,825 Swedish twins. Physiological age was measured as frailty index (FI) and functional aging index (FAI) and modeled independently in linear mixed-effects models adjusted for chronological age, sex, education, and smoking. We assessed curvilinear associations of BMI and chronological age with physiological age, and interactions between BMI, MetS, and chronological age. We found a significant three-way interaction between BMI, MetS, and chronological age on FI (p-interaction = 0006), not FAI. Consequently, we stratified FI analyses by age: < 65, 65-85, and >= 85 years, and modeled FAI across ages. Except for FI at ages >= 85, BMI had U-shaped associations with FI and FAI, where BMI around 26-28 kg/m(2) was associated with the lowest physiological age. MetS was associated with higher FI and FAI, except for FI at ages < 65, and modified the BMI-FI association at ages 65-85 (p-interaction = 002), whereby the association between higher BMI levels and FI was stronger in individuals with MetS. Age modified the MetS-FI association in ages >= 85, such that it was stronger at higher ages (p-interaction = 001). Low BMI, high BMI, and metabolic syndrome were associated with higher physiological age, contributing to overall health status among older individuals and potentially accelerating aging.

Background: Handgrip strength (HGS) is a surrogate marker of whole body strength that has been observed to correlate inversely with the metabolic syndrome (MetS). In this study, we examined whether HGS in young, healthy individuals, was associated with surrogate endpoints of the MetS. A secondary goal was to examine whether absolute HGS (absHGS) or relative HGS (relHGS) was a stronger predictor of MetS. Method: 834 subjects (577 women), aged 18–26, were recruited. Surrogate endpoints for MetS were waist circumference, HDL, fasting glucose, fasting insulin, triglycerides, and systolic and diastolic blood pressure (BP). We also examined the association between HGS and body fat percentage, HOMA-IR, CRP, orosomucoid and apolipoprotein A-1 and apolipoprotein B. The associations were examined using multivariable linear regression. Results: AbsHGS and relHGS were each associated with several surrogate endpoints of the metabolic syndrome, with RelHGS being statistically significantly associated with a greater number of the variables – all except fasting glucose and diastolic BP. Conclusion: RelHGS correlates with components of the MetS even in young, healthy populations. It is a better predictor of MetS components than absHGS. As a cheap and easy to use biomarker, relHGS holds merit as a screening tool for metabolic dysfunction even in preclinical contexts.

Cardiovascular diseases (CVDs) are the major causes of mortality and morbidity worldwideas well as in the Indian subcontinent, causing more than 25% of deaths. It has been predictedthat these diseases will increase rapidly in India, making it a host to more than half thecases of heart disease in the world within the next 15 years. The World Health Organization(WHO) reports that in the year 2005 CVDs caused 17.5 million (30%) of the 58 million deathsthat occurred worldwide. In the recent times, the association of metabolic syndrome (MS)is strongly linked with CVDs. MS is defined as a constellation of metabolic disorders in anindividual. The main components of MS are dyslipidemia (higher triglyceride, low-densitylipoproteins [LDL] and low high-density lipoproteins [HDL]), elevated blood pressure (BP),dysregulated glucose homeostasis, abdominal obesity and insulin resistance. Being one of themost widespread diseases in the world, almost half of the population of specific age groupsin developed countries is affected by it. Studies have shown that the independent risk factorsassociated with MS increase the likelihood of CVDs. It has been postulated that excess intakeof fructose promotes cell dysfunction, inflammation, intra-abdominal (visceral) adiposity,atherogenic dyslipidemia, weight gain, insulin resistance, hypertension thereby aggravatingthe chances for developing MS, type 2 diabetes and coronary heart disease

Cardiovascular diseases (CVDs) are the major causes of mortality and morbidity worldwideas well as in the Indian subcontinent, causing more than 25% of deaths. It has been predictedthat these diseases will increase rapidly in India, making it a host to more than half thecases of heart disease in the world within the next 15 years. The World Health Organization(WHO) reports that in the year 2005 CVDs caused 17.5 million (30%) of the 58 million deathsthat occurred worldwide. In the recent times, the association of metabolic syndrome (MS)is strongly linked with CVDs. MS is defined as a constellation of metabolic disorders in anindividual. The main components of MS are dyslipidemia (higher triglyceride, low-densitylipoproteins [LDL] and low high-density lipoproteins [HDL]), elevated blood pressure (BP),dysregulated glucose homeostasis, abdominal obesity and insulin resistance. Being one of themost widespread diseases in the world, almost half of the population of specific age groupsin developed countries is affected by it. Studies have shown that the independent risk factorsassociated with MS increase the likelihood of CVDs. It has been postulated that excess intakeof fructose promotes cell dysfunction, inflammation, intra-abdominal (visceral) adiposity,atherogenic dyslipidemia, weight gain, insulin resistance, hypertension thereby aggravatingthe chances for developing MS, type 2 diabetes and coronary heart disease

Cardiovascular diseases (CVDs) are the major causes of mortality and morbidity worldwideas well as in the Indian subcontinent, causing more than 25% of deaths. It has been predictedthat these diseases will increase rapidly in India, making it a host to more than half thecases of heart disease in the world within the next 15 years. The World Health Organization(WHO) reports that in the year 2005 CVDs caused 17.5 million (30%) of the 58 million deathsthat occurred worldwide. In the recent times, the association of metabolic syndrome (MS)is strongly linked with CVDs. MS is defined as a constellation of metabolic disorders in anindividual. The main components of MS are dyslipidemia (higher triglyceride, low-densitylipoproteins [LDL] and low high-density lipoproteins [HDL]), elevated blood pressure (BP),dysregulated glucose homeostasis, abdominal obesity and insulin resistance. Being one of themost widespread diseases in the world, almost half of the population of specific age groupsin developed countries is affected by it. Studies have shown that the independent risk factorsassociated with MS increase the likelihood of CVDs. It has been postulated that excess intakeof fructose promotes cell dysfunction, inflammation, intra-abdominal (visceral) adiposity,atherogenic dyslipidemia, weight gain, insulin resistance, hypertension thereby aggravatingthe chances for developing MS, type 2 diabetes and coronary heart disease

Material and Method: Cross-sectional, analytical study. 154 records of pregnant women in the first trimester, from January-February 2023. Obtaining sociodemographic and clinical variables. Descriptive statistics with the statistical program CIETmap SE, achieving simple frequencies, percentages, measures of central tendency and dispersion. Bivariate analysis for OR and 95%CI, the variables with the greatest association, were included in a multivariate model for adjusted OR and 95%CI. Results: The prevalence of metabolic syndrome according to the ATPIII criteria was 9.1% and according to the WHO criteria it was 5.8%, waist circumference prevailed with 27.27% and central obesity with 31.42%. The risk factors strongly associated in the multivariate analysis were complications in previous pregnancies (ORa 9.25, CI95% 2.25-38.06), obesity (ORa 5.70, CI95% 2.12-15.37), advanced maternal age (ORa 3.59, CI95% 1.33- 9.72). Conclusion: There is a prevalence of metabolic syndrome during pregnancy, which is underdiagnosed. Nine out of every hundred pregnant women present metabolic syndrome according to the ATPIII and six out of every hundred according to the WHO, the diagnostic criterion and factor with the greatest association was obesity., Objetivo: Determinar la prevalencia de síndrome metabólico y factores de riesgo asociados en embarazadas de la Unidad de Medicina Familiar No.9 de Acapulco, Guerrero. Material y método: Estudio transversal, analítico. 154 expedientes de embarazadas del primer trimestre, de enero-febrero 2023. Obteniendo variables sociodemográficas y clínicas. Estadística descriptiva con el programa estadístico CIETmap SE, logrando frecuencias simples, porcentajes, medidas de tendencia central y de dispersión. Análisis bivariado para OR e IC95%, las variables con mayor asociación, se incluyeron en un modelo multivariado para OR ajustados e IC95%. Resultados: La prevalencia del síndrome metabólico según los criterios de la ATPIII fue 9.1% y según los criterios de la OMS fue 5.8%, prevaleció la circunferencia de cintura con 27.27% y la obesidad central con 31.42%. Los factores de riesgo fuertemente asociados en el análisis multivariado fueron complicaciones en embarazos previos (ORa 9.25, IC95% 2.25-38.06), obesidad (ORa 5.70, IC95% 2.12-15.37), la edad materna avanzada (ORa 3.59, IC95% 1.33-9.72). Conclusión: Existe prevalencia del síndrome metabólico durante el embarazo, la cual es subdiagnosticada. Nueve de cada cien embarazadas presenta síndrome metabólico según la ATPIII y seis de cada cien según la OMS, el criterio diagnóstico y factor de mayor asociación fue la obesidad.

BACKGROUND: BIPCOM aims to (1) identify medical comorbidities in people with bipolar disorder (BD); (2) examine risk factors and clinical profiles of Medical Comorbidities (MC) in this clinical group, with a special focus on Metabolic Syndrome (MetS); (3) develop a Clinical Support Tool (CST) for the personalized management of BD and medical comorbidities. METHODS: The BIPCOM project aims to investigate MC, specifically MetS, in individuals with BD using various approaches. Initially, prevalence rates, characteristics, genetic and non-genetic risk factors, and the natural progression of MetS among individuals with BD will be assessed by analysing Nordic registers, biobanks, and existing patient datasets from 11 European recruiting centres across 5 countries. Subsequently, a clinical study involving 400 participants from these sites will be conducted to examine the clinical profiles and incidence of specific MetS risk factors over 1 year. Baseline assessments, 1-year follow-ups, biomarker analyses, and physical activity measurements with wearable biosensors, and focus groups will be performed. Using this comprehensive data, a CST will be developed to enhance the prevention, early detection, and personalized treatment of MC in BD, by incorporating clinical, biological, sex and genetic information. This protocol will highlight the study's methodology. DISCUSSION: BIPCOM's data collection will pave the way for tailored treatment and prevention approaches for individuals with BD. This approach has the potential to generate significant healthcare savings by preventing complications, hospitalizations, and emergency visits related to comorbidities and cardiovascular risks in BD. BIPCOM's data collection will enhance BD patient care through personalized strategies, resulting in improved quality of life and reduced costly interventions. The findings of the study will contribute to a better understanding of the relationship between medical comorbidities and BD, enabling accura, Study Protocol.Funded by the Joint Transnational Call for Proposals (JTC) 2022 on "Prevention in Personalised Medicine " within the framework of ERA PerMed, ERAPERMED2022-087—BIPCOM. This project was supported by: 1. Fondazione Regionale per la Ricerca Biomedica (Italy); 2. Bundesministerium für Bildung und Forschung (Germany); 3. VINNOVA (Sweden); 4. Norges Forskningsråd (Norway); 5. Agence Nationale de la Recherche (France); 6. Departament de Salut, Generalitat de Catalunya (Spain); 7. Sächsisches Staatsministerium für Wissenschaft und Kunst (Germany); under the frame of ERA PerMed.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) are implicated in the aetiology of non-communicable diseases. Our study aimed to evaluate associations between NAFLD and MetS with overall and cause-specific mortality. METHODS: We used dietary, lifestyle, anthropometric and metabolic biomarker data from a random subsample of 15,784 EPIC cohort participants. NAFLD was assessed using the fatty liver index (FLI) and MetS using the revised definition. Indices for metabolic dysfunction-associated fatty liver disease (MAFLD) were calculated. The individual associations of these indices with overall and cause-specific mortality were assessed using multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs). As a subobjective, risk associations with adaptations of new classifications of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic and alcohol-related liver disease (MetALD) were also assessed. RESULTS: Among the 15,784 sub-cohort participants, a total of 1997 deaths occurred (835 due to cancer, 520 to CVD, 642 to other causes) over a median 15.6 (IQR, 12.3-17.1) years of follow-up. Compared to an FLI < 30, FLI ≥ 60 was associated with increased risks of overall mortality (HR = 1.44, 95%CI = 1.27-1.63), and deaths from cancer (HR = 1.32, 95%CI = 1.09-1.60), CVD (HR = 2.06, 95% CI = 1.61-2.63) or other causes (HR = 1.21, 95%CI = 0.97-1.51). Mortality risk associations were also elevated for individuals with MAFLD compared to those without. Individuals with MetS were at increased risk of all mortality endpoints, except cancer-specific mortality. MASLD and MetALD were associated with higher risk of overall mortality. CONCLUSIONS: Our findings based on a prospective cohort suggest that individuals with hepatic steatosis or metabolic dysfunction have a higher overall and cause-specific mortality risk.

Background: The health benefits of the Mediterranean diet (MedDiet) have been linked to the presence of beneficial gut microbes and related metabolites. However, its impact on the fecal metabolome remains poorly understood. Objectives: Our goal was to investigate the weight-loss effects of a 1-y lifestyle intervention based on an energy-reduced MedDiet coupled with physical activity (intervention group), compared with an ad libitum MedDiet (control group), on fecal metabolites, fecal microbiota, and their potential association with cardiovascular disease risk factors. Methods: A total of 400 participants (200 from each study group), aged 55–75 y, and at high cardiovascular disease risk, were included. Dietary and lifestyle information, anthropometric measurements, blood biochemical parameters, and stool samples were collected at baseline and after 1 y of follow-up. Liquid chromatography-tandem mass spectrometry was used to profile endogenous fecal metabolites, and 16S amplicon sequencing was employed to profile the fecal microbiota. Results: Compared with the control group, the intervention group exhibited greater weight loss and improvement in various cardiovascular disease risk factors. We identified intervention effects on 4 stool metabolites and subnetworks primarily composed of bile acids, ceramides, and sphingosines, fatty acids, carnitines, nucleotides, and metabolites of purine and the Krebs cycle. Some of these were associated with changes in several cardiovascular disease risk factors. In addition, we observed a reduction in the abundance of the genera Eubacterium hallii group and Dorea, and an increase in alpha diversity in the intervention group after 1 y of follow-up. Changes in the intervention-related microbiota profiles were also associated with alterations in different fecal metabolite subnetworks and some cardiovascular disease risk factors. Conclusions: An intervention based on an energy-reduced MedDiet and physical activity promotion, compared wi

Material and Method: Cross-sectional, analytical study. 154 records of pregnant women in the first trimester, from January-February 2023. Obtaining sociodemographic and clinical variables. Descriptive statistics with the statistical program CIETmap SE, achieving simple frequencies, percentages, measures of central tendency and dispersion. Bivariate analysis for OR and 95%CI, the variables with the greatest association, were included in a multivariate model for adjusted OR and 95%CI. Results: The prevalence of metabolic syndrome according to the ATPIII criteria was 9.1% and according to the WHO criteria it was 5.8%, waist circumference prevailed with 27.27% and central obesity with 31.42%. The risk factors strongly associated in the multivariate analysis were complications in previous pregnancies (ORa 9.25, CI95% 2.25-38.06), obesity (ORa 5.70, CI95% 2.12-15.37), advanced maternal age (ORa 3.59, CI95% 1.33- 9.72). Conclusion: There is a prevalence of metabolic syndrome during pregnancy, which is underdiagnosed. Nine out of every hundred pregnant women present metabolic syndrome according to the ATPIII and six out of every hundred according to the WHO, the diagnostic criterion and factor with the greatest association was obesity., Objetivo: Determinar la prevalencia de síndrome metabólico y factores de riesgo asociados en embarazadas de la Unidad de Medicina Familiar No.9 de Acapulco, Guerrero. Material y método: Estudio transversal, analítico. 154 expedientes de embarazadas del primer trimestre, de enero-febrero 2023. Obteniendo variables sociodemográficas y clínicas. Estadística descriptiva con el programa estadístico CIETmap SE, logrando frecuencias simples, porcentajes, medidas de tendencia central y de dispersión. Análisis bivariado para OR e IC95%, las variables con mayor asociación, se incluyeron en un modelo multivariado para OR ajustados e IC95%. Resultados: La prevalencia del síndrome metabólico según los criterios de la ATPIII fue 9.1% y según los criterios de la OMS fue 5.8%, prevaleció la circunferencia de cintura con 27.27% y la obesidad central con 31.42%. Los factores de riesgo fuertemente asociados en el análisis multivariado fueron complicaciones en embarazos previos (ORa 9.25, IC95% 2.25-38.06), obesidad (ORa 5.70, IC95% 2.12-15.37), la edad materna avanzada (ORa 3.59, IC95% 1.33-9.72). Conclusión: Existe prevalencia del síndrome metabólico durante el embarazo, la cual es subdiagnosticada. Nueve de cada cien embarazadas presenta síndrome metabólico según la ATPIII y seis de cada cien según la OMS, el criterio diagnóstico y factor de mayor asociación fue la obesidad.

Background: Antipsychotic medications are associated with weight gain and metabolic derangement. However, comprehensive evidence for the efficacy of co-commenced pharmacological treatments to mitigate initial weight gain is limited. Metformin has been shown to be effective in reducing weight among people on antipsychotic medications who are already overweight, but the potential benefits of metformin co-commencement in mitigating antipsychotic-induced weight gain has not been systematically reviewed. Method: We conducted a systematic review of PubMed, EMBASE, PsychInfo, CINAHL, the Cochrane database, and China National Knowledge Infrastructure from inception to 18 November 2023. We undertook a meta-analysis of concomitant commencement of metformin versus placebo for attenuation of weight gain and metabolic syndrome for people with schizophrenia commencing a new antipsychotic. Results: Fourteen studies from Australia, United States, Venezuela, and China with 1126 participants were included. We found that metformin was superior to placebo in terms of attenuating weight gain (−3.12 kg, 95% CI −4.22 to −2.01 kg). Metformin also significantly attenuated derangement of fasting glucose levels, total cholesterol, and total triglyceride levels. Sensitivity analysis on study quality, duration, and antipsychotic agent did not impact the results. Meta-analysis was also conducted on adverse drug reactions (ADR) reported in each study which showed no significant difference in ADR incidence between metformin and placebo groups. Subgroup analysis on antipsychotic-naïve participants and participants switching to new antipsychotic did not impact the results. Conclusion: Metformin led to statistically significant and clinically meaningful attenuation of weight gain as well as attenuation of several other metabolic parameters when commenced concomitantly with antipsychotic medications. Co-commencement of metformin with antipsychotic medications, where tolerat, Background: Antipsychotic medications are associated with weight gain and metabolic derangement. However, comprehensive evidence for the efficacy of co-commenced pharmacological treatments to mitigate initial weight gain is limited. Metformin has been shown to be effective in reducing weight among people on antipsychotic medications who are already overweight, but the potential benefits of metformin co-commencement in mitigating antipsychotic-induced weight gain has not been systematically reviewed. Method: We conducted a systematic review of PubMed, EMBASE, PsychInfo, CINAHL, the Cochrane database, and China National Knowledge Infrastructure from inception to 18 November 2023. We undertook a meta-analysis of concomitant commencement of metformin versus placebo for attenuation of weight gain and metabolic syndrome for people with schizophrenia commencing a new antipsychotic. Results: Fourteen studies from Australia, United States, Venezuela, and China with 1126 participants were included. We found that metformin was superior to placebo in terms of attenuating weight gain (−3.12 kg, 95% CI −4.22 to −2.01 kg). Metformin also significantly attenuated derangement of fasting glucose levels, total cholesterol, and total triglyceride levels. Sensitivity analysis on study quality, duration, and antipsychotic agent did not impact the results. Meta-analysis was also conducted on adverse drug reactions (ADR) reported in each study which showed no significant difference in ADR incidence between metformin and placebo groups. Subgroup analysis on antipsychotic-naïve participants and participants switching to new antipsychotic did not impact the results. Conclusion: Metformin led to statistically significant and clinically meaningful attenuation of weight gain as well as attenuation of several other metabolic parameters when commenced concomitantly with antipsychotic medications. Co-commencement of metformin with antipsychotic medications, where tolerated, should be considered

Background Biomarkers associated with disease severity and comorbid metabolic syndrome (MetS) in patients with hidradenitis suppurativa (HS) are lacking. Objective To identify biomarkers associated with disease severity and comorbid MetS in patients with HS. Methods Data on hospital outpatients with HS were obtained through clinical examination and interviews. Indicators of systemic inflammation; C-reactive protein (CRP), erythrocyte sedimentation-rate (ESR), neutrophil/lymphocyte-ratio (NLR), platelet/lymphocyte-ratio (PLR), monocyte/lymphocyte-ratio (MLR), platelet/neutrophil-ratio (PNR), pan-immune-inflammation-value (PIV), and systemic-immune-inflammatory-index (SII), were calculated from blood samples. Results Seven hundred patients were included; of those 444 (63.4%) and 256 (36.6%) were female and male, respectively, with a median age of 38.3 years (IQR = 27.9-51.0). Increasing CRP, ESR, NLR, PIV, and SII (P < .001) were significantly associated with increasing Hurley-stage and international hidradenitis suppurativa severity score system 4 (IHS4)-score in adjusted analysis. A doubling in CRP (OR 1.59 (1.36-1.85), P < .001), ESR (OR 1.39 (1.17-1.66), P < .001) and PIV (OR 1.41 (1.12-1.77) P = .002) was associated with MetS in adjusted analysis. ESR was the best estimator for severe IHS4-score (AUC = 0.72 (0.66-0.77), P < .001) and Hurley III (AUC = 0.79 (0.73-0.85), P < .001) whereas CRP was best for MetS (AUC = 0.67 (0.62-0.72), P < .001). Limitations Patients in a hospital setting tend to have more severe disease. Conclusion Biomarkers like CRP, ESR, and PIV measuring systemic inflammation were associated with disease severity and comorbid MetS in patients with HS., Background: Biomarkers associated with disease severity and comorbid metabolic syndrome (MetS) in patients with hidradenitis suppurativa (HS) are lacking. Objective: To identify biomarkers associated with disease severity and comorbid MetS in patients with HS. Methods: Data on hospital outpatients with HS were obtained through clinical examination and interviews. Indicators of systemic inflammation; C-reactive protein (CRP), erythrocyte sedimentation-rate (ESR), neutrophil/lymphocyte-ratio (NLR), platelet/lymphocyte-ratio (PLR), monocyte/lymphocyte-ratio (MLR), platelet/neutrophil-ratio (PNR), pan-immune-inflammation-value (PIV), and systemic-immune-inflammatory-index (SII), were calculated from blood samples. Results: Seven hundred patients were included; of those 444 (63.4%) and 256 (36.6%) were female and male, respectively, with a median age of 38.3 years (IQR = 27.9-51.0). Increasing CRP, ESR, NLR, PIV, and SII (P < .001) were significantly associated with increasing Hurley-stage and international hidradenitis suppurativa severity score system 4 (IHS4)-score in adjusted analysis. A doubling in CRP (OR 1.59 (1.36-1.85), P < .001), ESR (OR 1.39 (1.17-1.66), P < .001) and PIV (OR 1.41 (1.12-1.77) P = .002) was associated with MetS in adjusted analysis. ESR was the best estimator for severe IHS4-score (AUC = 0.72 (0.66-0.77), P < .001) and Hurley III (AUC = 0.79 (0.73-0.85), P < .001) whereas CRP was best for MetS (AUC = 0.67 (0.62-0.72), P < .001). Limitations: Patients in a hospital setting tend to have more severe disease. Conclusion: Biomarkers like CRP, ESR, and PIV measuring systemic inflammation were associated with disease severity and comorbid MetS in patients with HS.

The increasing occurrence of metabolic syndrome in children and teenagers is alarming due to the potential for  significant long-term health issues. Recognizing and addressing this condition early are essential to avoid permanent  harm. Traditional Ayurvedic perspectives offer valuable insights into this issue. Conditions such as Sthaulya (Obesity), Prameha (Diabetes), Shonita Dusti (Blood Impurity), and Dhamani Pratichaya (Vascular Diseases) share  similarities with metabolic syndrome. These arise from excessive intake and accumulation (Santarpana nidana),  leading to a build-up of Kapha (one of three senses of humor having unctuous property) and Medha (fat), eventually  affecting other Doshas (humor) and multiple tissues. Ayurvedic treatments aim to manage these conditions, as they  tend to be chronic and prone to complications, potentially progressing to Vatavyadhi (neurological disorders) over  time. The interplay of kapha and medha in blocking channels (Margavarana) is a crucial consequence of these  conditions, contributing to the development of vatavyadhi. This review article highlights the importance of early  intervention and traditional Ayurvedic approaches in managing metabolic syndrome-like conditions in children and  adolescents to prevent long-term complications.&nbsp

Background: Metabolic syndrome (MetS) encompasses a cluster of metabolic abnormalities including hypertension, hyperlipidemia, hyperuricemia, hyperglycemia, central obesity, and insulin resistance. MetS and chronic kidney disease (CKD) are intricately linked and can influence each other. This study aims to serve a comprehensive systematic review to evaluate the association of MetS and CKD in literatures of the last 10 years. Methods: The review adhered to PRISMA 2020 standards and analyzed full-text English literature from 2014 to 2024. It excluded editorials, review papers from the same journal, and submissions lacking a DOI. Literature sources included PubMed, SagePub, SpringerLink, and Google Scholar. Result: A total of 488 articles were retrieved from online databases (PubMed, SagePub, SpringerLink and Google Scholar). After three rounds of screening, five articles directly relevant to the systematic review were selected for full-text reading and analysis. Conclusion: The discussion emphasizes the complex link between metabolic syndrome (MetS) and chronic kidney disease (CKD), driven by modern lifestyle habits causing metabolic overload. Kidneys are especially susceptible to MetS effects, but effective treatment strategies are lacking. Further research is needed to understand and address MetS-related kidney damage.

Background: Metabolic syndrome (MetS) encompasses a cluster of metabolic abnormalities including hypertension, hyperlipidemia, hyperuricemia, hyperglycemia, central obesity, and insulin resistance. MetS and chronic kidney disease (CKD) are intricately linked and can influence each other. This study aims to serve a comprehensive systematic review to evaluate the association of MetS and CKD in literatures of the last 10 years. Methods: The review adhered to PRISMA 2020 standards and analyzed full-text English literature from 2014 to 2024. It excluded editorials, review papers from the same journal, and submissions lacking a DOI. Literature sources included PubMed, SagePub, SpringerLink, and Google Scholar. Result: A total of 488 articles were retrieved from online databases (PubMed, SagePub, SpringerLink and Google Scholar). After three rounds of screening, five articles directly relevant to the systematic review were selected for full-text reading and analysis. Conclusion: The discussion emphasizes the complex link between metabolic syndrome (MetS) and chronic kidney disease (CKD), driven by modern lifestyle habits causing metabolic overload. Kidneys are especially susceptible to MetS effects, but effective treatment strategies are lacking. Further research is needed to understand and address MetS-related kidney damage.

Background Metabolic Syndrome (MetS) is a progressive pathophysiological state defined by a cluster of cardiometabolic traits. However, little is known about metabolites that may be predictors of MetS incidence or reversion. Our objective was to identify plasma metabolites associated with MetS incidence or MetS reversion. Methods The study included 1468 participants without cardiovascular disease (CVD) but at high CVD risk at enrollment from two case-cohort studies nested within the PREvención con DIeta MEDiterránea (PREDIMED) study with baseline metabolomics data. MetS was defined in accordance with the harmonized International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute criteria, which include meeting 3 or more thresholds for waist circumference, triglyceride, HDL cholesterol, blood pressure, and fasting blood glucose. MetS incidence was defined by not having MetS at baseline but meeting the MetS criteria at a follow-up visit. MetS reversion was defined by MetS at baseline but not meeting MetS criteria at a follow-up visit. Plasma metabolome was profiled by LC-MS. Multivariable-adjusted Cox regression models and elastic net regularized regressions were used to assess the association of 385 annotated metabolites with MetS incidence and MetS reversion after adjusting for potential risk factors. Results Of the 603 participants without baseline MetS, 298 developed MetS over the median 4.8-year follow-up. Of the 865 participants with baseline MetS, 285 experienced MetS reversion. A total of 103 and 88 individual metabolites were associated with MetS incidence and MetS reversion, respectively, after adjusting for confounders and false discovery rate correction. A metabolomic signature comprised of 77 metabolites was robustly associated with MetS incidence (HR: 1.56 (95 % CI: 1.33–1.83)), and a metabolomic signature of 83 metabolites associated with MetS reversion (HR: 1.44 (95 % CI: 1.25–1.67)), bo, Background: Metabolic Syndrome (MetS) is a progressive pathophysiological state defined by a cluster of cardiometabolic traits. However, little is known about metabolites that may be predictors of MetS incidence or reversion. Our objective was to identify plasma metabolites associated with MetS incidence or MetS reversion. Methods: The study included 1468 participants without cardiovascular disease (CVD) but at high CVD risk at enrollment from two case-cohort studies nested within the PREvención con DIeta MEDiterránea (PREDIMED) study with baseline metabolomics data. MetS was defined in accordance with the harmonized International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute criteria, which include meeting 3 or more thresholds for waist circumference, triglyceride, HDL cholesterol, blood pressure, and fasting blood glucose. MetS incidence was defined by not having MetS at baseline but meeting the MetS criteria at a follow-up visit. MetS reversion was defined by MetS at baseline but not meeting MetS criteria at a follow-up visit. Plasma metabolome was profiled by LC-MS. Multivariable-adjusted Cox regression models and elastic net regularized regressions were used to assess the association of 385 annotated metabolites with MetS incidence and MetS reversion after adjusting for potential risk factors. Results: Of the 603 participants without baseline MetS, 298 developed MetS over the median 4.8-year follow-up. Of the 865 participants with baseline MetS, 285 experienced MetS reversion. A total of 103 and 88 individual metabolites were associated with MetS incidence and MetS reversion, respectively, after adjusting for confounders and false discovery rate correction. A metabolomic signature comprised of 77 metabolites was robustly associated with MetS incidence (HR: 1.56 (95 % CI: 1.33–1.83)), and a metabolomic signature of 83 metabolites associated with MetS reversion (HR: 1.44 (95 % CI: 1.25–1.67)), both p < 0.00

Background: Antipsychotic medications are associated with weight gain and metabolic derangement. However, comprehensive evidence for the efficacy of co-commenced pharmacological treatments to mitigate initial weight gain is limited. Metformin has been shown to be effective in reducing weight among people on antipsychotic medications who are already overweight, but the potential benefits of metformin co-commencement in mitigating antipsychotic-induced weight gain has not been systematically reviewed. Method: We conducted a systematic review of PubMed, EMBASE, PsychInfo, CINAHL, the Cochrane database, and China National Knowledge Infrastructure from inception to 18 November 2023. We undertook a meta-analysis of concomitant commencement of metformin versus placebo for attenuation of weight gain and metabolic syndrome for people with schizophrenia commencing a new antipsychotic. Results: Fourteen studies from Australia, United States, Venezuela, and China with 1126 participants were included. We found that metformin was superior to placebo in terms of attenuating weight gain (−3.12 kg, 95% CI −4.22 to −2.01 kg). Metformin also significantly attenuated derangement of fasting glucose levels, total cholesterol, and total triglyceride levels. Sensitivity analysis on study quality, duration, and antipsychotic agent did not impact the results. Meta-analysis was also conducted on adverse drug reactions (ADR) reported in each study which showed no significant difference in ADR incidence between metformin and placebo groups. Subgroup analysis on antipsychotic-naïve participants and participants switching to new antipsychotic did not impact the results. Conclusion: Metformin led to statistically significant and clinically meaningful attenuation of weight gain as well as attenuation of several other metabolic parameters when commenced concomitantly with antipsychotic medications. Co-commencement of metformin with antipsychotic medications, where tolerat, Background: Antipsychotic medications are associated with weight gain and metabolic derangement. However, comprehensive evidence for the efficacy of co-commenced pharmacological treatments to mitigate initial weight gain is limited. Metformin has been shown to be effective in reducing weight among people on antipsychotic medications who are already overweight, but the potential benefits of metformin co-commencement in mitigating antipsychotic-induced weight gain has not been systematically reviewed. Method: We conducted a systematic review of PubMed, EMBASE, PsychInfo, CINAHL, the Cochrane database, and China National Knowledge Infrastructure from inception to 18 November 2023. We undertook a meta-analysis of concomitant commencement of metformin versus placebo for attenuation of weight gain and metabolic syndrome for people with schizophrenia commencing a new antipsychotic. Results: Fourteen studies from Australia, United States, Venezuela, and China with 1126 participants were included. We found that metformin was superior to placebo in terms of attenuating weight gain (−3.12 kg, 95% CI −4.22 to −2.01 kg). Metformin also significantly attenuated derangement of fasting glucose levels, total cholesterol, and total triglyceride levels. Sensitivity analysis on study quality, duration, and antipsychotic agent did not impact the results. Meta-analysis was also conducted on adverse drug reactions (ADR) reported in each study which showed no significant difference in ADR incidence between metformin and placebo groups. Subgroup analysis on antipsychotic-naïve participants and participants switching to new antipsychotic did not impact the results. Conclusion: Metformin led to statistically significant and clinically meaningful attenuation of weight gain as well as attenuation of several other metabolic parameters when commenced concomitantly with antipsychotic medications. Co-commencement of metformin with antipsychotic medications, where tolerated, should be considered

Background Biomarkers associated with disease severity and comorbid metabolic syndrome (MetS) in patients with hidradenitis suppurativa (HS) are lacking. Objective To identify biomarkers associated with disease severity and comorbid MetS in patients with HS. Methods Data on hospital outpatients with HS were obtained through clinical examination and interviews. Indicators of systemic inflammation; C-reactive protein (CRP), erythrocyte sedimentation-rate (ESR), neutrophil/lymphocyte-ratio (NLR), platelet/lymphocyte-ratio (PLR), monocyte/lymphocyte-ratio (MLR), platelet/neutrophil-ratio (PNR), pan-immune-inflammation-value (PIV), and systemic-immune-inflammatory-index (SII), were calculated from blood samples. Results Seven hundred patients were included; of those 444 (63.4%) and 256 (36.6%) were female and male, respectively, with a median age of 38.3 years (IQR = 27.9-51.0). Increasing CRP, ESR, NLR, PIV, and SII (P < .001) were significantly associated with increasing Hurley-stage and international hidradenitis suppurativa severity score system 4 (IHS4)-score in adjusted analysis. A doubling in CRP (OR 1.59 (1.36-1.85), P < .001), ESR (OR 1.39 (1.17-1.66), P < .001) and PIV (OR 1.41 (1.12-1.77) P = .002) was associated with MetS in adjusted analysis. ESR was the best estimator for severe IHS4-score (AUC = 0.72 (0.66-0.77), P < .001) and Hurley III (AUC = 0.79 (0.73-0.85), P < .001) whereas CRP was best for MetS (AUC = 0.67 (0.62-0.72), P < .001). Limitations Patients in a hospital setting tend to have more severe disease. Conclusion Biomarkers like CRP, ESR, and PIV measuring systemic inflammation were associated with disease severity and comorbid MetS in patients with HS., Background: Biomarkers associated with disease severity and comorbid metabolic syndrome (MetS) in patients with hidradenitis suppurativa (HS) are lacking. Objective: To identify biomarkers associated with disease severity and comorbid MetS in patients with HS. Methods: Data on hospital outpatients with HS were obtained through clinical examination and interviews. Indicators of systemic inflammation; C-reactive protein (CRP), erythrocyte sedimentation-rate (ESR), neutrophil/lymphocyte-ratio (NLR), platelet/lymphocyte-ratio (PLR), monocyte/lymphocyte-ratio (MLR), platelet/neutrophil-ratio (PNR), pan-immune-inflammation-value (PIV), and systemic-immune-inflammatory-index (SII), were calculated from blood samples. Results: Seven hundred patients were included; of those 444 (63.4%) and 256 (36.6%) were female and male, respectively, with a median age of 38.3 years (IQR = 27.9-51.0). Increasing CRP, ESR, NLR, PIV, and SII (P < .001) were significantly associated with increasing Hurley-stage and international hidradenitis suppurativa severity score system 4 (IHS4)-score in adjusted analysis. A doubling in CRP (OR 1.59 (1.36-1.85), P < .001), ESR (OR 1.39 (1.17-1.66), P < .001) and PIV (OR 1.41 (1.12-1.77) P = .002) was associated with MetS in adjusted analysis. ESR was the best estimator for severe IHS4-score (AUC = 0.72 (0.66-0.77), P < .001) and Hurley III (AUC = 0.79 (0.73-0.85), P < .001) whereas CRP was best for MetS (AUC = 0.67 (0.62-0.72), P < .001). Limitations: Patients in a hospital setting tend to have more severe disease. Conclusion: Biomarkers like CRP, ESR, and PIV measuring systemic inflammation were associated with disease severity and comorbid MetS in patients with HS.

Diets high in fat and sugar lead to metabolic syndrome (MetS) and related chronic diseases. We investigated the effects of commercially available, cold-pressed polyphenol-rich black currant (BC) and cornelian cherry (CC) juices on the prevention of MetS in Wistar rats induced by a 10-weeks high-fat high-fructose (HFF) diet. Juice consumption, either BC or CC, with a HFF diet resulted in lower serum triglycerides compared to only the HFF consumption. Both juices also mitigated the effects of HFF on the liver, pancreas, and adipose tissue, by preserving liver and pancreas histomorphology and reducing visceral fat and adipocyte size. Furthermore, supplementation with both juices reduced glucagon and up-regulated insulin expression in the pancreas of the rats on the HFF diet, whereas the BC also showed improved glucose regulation. BC juice also reduced the expression of IL-6 and hepatic inflammation compared to the group only on HFF diet. Both juices, especially BC, could be a convenient solution for the prevention of MetS in humans.

Pulmonary hypertension and right ventricular (RV) dysfunction are major prognostic determinants in patients with heart failure with preserved ejection fraction (HFpEF). The underlying pathomechanisms remain unknown. In this context, we sought to study the pathogenesis of pulmonary hypertension and RV dysfunction in a rat model of obesity-associated HFpEF., SCOPUS: ar.j, info:eu-repo/semantics/published