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Introduction: This study aimed to determine the burden of suspected nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) in a predominantly Hispanic patient population and explore the utility of the American Gastroenterological Association's NAFLD Clinical Care Pathway (CCP). Methodology: Electronic medical records (n = 223) were used to divide patients into risk groups based on the amount of metabolic risk factors they presented, diabetic status, or if they presented other liver diseases. Fribosis-4 (FIB-4) scores were used to determine the risk for advanced fibrosis. Results: Most patients (83.8%) were considered at risk for NAFLD based on CCP criteria, and about a third of patients (33.2%) were found to be at indeterminate (n = 60; 26.9%) or high risk (n = 14; 6.3%) for advanced fibrosis. Most indeterminate-risk patients (78.3%) were not referred for liver imaging. Discussion: This study demonstrates the potential of the CCP as a corrective tool that could help to better identify and screen patients at risk for NAFLD. [ABSTRACT FROM AUTHOR]

Background: Special low protein foods (SLPF) that are phenylalanine (Phe)-free or have a low Phe content are an integral part of PKU diet therapy. Aim: The aim of this study is to determine the nutritional profiles of SLPFs used in Turkey and to compare their contents with equivalent products in the "regular" category, in order to evaluate nutritional and metabolic risks. Methods: Between February and March 2022, the information concerning the nutritional contents of "special low protein products" recommended for PKU and available in Turkey were obtained from the websites of producers/suppliers. Results: A total of 148 SLPFs were identified in Turkey. Compared to regular products, SLPFs were determined to contain less sugar and high carbohydrate content in the Turkish market (p < 0.001). Overall, SLPF products had higher dietary fiber compared to products with regular protein content (p < 0.001). In SLPF subgroups, meat substitutes, rice and pasta, and soup products had significantly less total fat than regular products; low protein bread, sweet snacks, and salted crackers were found to contain less saturated fat (p < 0.05). Moreover, all SLPFs contained significantly more salt than regular products, especially the salt content of subgroups of low protein bread, flour, pasta, and rice was significantly higher than regular products (p < 0.05). Conclusion: Including detailed nutritional information on the Turkish SLPFs' food labels will be effective for patients with PKU to follow themselves on their own. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) being a biological abnormality confers the highest risk of type 2 diabetes mellitus (T2DM). Aim: To assess MetS indicators in the newly diagnosed T2DM Pakistani population. Methods: A cross-sectional study (N = 123) with newly diagnosed T2DM patients (gender: both, MeanAge: 49.24 ± 6.84 years) was selected from Medical OPD, Pakistan Institute of Medical Sciences, Islamabad. Basic profile, family history, and physical activity were recorded through a predesigned questionnaire, dietary intake through seven days Food Diary and Food Frequency Questionnaire. Blood pressure and selected clinical signs and symptoms were recorded. Anthropometric measurements included mid-upper arm circumference (MUAC), body mass index (BMI), waist circumference (WC), waist-and-hip ratio (WHR), waist-to-height ratio (WHtR), and conicity index. Lab parameters included fasting blood glucose, HbA1c, insulin levels, and lipid profile. Homeostatic model assessment of insulin resistance (HOMA-IR) was computed to assess insulin resistance. Results: Almost all parameters related to MetS were higher than normal. The prevalence of MetS was 59.7%. BMI, MUAC, and WHtR were independently associated with HOMA-IR, but WC, WHR, and the conicity index had no relationship MetS indicators. Conclusion: The prevalence rate of MetS was found to be 59.7% in newly diagnosed T2DM patients. MUAC was found to be a better parameter for the diagnosis of central obesity and insulin resistance in the selected population. [ABSTRACT FROM AUTHOR]

The relationship between socioeconomic status (SES) and health outcomes has garnered significant attention. However, there is a limited amount of research exploring the association between SES and the risk of metabolic syndrome in Malaysian adults. This study aimed to determine the association between SES and risk of hypertension, diabetes and obesity. By using data from the National Health and Morbidity Survey (NHMS), SES was derived through principal component analysis involving six variables. Two different SES components were identified and labeled as "social status" and "wealth status." Among the participants, 36% were diagnosed with hypertension, 18% with obesity, and 21% with diabetes. Adults with high wealth and social status showed a significantly increased risk of obesity. Meanwhile, high social status was significantly associated with a reduction in the risk of hypertension and diabetes. A comprehensive understanding of the associations between SES and noncommunicable diseases could facilitate initiatives that promote healthy lifestyle behaviors, thereby enhancing the holistic well-being of Malaysians. [ABSTRACT FROM AUTHOR]

The prevalence of metabolic syndrome (MetS) as well as related social costs and efforts is increasing. The purpose of this study was to investigate the association between age at menarche and the risk of MetS, obesity, diabetes, and cardiovascular disease (CVD) in women over 30 years, using data from the Korean National Health and Nutrition Examination Survey (2010-2020). The analysis of 30 916 participants showed that early menarche (before 11 years) significantly increased the risk of obesity, diabetes, and MetS compared with the median age of 14 years. Late menarche (after 17 years) was also linked to MetS and related disorders. The relationship between age at menarche (at <10 years and >19 years) and the risk of MetS and related disorders exhibited a reversed J-shaped (し) pattern characterized by a pronounced increased risk among those who experience early menarche, whereas the increased risk associated with late menarche was less consistent. These results will help to decrease the risk of MetS and related disorders by enabling early intervention in early and late menarche age groups. [ABSTRACT FROM AUTHOR]

Across the globe, metabolic syndrome, hyperuric acid, and their related diseases, such as cardiovascular disease, diabetes, and insulin resistance, are increasing in incidence due to metabolic imbalances. Due to the pathogenesis, women are more prone to these diseases than men. As estrogen levels decrease after menopause, obesity and metabolic disorders are more likely to occur. Men are also affected by hyperuric acid. To provide ideas for the prevention and treatment of metabolic syndrome and hyperuricemia, this article reviews and analyzes the relationship between estrogen receptors, metabolic syndrome, and hyperuricemia. Plain language summary: Influence of estrogen receptor on metabolic syndrome and hyperuricemia A narrative review discusses the mechanism of estrogen and estrogen receptors for metabolic syndrome and hyperuric acid, and highlights the important for prevention and treatment of metabolic balances. [ABSTRACT FROM AUTHOR]

The aim of this study was to estimate the prevalence of metabolic syndrome (MetS) in a Spanish rural population and assess differences in prevalence according to loneliness level, social isolation, and social support. This is a cross-sectional study of 310 patients. MetS was defined by National Cholesterol Education Program–Third Adult Treatment Panel. The UCLA (University of California, Los Angeles) Loneliness Scale, Multidimensional Scale of Social Support, and Lubben Social Network Scale were used to assess loneliness, perceived social support, and social isolation. Almost half of the participants fulfilled MetS diagnosis criteria. Subjects with MetS showed significantly higher levels of loneliness, less social support, and greater social isolation. Systolic blood pressure was significantly higher in socially isolated rural adults. Environmental factors may play a key role in the prevalence of MetS, so specific screening and prevention programs could help health professionals prevent the increasing rates of MetS in rural populations under these socially specific conditions of vulnerability. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the effects of aerobic interval training and resistance training on anti-inflammatory adipokines, high sensitivity C-reactive protein, and clinical outcomes in sedentary men with metabolic syndrome. Methods: A total of 33 sedentary men with metabolic syndrome (age: 46.2 ± 4.6 years; body mass index: 35.4 ± 1.9 kg.m2) were randomly assigned to one of 3 groups: aerobic interval training (n = 12), resistance training (n = 10), or control (n = 11). Participants in the exercise groups completed a 12-week training program, 3 sessions per week, while those in the control group maintained their sedentary lifestyle. The levels of high sensitivity C-reactive protein (hs-CRP), omentin-1, adiponectin, lipid profiles, blood pressure, glucose metabolism, body composition, and peak oxygen uptake (VO2peak) were measured at baseline and after the intervention. Results: Both aerobic interval training and resistance training significantly improved the levels of omentin-1 and adiponectin, as well as reduced inflammation, as indicated by a decrease in hs-CRP levels. Exercise training also led to significant improvements in lipid profiles, blood pressure, glucose metabolism, and body composition. Specifically, the aerobic interval training group had significantly greater increases in high-density lipoprotein cholesterol and VO2peak, as well as greater reductions in low-density lipoprotein cholesterol, triglycerides, and total cholesterol compared to the resistance training group. Conclusion: Exercise training, particularly aerobic interval training and resistance training, can be an effective non-pharmacological intervention for managing inflammation and improving cardiovascular health in metabolic syndrome patients. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to investigate associations between psychosocial work exposure and the presence of biological and imaging biomarkers of cardiovascular disease. Methods: This cross-sectional study was conducted in a sub-cohort of the Swedish CArdioPulmonary bioImage Study (SCAPIS). Psychosocial exposure was evaluated with the job demand–control model, and analysed according to the standard categorization: high strain, active, passive and low strain (reference). Biomarkers (blood pressure, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, coronary artery calcification (CAC) and metabolic syndrome) were measured, or derived through measurements, from clinical examinations. Gender-specific prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated with regression models and adjusted for age, education, smoking, physical activity, general life stress and body mass index (BMI). Results: The analyses included 3882 participants (52.5% women). High strain (high demands–low control) was linked to increased PR for low HDL cholesterol in women, adjusted for all covariates (PR 1.76; 95% CI 1.25–2.48). High strain was also related to moderately increased PR for metabolic syndrome in men, after adjustments for all covariates except BMI (PR 1.25; 95% CI 1.02–1.52). In addition, passive work (low demands–low control) was associated with diastolic hypertension in women (fully adjusted: PR 1.29; 95% CI 1.05–1.59). All relationships between psychosocial factors and LDL cholesterol or CAC (both genders), or hypertension (men), were non-significant. Conclusions: Poor psychosocial job conditions was associated with the presence of low HDL cholesterol and diastolic hypertension in women, and metabolic syndrome in men. These findings contribute to the knowledge of potential pathways between stressful work and coronary heart disease. [ABSTRACT FROM AUTHOR]

Background. Among lifestyle factors, obesity has been postulated as the most important risk factor for metabolic syndrome (MS). Lifestyle factors such as physical activity (PA), diet quality, and weight management are so closely related, it is not clear if the role of lifestyle factors is exclusively through its effect on weight, or if they contribute independently. Objective. To examine the effect of lifestyle factors such as diet quality, weight change, and leisure time PA on MS occurrence in lean and overweight/obese (OW/OB) adults over a 6-year period. Methods. This was a longitudinal analysis of data from adults participating in the Health Workers Cohort Study. Results. A total of 1046 participants were included; 37.2% of the OW/OB group and 16.2% of the lean participants developed MS. Becoming overweight had a hazard ratio (HR) of 3.06 for developing MS compared with remaining lean (95% CI = 1.98, 4.74). Going from OW/OB to lean was associated with lower risk of MS (HR = 0.41; 95% CI = 0.22, 0.79). Among OW/OB, becoming active was associated with lower risk (HR = 0.63; 95% CI = 0.42, 0.95) in comparison with an inactive pattern; diet quality was not associated with occurrence of MS. Conclusion. Weight change was the most relevant factor predicting MS over a 6-year period. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency is prevalent worldwide. Since the discovery of the expression of vitamin D receptor in ventricular cardiomyocytes, fibroblasts, and blood vessels, there has been a growing body of literature assessing the link between vitamin D status and cardiovascular health from one side, and the effect of vitamin D supplementation on prevention of cardiovascular diseases from the other side. In this review, we summarized studies highlighting the role of vitamin D on cardiovascular health, namely atherosclerosis, hypertension, heart failure, and metabolic syndrome, a recognized significant risk factor for cardiovascular diseases. Studies showed discrepancies between findings from cross-sectional and longitudinal cohorts and those from interventional trials, but also between one outcome and another. Cross-sectional studies found a strong association between low 25 hydroxyvitamin D (25(OH)D3) and acute coronary syndrome, and heart failure. These findings encouraged the promotion for vitamin D supplementation as a preventive measure for cardiovascular diseases in the elderly, namely in women. This fact, however, turned out into a myth with the results of large interventional trials that did not show any benefit from vitamin D supplementation in reducing ischemic events, heart failure or its outcomes, or hypertension. Although some clinical studies showed beneficial effect of vitamin D supplementation on insulin sensitivity and metabolic syndrome, this effect was not consistent across all studies. [ABSTRACT FROM AUTHOR]

Objective: Patients with bipolar disorder treated with lithium often require additional antipsychotics or anticonvulsants. However, the comparative effectiveness and safety of these agents as add-on to lithium has not been studied. Methods: This secondary analysis combined two similar 24-week trials on outpatients with bipolar disorder randomized to lithium (target serum level 0.4–0.6 mEq/L). Guideline-based adjunctive antipsychotics (Li+AP) and anticonvulsants (Li+AC) could be used if clinically indicated and was assessed at every study visit. Response was measured on the Clinical Global Impression scale and we performed adjusted mixed effects linear regression analyses. Analysis of variance tests compared metabolic measures including a binary diagnosis of metabolic syndrome before and after 24 weeks of treatment. Results: Among 379 outpatients (57% female, mean age 38 years, mean Clinical Global Impression 4.4), users of Li+AP (N = 50, primarily quetiapine and aripiprazole) improved to a similar degree (mean Clinical Global Impression improvement = 1.6, standard deviation = 1.5) as those using lithium-only (i.e. without adjunctive antipsychotics or anticonvulsants, N = 149, mean Clinical Global Impression improvement = 1.7, standard deviation = 1.4) (p = 0.59). Users of Li+AC (N = 107, primarily lamotrigine and valproate, mean Clinical Global Impression improvement = 1.2, standard deviation = 1.3) and users of Li+AP+AC (N = 73, mean Clinical Global Impression improvement = 1.1, standard deviation = 1.3) showed worse response compared to lithium-only users (all p < 0.01). When comparing Li+AP to Li+AC, users of Li+AP improved slightly better on general (p = 0.05) and manic symptoms (p = 0.01), but showed a worse development of glucose, triglycerides, and metabolic syndrome. Conclusion: Despite treatment-by-indication confounding, these findings are relevant for real-world treatment settings and emphasize the need for randomized trials on this clinically important topic. [ABSTRACT FROM AUTHOR]

Introduction: Asian Americans (AsAms) have a high prevalence of metabolic syndrome (MetS) and are one of the least physically active racial groups in America. The purpose of this study was to examine the relationship between MetS and moderate-to-vigorous physical activity (MVPA) among AsAm adults and whether acculturation modifies this relationship. Method: Data were from 2,259 AsAms participating in the 2011–2016 National Health and Nutrition Examination Survey. Physical activity (PA) was self-reported as minutes of weekly MVPA. Acculturation included nativity, length of residency in America, and language preference. The International Diabetes Federation criteria was used to determine the presence of MetS. Results: About 64.4% of AsAms did not meet the PA recommendation (MVPA ≥150 min/week). The prevalence of MetS was 39.2%. The odds of having MetS were greater among AsAms who did not meet MVPA recommendations compared with those who did meet MVPA recommendations (odds ratio [OR] = 1.5, 95% confidence interval [CI] = [1.11, 2.07]). When stratified by acculturation, this association remained statistically significant in the groups who immigrated to America more than 15 years ago and who spoke English only. Conclusion: MVPA reduces MetS risk in AsAm adults, especially among more acculturated AsAms. Culturally adapted programs are warranted to promote PA and adequate knowledge of disease prevention in this population. [ABSTRACT FROM AUTHOR]

Background: Inconsistent results due to age, ethnic, and geographic differences have been found on the predictive capacity of atherogenic indices in previous studies. The aim of this study was to assess the predictive value of 6 atherogenic indices for MetS in a Spanish adolescent population. Methods: A cross-sectional study was performed on 981 adolescents (13.2 ± 1.2y) that were randomly recruited from schools in Southeastern Spain. Anthropometric and biochemical parameters were evaluated to identify the presence of MetS. The following atherogenic indices were calculated: triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), non-HDL cholesterol, triglycerides to HDL-cholesterol ratio (TG/HDL-c), LDL-cholesterol to HDL-cholesterol ratio (LDL-c/HDL-c), and total cholesterol to HDL-cholesterol ratio (TC/HDL-c). Results: The area under the curve (AUC) of receiver operating characteristic curves was used for discrimination purposes. AIP was the atherogenic index most strongly associated with MetS with an unadjusted odds ratio (OR) of 37.98 in boys and of 28.75 in girls. A high OR was maintained after adjustment by different factors. AUC values for all atherogenic indices were above 0.83 and 0.88 in boys and in girls, respectively. Conclusions: Among the 6 atherogenic indices studied, AIP was the one most strongly associated with MetS in Spanish adolescents. The AUC values obtained from ROC analyses suggest that all atherogenic indices have the ability to predict MetS. These atherogenic indices are interesting and useful predictive indicators for MetS. However, more studies are needed to explore in-depth this predictive capacity. [ABSTRACT FROM AUTHOR]

Background: Breast cancer molecular subtypes share various prognostic profiles, and luminal A molecular subtypes have a better prognosis compared with other molecular subtypes. However, whether metabolic syndrome or individual risk factors of metabolic syndrome influence on the development of molecular subtype remains elusive. We aimed to assess the association between metabolic syndrome risk factors and breast cancer molecular subtypes among patients with metabolic syndrome in a clinical setting. Methods: In total, 101 breast cancer patients with mean age, 58.4 ± 8.5 years, and overt metabolic syndrome prospectively were recruited. Immunohistochemistry procedure was used to determine molecular subtypes. Assessment of clinical, biochemical, and anthropometric parameters was performed. Logistic regression analysis was used to assess the relationship between risk factors and breast cancer molecular subtypes categories. A similar approach was used to assess the relation between breast cancer molecular subtypes and menopause. Results: Comparison of metabolic syndrome individual risk factors according to breast cancer molecular subtypes no statistical difference was found for systolic (P =.33) and diastolic blood pressure (P =.17), fasting glucose (P =.77), triglycerides (P =.62), high-density lipoprotein (P =.33), body mass index (P =.87), and waist circumference (P =.81). A positive trend was found between high-density lipoprotein and HER2+. No association was found with other risk factors. Moreover, an association was found between HER2+ categories and menopause. Conclusion: In breast cancer patients with metabolic syndrome, we observed an increased trend between high-density lipoprotein and HER2+ molecular subtype, suggesting that underlying dyslipidemia may favor poor prognosis. HER2+ was associated with menopause which may influence further expression of HER2+. [ABSTRACT FROM AUTHOR]

This is a descriptive study conducted to determine the prevalence of Metabolic Syndrome (MetS) in Schizophrenia patients and identify the effects of hopelessness and some variables on MetS. The study was conducted at the Psychiatry Clinic of a university hospital in Turkey between May and August 2020 with 105 schizophrenia patients receiving treatment as inpatients. The data of the study were collected by a Personal Information Form, a Physiological Measurements Form and (BHS). The data were analyzed by using SPSS 25. The mean age of the patients was 35.31 ± 9.07, their mean duration of disease was 11.35 ± 9.07 years, and 60.0% of the patients were using atypical antipsychotics as their latest drug treatment. 42.9% of the patients had MetS, while the mean hopelessness level of those with MetS was 10.84 ± 3.81. It was determined that hopelessness levels and some sociodemographic (age) and clinical variables significantly predicted the MetS status in the schizophrenia patients. [ABSTRACT FROM AUTHOR]

BACKGROUND:While the fast extension of combination antiretroviral therapy (cART) has resulted in significant increases in life expectancy, disorders such as cardiometabolic syndrome (CMetS), which have received less attention, are becoming a major concern in HIV/AIDS patients (PLWHA). OBJECTIVES: The purpose of this research was to identify biomarkers and determine the prevalence of CMetS in PLWHA using the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) tools. METHODS: Between January 2019 and February 2021, a hospital-based study of HIV-infected patients (n = 288) was conducted. The data were analyzed using binary logistic regression. To control the effect of confounders, independent variables with a P-value of <.20 in the bivariate logistic regression were incorporated into multivariate logistic regression. Statistical significance was defined as a 95% confidence interval and a P-value of less than .05. RESULTS: The risk of CMetS increased twofold as age increased each year (P = .009), 1.2 times as the age at which cART began increased (P = .015), and 6 times with 1 or more co-morbidities (P = .028), according to the NCEP tool. Furthermore, significant NCEP-CMetS correlations were produced by a rise in diastolic blood pressure (P < .001) and cART duration (P = .006). Male gender was 99.9% less likely to be related to CMetS using the IDF tool, and the risk of CMetS increased fourfold with each unit increase in waist circumference (P < .001). Triglycerides and blood type "A" have been found to have substantial relationships with CMetS using both techniques. CONCLUSION: According to the study, CMetS was found to be common in PLWHA. Age, time on cART, age when cART started, gender, co-morbidities, waist circumference, and diastolic blood pressure were all revealed to be significant predictors of CMetS. Triglycerides and blood type "A" were the only biomarkers found to be significant with CMetS using both the NCEP and IDF tools. [ABSTRACT FROM AUTHOR]

This study aimed to assess the performance of waist-to-height ratio (WHtR) in the prediction of metabolic syndrome and to determine the appropriate cutoff value in Thai adolescents. Demographic data, blood pressure, fasting blood glucose, and lipid profile were obtained from the Thai National Health Examination Survey V database. The performances of WHtR, waist circumference, body mass index (BMI), and BMI z -score were analyzed by the receiver operating characteristics. Among 2644 adolescents, metabolic syndrome was identified in 4.27%. The areas under the receiver operating characteristic curves of WHtR, waist circumference, BMI, and BMI z -score were comparable (0.924-0.960). Performance of WHtR was more constant across age groups compared with other parameters. Using the cutoff value of WHtR at 0.5 resulted in the sensitivity and specificity of 98.5%/83.4% and 88.9%/86.0% in males and females, respectively. In conclusion, the cutoff value of WHtR at 0.5 provided good sensitivity and specificity for identifying metabolic syndrome in both genders. However, the other clinical risk factors or more definite scores should be considered when further assessment. [ABSTRACT FROM AUTHOR]

Background: The reported association between metabolic syndrome (MetS) and breast cancer may have a significant impact on the incidence and mortality related to breast cancer. We undertook this study to find if the disease is different in patients with MetS. Materials and Methods: Patients with biopsy-proven breast cancer were divided into groups based on the presence or absence of MetS (according to the IDF definition of 2006) and also based on menopausal status. The presence of known risk and prognostic factors were also recorded, and the groups were compared. Results: A total of 305 patients were recruited, of which 191 (62.6%) had MetS. Patients with MetS were older than those without (52.1 versus 48.3 years, P =.014) and had a lower incidence of nulliparity (4.1% vs 12.8%, P =.005) and dense breasts (2.9% in MetS vs 10.8% in no MetS, P =.009). On further dividing into premenopausal and postmenopausal, these differences persisted only in premenopausal patients. MetS group had a lower number of HER2-positive tumours (14.3% for MetS, 23.9% for no MetS; P =.036). After dividing into premenopausal and postmenopausal, significant differences were observed in distant metastases (5.4% in MetS vs 16.1% in no MetS, P =.045) and in grade (higher grade in MetS, P =.05) in premenopausal patients. In postmenopausal patients, difference was observed in HER2 positivity (12.3% in MetS vs 28.8% in no MetS, P =.008). Conclusions: Breast cancer in patients with MetS may not be significantly different from breast cancer in patients without MetS. [ABSTRACT FROM AUTHOR]

Chemerin (CHEM) is a new proinflammatory adipokine involved in the immune, metabolic and reproductive processes. Low–grade state inflammation (LGSI) is a key element in the pathogenesis of metabolic syndrome (MS). Low SHBG is a good marker of male hypogonadism in MS. This study evaluated the prognostic value of selected adipokine, LGSI, and androgenic parameters in predicting the risk of MS among men. One hundred thirty-two random men aged 40 to 70 years old were enrolled. Measurements of anthropometric indices, blood pressure, and laboratory tests were carried out. A total of 62 men (47%) were diagnosed with MS. Chemerin concentrations were higher in men diagnosed with MS compared to healthy: 89.48 (78.12–112.10) vs. 77.9 (65.12–98.64) ng/mL; p =.002. Men diagnosed with MS presented with lower levels of total testosterone: 5.75 (4.00–6.57) vs. 6.40 (5.50–8.40) ng/mL; p =.0014 and SHBG: 46.58 (35.13–66.28) vs. 71.97 (56.1–92.7) nM/L; p < 0.000001. Elevated LGSI indices were demonstrated in men with MS as opposed to healthy [IL–18: 530.64 (409.12–640.56) vs. 418.85 (348.14–496.44) pg/mL; p =.000033 and hs–CRP: 2.15 (0.97–4.26) vs. 1.01 (0.41–2.68) ng/mL; p =.0057)]. In multivariate regression analysis, the highest negative predictive value in assessing the risk of MS was SHBG serum concentration, while the highest positive predictive values were: IL-18, hypertriglyceridemia, and waist circumference. Decreased SHBG levels, combined with elevated IL-18 concentrations in men showing hypertriglyceridemic waist phenotype, significantly increase the risk of MS. [ABSTRACT FROM AUTHOR]

Visceral adipose tissue is an independent risk factor for the development of atherosclerotic coronary disease, arterial hypertension, diabetes and metabolic syndrome. Right heart morphology often involves the presence of adipose tissue, which can be quantified by non-invasive imaging methods. The last decade brought a wealth of new insights into the function and morphology of adipose tissue, with great emphasis on its role in the pathogenesis of heart disease. Cardiac adipose tissue is involved in thermogenesis, mechanical protection of the heart and energy storage. However, it can also be an endocrine organ that synthesises numerous pro-inflammatory and anti-inflammatory cytokines, the effect of which is accomplished by paracrine and vasocrine mechanisms. Visceral adipose tissue has several compartments that differ in their embryological origin and vascularisation. Deficiency of cardiac adipose tissue, often due to chronic pathological conditions such as oncological diseases or chronic infectious diseases, predicts increased mortality and morbidity. To date, knowledge about the influence of visceral adipose tissue on cardiac morphology is limited, especially the effect on the morphology of the right heart in a state of excess or deficient visceral adipose tissue. [ABSTRACT FROM AUTHOR]

This study involved the development of an expert system for the pre-diagnosis of hypertension, diabetes mellitus type 2 and metabolic syndrome. The expert system has been developed using web technologies, PHP, Apache and MySQL with CLIPS tool; the expert system includes three algorithms designed by the authors, one for each disease. The objective of this study is to provide an expert system capable of performing a pre-diagnosis for early detection of hypertension, diabetes mellitus type 2 and metabolic syndrome. The methodology to build the system consists in associated risk factors, clinical variables diagnosis criteria based on World Health Organization standards in three algorithms and then develop a program that interacts with users, besides the expert system is compared with the existing expert systems in order to show its originality and innovation. The rules of systems are designed using CLIPS systems and the Architecture Apache, MySQL and PHP for the user interface and database. The system was validated by 72 patient(s) and 3 real doctors, the total result over 72 patient(s) is low risk 16.6 percent, moderate risk 30.5 percent, moderate high risk 13.8 percent, high risk 23.6 percent, very high risk 15.2 percent, and the doctors' feedback was similar to that shown by the system. The number of rules to create the algorithms and the criteria used were adequate and sufficient to obtain the pre-diagnosis of each disease; in addition, the languages used to design and create the web application were stable. All users who used the system obtained similar results to those obtained by doctors. [ABSTRACT FROM AUTHOR]

While weight gain is common following migration to a new country and Mexican Americans have a disparate prevalence of overweight and obesity. In particular, Mexican American women have one of the world's highest rates of Metabolic Syndrome (MetS), characterized by abdominal obesity, insulin resistance, hypertension, and dyslipidemia, all of which increase the risk for atherosclerotic cardiovascular disease (CVD). Although the etiology of this dilemma is not well understood, using the framework of allostatic load (AL), we posit that exposure to multiple physiologic, psychosocial and environmental stressors over the course of the lifespan may contribute to an increased risk of MetS among indigenous Mexican immigrant women. Two such frequently overlooked stressors are: 1) a history of childhood growth stunting (CGS) and 2) dietary changes post migration that result in decreased diversity of the gut microbiome (dysbiosis). To date, little is known about how migration experiences differentially affect the relationship between CGS and MetS in adulthood. The purpose of this theoretical article is to present a proposed model of how early life stressors (ELS), specifically CGS, may interact with insalubrious aspects of the immigration experience to promote an increased risk for MetS among indigenous Mexican immigrant women. This model may be used in a bi-national effort to guide intervention efforts to decrease CGS in Mexico and to prevent, monitor or delay the components of MetS post migration in the US. [ABSTRACT FROM AUTHOR]

This study examines the link between negative work–family spillover and metabolic risk factors over a 9-year period. Data from two waves of the Midlife in the United States Survey were used to explore relationships between negative work–family spillover and four indicators of metabolic syndrome—blood pressure, triglycerides, body mass index, and glucose levels. In a sample of full-time working men and women (N = 630), increased negative spillover at baseline significantly predicted higher body mass index nearly a decade later, with a marginally significant effect for triglyceride levels. Increases in spillover also body mass index and glucose levels at follow-up. This study extends research tying work–life spillover to health and suggests that further investigation is needed to fully understand the long-term effects of work stress. [ABSTRACT FROM AUTHOR]

Introduction: This study was a randomized controlled trial that examined the effects of a web-based expert support self-management program (WEST) on metabolic syndrome risk factors and self-efficacy among Korean women with breast cancer.Methods: Participants were 60 women with breast cancer (30 participants each in both the experimental and control groups) who also had metabolic risk factors. WEST is based on the self-efficacy theory and is a self-health management program consisting of a web-based program, DIETEX (which entails keeping a health diary, identifying a lifestyle type, inputting personal health information), and expert support. WEST was provided to the experimental group once a week for 24 weeks. Metabolic syndrome risk factors and self-efficacy of the experimental and control groups were examined pre-intervention and at 12 and 24 weeks after intervention.Results: The decreases in body fat, body fat percentage, and waist circumference were greater in the experimental group than in the control group at 24 weeks (p = 0.019, p = 0.025, and p = 0.038, respectively).Discussion: The present study can provide basic data for the development and application of interventions for women with breast cancer in the future. Additionally, we propose that WEST be included in the treatment process to complement the intervention of medical personnel for improving metabolic risk factors in women with breast cancer. [ABSTRACT FROM AUTHOR]

Childhood maltreatment is a risk factor for poor physical health outcomes in later life, such as cardiovascular disease and type 2 diabetes. In order to target preventive interventions to reduce this risk, it is important to understand the biological mechanisms linking childhood maltreatment to cardiometabolic disorders. Research reviewed here suggests that maltreated children show alterations in biological systems relating to metabolism and the immune system which could, in turn, increase the risk of long-term cardiometabolic disease risk. Specifically, maltreated children show an elevated risk of obesity in adulthood and greater inflammation levels in adolescence and adulthood. These findings from observational studies of humans are consistent with evidence from experimental animal models showing the causal effects of early life stress on obesity and immune function. To help prevent maltreated children from developing cardiometabolic disease later in life, clinical assessment and treatment should focus on physical as well as mental health. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of type 2 diabetes mellitus (T2DM) and associated metabolic complications lead to the development of a syndrome known as "metabolic syndrome" (MetS), which is considered as one of the major risk factor not only for the development of cardiovascular diseases but also have a great impact on the quality of life. Research Design and Methods: A descriptive, observational study involving the recruitment of patients with T2DM with and without MetS was carried out in outpatient department of endocrinology. The MetS was defined as per the National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III) criteria. Patients with T2DM were screened as per the American Diabetes Association (ADA; ie, fasting blood glucose [FBG] ≥ 126 mg/dL) and who were using oral antidiabetic drugs. Short Form-36 (SF-36) was used to assess the health-related quality of life (HRQoL). Results: Patients were grouped as T2DM with MetS (n = 100) and T2DM without MetS (n = 100). A greater significant decline was observed in physical component summary (PCS) and mental component summary (MCS) in patients with T2DM with MetS as compared to patients without MetS (P ≤.05). Multiple linear regression analysis revealed that in patients with T2DM having MetS, age and waist circumference (WC) are independent predictors for worsening of both PCS and MCS aspects of health-related quality of life (HRQOL). In addition, high triglycerides and raised FBG were found to be correlated with the decline in PCS and MCS, respectively. Conclusion: The study demonstrated that patients with T2DM with MetS have overall poor HRQOL as compared to patients with T2DM without MetS. [ABSTRACT FROM AUTHOR]

Background: Atypical antipsychotics are associated with metabolic complications that contribute to a higher risk of cardiovascular disease. Current evidence reveal suboptimal adherence to the complex and variable official recommendations on metabolic monitoring in the corresponding patient population. A study evaluating metabolic monitoring at guideline-recommended intervals may help identify areas for intervention. Objective: Describe the frequency of monitoring metabolic adverse effects in patients receiving atypical antipsychotics in an outpatient psychiatric clinic with respect to the specific guideline-recommended intervals. Methods: A retrospective chart review was conducted in the outpatient psychiatric clinic. The primary outcome measure was the percentage of patients monitored for metabolic parameters at the current guideline-recommended intervals. The secondary end points were the percentage of patients with documented primary care physician, untreated metabolic comorbidities, and treated metabolic comorbidities by disease state. Results: The most assessed parameters were family history (98%), blood pressure (81%), and body mass index/body weight (83%) at the baseline interval. The least assessed parameters were lipids (14%) at the 12-week interval and waist circumference (0%) at any interval. Conclusion: Interventions are needed to encourage higher compliance with current recommendations. The complexity of the recommendations is the most likely reason for the suboptimal compliance. [ABSTRACT FROM AUTHOR]

With the rapid advancement of omics-based research, particularly big data such as genome- and epigenome-wide association studies that include extensive environmental and clinical variables, data analytics have become increasingly complex. Researchers face significant challenges regarding how to analyze multifactorial data and make use of the findings for clinical translation. The purpose of this article is to provide a scientific exemplar for use of genetic burden scores as a data analysis method for studies with both genotype and DNA methylation data in which the goal is to evaluate associations with chronic conditions such as metabolic syndrome (MetS). This study included 739 African American men and women from the Genetic Epidemiology Network of Arteriopathy Study who met diagnostic criteria for MetS and had available genetic and epigenetic data. Genetic burden scores for evaluated genes were not significant after multiple testing corrections, but DNA methylation at 2 CpG sites (dihydroorotate dehydrogenase cg22381196 pFDR =.014; CTNNA3 cg00132141 pFDR =.043) was significantly associated with MetS after controlling for multiple comparisons. Interactions between the marginally significant CpG sites and burden scores, however, were not significant. More work is required in this area to identify intermediate biological pathways influenced by environmental, genetic, and epigenetic variation that may explain the high prevalence of MetS among African Americans. This study does serve, however, as an example of the use of the genetic burden score as an alternative data analysis approach for complex studies involving the analysis of genetic and epigenetic data simultaneously. [ABSTRACT FROM AUTHOR]

Objective: Unhealthy lifestyle behaviors, such as smoking, drinking, betel-quid chewing, insufficient exercise, and inadequate sleep are significantly correlated with metabolic syndrome (MetS). To further understand this relationship, this study examined the main effect of unhealthy lifestyle behaviors and their interaction on MetS by gender in young adults. Method: A cross-sectional study involving 694 young adults from a national survey was performed in which demographic characteristics, unhealthy lifestyle behaviors, anthropometric measurements, and blood chemistry panels were collected during face-to-face interviews. Results: The prevalence of MetS among young adults was 17.4% and was greater in males than females (19.0% vs. 7.8%). The unhealthy lifestyle-behavior risk factors associated with MetS included smoking (odds ratio [OR] = 4.53) and physical activity (OR = 0.51) among males and betel-quid chewing (OR = 8.90) and less sleep (OR = 0.08) among females. Significant interaction effects were observed between the abovementioned behaviors and gender for the risk of developing MetS. Conclusion: These results can guide health-care providers in reducing MetS risk by encouraging young adult males to reduce or quit cigarette smoking and maintain optimum levels of physical activity and young adult females to quit chewing betel quid and obtain appropriate amounts of sleep. [ABSTRACT FROM AUTHOR]

Differences in sociodemographic variables, health beliefs, and a healthy lifestyle all contribute to the varied prevalence of metabolic syndrome (MetS). We investigated the associations among MetS-related risk factors and performed a cross-sectional study, recruiting 1741 Taiwanese residents aged ≥30 years, between August 2014 and August 2015. Data were obtained on sociodemographic factors, health beliefs, and health-promoting lifestyle profiles using questionnaires. Multivariate analysis revealed that age ≥65 years (odds ratio [OR] = 2.17), low educational level (OR = 1.46), body mass index ≥24 kg/m2 (OR = 9.00), more health responsibility (OR = 1.08), and less exercise (OR = 0.924) were independent risk factors for MetS development. A correlation existed between health beliefs and health-promoting lifestyle profiles, suggesting that the establishment of an effective health-promoting program should consider participants' health beliefs. [ABSTRACT FROM AUTHOR]

The authors reflect on the study by M. Peer and colleagues on adiponectin and aldosterone as independent predictors of left ventricular hypertrophy (LVF). Topics they discussed include the interplay between aldosterone and adiponectin in LVH pathogenesis, the feasibility of aldosterone inhibition and adiponectin increase to benefit LVH patients, and the use of atorvastatin and amlodipine to reverse LVH in hypertension patients.

The association between smoking cessation period and metabolic syndrome (MS) is currently unknown. We studied 6032 men aged >19 years who participated in the Korean National Health and Nutrition Examination Surveys between 2010 and 2012. The risk of MS according to the amount of smoking and duration of smoking cessation was examined, and adjusted for age, amount of alcohol consumed, physical activity, body mass index, income, and education levels. Compared with never-smokers, there was a significant increase in the risk of MS among current smokers >10 pack-years and former smokers with a history of pack-years >30. The odds ratio for MS increased with smoking amount in both current and former smokers. But the risk of MS in former smokers was no longer significant after 20 years of smoking cessation adjusted for past smoking amount. Thus, to prevent MS, current smokers should quit smoking early and former smokers should continue quitting. [ABSTRACT FROM AUTHOR]

Aims: The main aim of the present study was to investigate the clustering of risk factors for cardiovascular diseases and metabolic syndrome in a large, healthy representative Norwegian child population. Methods: From a population of 2817, parents of 2297 children agreed to participate. Values of waist circumference (WC), total cholesterol (TC), high-density lipoprotein (HDL), systolic blood pressure (sysBP), haemoglobin-A1c (HbA1c) and Andersen aerobic fitness test were used to test clustering of cardiometabolic risk factors in this sample. Expected distributions of probability for zero to five risk factors are, respectively, 23.7%, 39.6%, 26.4%, 8.8%, 1.5% and 0.1%. A cardiometabolic risk score from zero to five for each individual was derived by adding the number of variables in the least desirable quartile (highest for WC, sysBP, TC and HbA1c; lowest for aerobic fitness and HDL). Results: A risk ratio of 5.8 (95% confidence interval 0.7–46.9) was found for five risk factors, though the small sample size rendered the results non-significant. An explorative analysis combining children with four and five risk factors did not reveal any significant clustering either. Conclusions: No clustering of risk factors was found among Norwegian children aged 6–12 years. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the association between life-course exposure to snus and prevalence of the metabolic syndrome and its components in adulthood. Design and method: Tobacco habits at baseline (age 16) and three follow-ups (ages 21, 30 and 43) were assessed among 880 participants in a population-based cohort in Northern Sweden. Presence of the metabolic syndrome at age 43 was ascertained using the International Diabetes Federation criteria. Odds ratios and CIs for risk of the metabolic syndrome and its components by snus use at 16, 21, 30 and 43 years were calculated using logistic regression. Cumulative snus use was defined as number of life periods (1–4) with current snus use. Results: At age 43, 164 participants (18.6%) were current snus users. We found no association between exclusive snus use at the ages of 16, 21, 30 and 43 years and the metabolic syndrome at age 43 years. Snus use (among non-smokers) was associated with raised triglycerides and high blood pressure in crude analysis, but not in multivariable models. There was no association between cumulative snus use and risk of the metabolic syndrome. Cumulative snus use was associated with central obesity, raised triglycerides and impaired fasting glucose/diabetes mellitus type 2 in crude analyses, but not after adjustments. Conclusions: The health consequences of snus exposure from adolescence to mid-adulthood do not seem to include increased risk of the metabolic syndrome or its components. The cardio-metabolic risk of dual exposure to snus and cigarettes may warrant further attention. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the author discuss issue on topics including role of perirenal fat as an emerging cardiovascular risk factor, the risk of coronary heart disease, and absence of alcohol abuse or other chronic liver diseases.

The purpose of the study is to assess the relationship between the prevalence of metabolic syndrome–related risk factors and work tenure among office workers. A 10-year cohort analysis was conducted using employees’ health examinations given to new employees within 1 or 2 years of joining the firm and every 5 years thereafter. Age-adjusted odds ratios (95% confidence interval [CI], p < .05) were calculated based on a contrast test with general estimating equations. Specifically, the age-adjusted odds ratios and CIs of those with 20 ± 1 years of work, compared with those with 1 to 2 years of work, were as follows: triglycerides (≥150 mg/dl) 3.01 (2.11, 4.28), waist circumference (male ≥90 cm) 2.70 (1.63, 4.45), and fasting glucose (≥100 mg/dl) 2.67 (1.78, 4.01). The findings of the relationship between metabolic syndrome risk and work tenure as well as the baseline health data of new employees provide a foundation for developing a workplace health management system. [ABSTRACT FROM AUTHOR]

Metabolic syndrome is a continuing problem in the United States, and the Hispanic population is at increased risk of developing complications from this disease process. Many of the workers at a South Jersey yacht-building company are Hispanic, and a culturally sensitive education program was implemented to improve their overall health. Program assessments included the Latino Dietary Behavior Questionnaire (LDBQ), anthropomorphic measurements, and laboratory studies both pre and post intervention. The intervention included a Spanish-language lecture on metabolic syndrome and healthy nutrition, followed by an interactive culturally appropriate cooking demonstration for the participants and their significant others. Program participants showed reductions in body mass index, blood pressure, lipid levels, and hemoglobin A1c, and more knowledge of healthy nutrition as measured by the LDBQ. This finding supports culturally sensitive education programs to improve the health of Hispanic populations. [ABSTRACT FROM AUTHOR]

Background: Atypical antipsychotic medications increase the risk of developing metabolic syndrome (MetS) and cardiovascular diseases in people with schizophrenia. Aim: To explore the prevalence of MetS and the predictors associated with the number of MetS components in people with chronic schizophrenia. Methods: We recruited 357 participants from 10 rehabilitation wards in northern Taiwan. The Beck Anxiety Inventory, Beck Depression Inventory-II, Health-Promoting Lifestyle Profile (HPLP), and modified Baecke physical activity questionnaire were used to evaluate the participants. MetS prevalence was calculated using the modified Adult Treatment Panel III criteria for Asians. Results: The prevalence of MetS in this sample was 37.8%. Multinomial logistic regression revealed that the HPLP-exercise score (odds ratio [OR] = 0.411, p = .002) and depressive symptoms (OR = 0.949, p = .040) were protective factors for ≥4 MetS components. The leisure physical activity level (OR = .536, p = .024) was a protective factor for three MetS components. Body mass index ≥24 kg/m2 was the strongest risk factor for two MetS components (OR = 8.057, p < .001), three MetS components (OR = 11.287, p < .001), and ≥four MetS components (OR = 15.621, p < .001). Additionally, participants’ age >40 (OR = 3.638, p = .012) was a risk factor for ≥four MetS components. Conclusion: In this study, the prevalence of MetS was higher than that reported for patients utilizing community-based services in Taiwan. The important risk factors for MetS were being overweight and older than 40. The protective factors for MetS were a high HPLP-exercise score and leisure-based physical activities. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance plays a determinant role in the development of metabolic syndrome in adolescents. The objective of the present study was to determine the influence of factors commonly associated with insulin resistance in a sample of adolescents. Methods: This cross-sectional study included 976 adolescents from southeast Spain. Anthropometric and biochemical measurements were performed, and insulin resistance was assessed using the homeostasis model assessment–insulin resistance (HOMA-IR). Results: Subjects with abnormal HOMA-IR values had significantly higher body mass index (BMI), body fat content, waist circumference, and systolic blood pressure (BP) than those with normal values. Furthermore, levels of glucose, insulin, glycosylated hemoglobin, total cholesterol, triglycerides, low-density lipoprotein-cholesterol, homocysteine, nonesterified fatty acids, and ceruloplasmin were higher in subjects with abnormal HOMA-IR values. Multivariate logistic regression analysis showed the highest odds ratio (OR) for BMI and that combinations of BMI with body fat content or systolic BP can increase the risk of insulin resistance 7-fold. Discussion: Anthropometric indicators have different levels of influence on the risk of insulin resistance in adolescents, and a combination of two of these indicators is enough to increase the risk 7-fold. Since the highest OR was observed for BMI, the greatest effort should be directed to reducing this parameter in adolescents. An adequate understanding by nursing personnel of factors associated with insulin resistance is a key factor in the prevention of this pathophysiological condition and its complications in adolescents. [ABSTRACT FROM AUTHOR]

Purpose: Filipino Americans (FAs) are at high risk for cardiovascular disease. The purpose of this literature review is to enhance understanding of cardiovascular health among FAs. Design: Databases searched: MEDLINE (via PubMed), Google Scholar, Journals@OVID, and EBSCO databases including CINAHL Complete. Health Source: Nursing/Academic Edition, Academic Search Complete, and Biological Abstracts 1969-Present. Key terms used: FAs and cardiovascular disease. Criteria for inclusion: peer-reviewed empirical articles published in English. Findings/Results: A total of 51 studies were identified and 27 were selected for the review based on relevance to nursing care for FAs. Three main themes emerged from the literature reviewed: risk factors and disease prevalence, health promotion, and health beliefs/practices. Discussion/Conclusions: The literature review identified that FAs were at high risk for cardiovascular disease, hypertension, type 2 diabetes, and metabolic syndrome at lower BMI levels. Implications for Practice: Health care providers should implement prevention strategies and interventions for the FA population to ensure the best outcomes. [ABSTRACT FROM AUTHOR]

γ-glutamyltransferase plays a key role in the synthesis and metabolism of extracellular glutathione, a major antioxidant in several defence mechanisms in the body. γ-glutamyltransferase is affected by environmental and genetic factors, and is raised when there is depletion of glutathione. Hence, it is a marker of oxidative stress. There is robust evidence that γ-glutamyltransferase even when values are within the reference interval is associated with increased cardiovascular and all-cause mortality in both sexes, in normal subjects and subjects with coronary artery disease, in the middle-aged and the elderly after adjusting for confounding factors. γ-glutamyltransferase even within the reference interval is associated with future presentation of type 2 diabetes, and the longitudinal increase in γ-glutamyltransferase activity is associated with increased risk of type 2 diabetes and cardiovascular mortality. γ-glutamyltransferase is associated with cardiovascular risk factors and metabolic syndrome. It has a prognostic value after a previous acute myocardial infarction and may be an indicator of adverse outcome in acute coronary syndromes and other chronic cardiac disorders. There is limited data about γ-glutamyltransferase and any association with peripheral arterial disease and also whether knowing γ-glutamyltransferase activity improves cardiovascular risk prediction beyond conventional risk factors. γ-glutamyltransferase is present in atherosclerotic lesions in the coronary and carotid arteries, and has a prooxidant role leading to the production of reactive oxygen species and atherosclerosis. Current reference intervals for γ-glutamyltransferase are inappropriate and need to be addressed. Some laboratories still use non- International Federation of Clinical Chemistry methods for estimation of γ-glutamyltransferase which are associated with lower results. Such laboratories should review their method and consider changing to the International Federation of Clinical Chemistry method. [ABSTRACT FROM AUTHOR]

Purpose Cytotoxic treatment may cause weight gain and important alterations in the metabolic status of breast cancer (BC) patients. The aim of this study was to investigate the changes in metabolic and anthropometric parameters of patients with BC who received adjuvant chemotherapy. Methods All consecutive women treated with adjuvant TAC (docetaxel 75 mg/m2, doxorubicine 50 mg/m2, cyclophosphamide 500 mg/m2) chemotherapy for node-positive breast carcinoma at our Institution between 2008 and 2010 were included. Results Among 104 patients, 84 of them were stage II and 20 of them were stage III. When we compared the measurements between 1st and 6th adjuvant chemotherapy, we observed statistically significant increases in weight and serum triglyceride levels, and decreases in high density lipoprotein, apolipoprotein A-1, transferrin, albumin and prealbumin levels. An elevation of follicle stimulating hormone, luteinizing hormone together with the decrease of estradiol was detected. Waist-to-hip ratio has also increased significantly. In subgroup analyses, we observed dramatic changes in body mass index in pre-menopausal women whereas no significant change was seen in the post-menopausal group. Conclusions Adjuvant chemotherapy may contribute to an increased risk for metabolic syndrome in patients with BC and these changes are more profound in pre-menopausal patients. [ABSTRACT FROM AUTHOR]

Objectives Metabolic syndrome (MetS) is highly prevalent in patients with systemic lupus erythematosus (SLE) and it has been associated with increased cardiovascular risk. We examined the contribution of MetS to inflammatory markers, arterial stiffness and circulating endothelial progenitor cells (EPCs) as surrogates of subclinical atherosclerosis. Methods Cardiovascular risk factors, SLE-specific factors and peripheral blood EPCs were assessed in 50 female SLE patients. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III. Simultaneously, atherosclerosis was assessed by measuring the carotid–femoral pulse wave velocity (PWV) by doppler velocimetry. Results Beyond the factors included in the definition, SLE patients with MetS have a significantly higher serum level of uric acid (6.88 ± 2.20 vs 4.45 ± 1.17, p < 0.001) and some inflammatory biomarkers such as homocysteine, IL-8, sICAM-1 or complement molecules. The presence of MetS in our patients was closely linked with a significantly increased patient organ damage score (3.20 ± 1.97 vs 1.60 ± 1.67, p = 0.008), a decreased percentage of circulating EPCs (0.53 ± 0.24 vs 0.85 ± 0.57, p = 0.007) and an increased arterial stiffness (9.89 ± 2.40 vs 7.13 ± 1.51, p < 0.001). Conclusions MetS may contribute to the development of atherosclerosis by significantly increasing inflammation levels and arterial stiffness and decreasing circulating EPCs. This finding would justify close monitoring of these patients. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between cardiometabolic risk (percent body fat [BF%], triglycerides [TG], high-density lipoprotein [HDL]-cholesterol, hemoglobin A1c [HbA1c]), socio-psychological factors (education and self-rated health [SRH]), and trajectories of grip strength (GS) in older adults. Method: Longitudinal 8-year data from 1,381 Japanese adults aged 65 years or above were analyzed using hierarchical linear models, stratified according to gender. Results: GS declined following a linear trajectory. In both genders, higher BF% was associated with weaker GS, but not with the rate of decline. GS trajectory did not correlate with baseline TG, HDL-C, or HbA1c. Cardiometabolic factors mediated educational differences in GS intercept in both genders. In women, better SRH predicted stronger GS. The effect of SRH was robust to adjustments for cardiometabolic risk. Discussion: In older adults, GS and its rate of decline are selectively associated with both cardiometabolic risk and socio-psychological characteristics. Cardiometabolic risk mediates educational disparities in GS but not differences in subjective assessments of health. [ABSTRACT FROM AUTHOR]

The article presents a reply to comments made by Mehmet Agilli et al on prealbumin where they emphasized the importance of differential effects on prealbumin and acknowledged that some accompanying condition and medications may influence the results of the authors' study. The authors note that none of the patients in their study received hormone replacement therapy including estrogens and progestational agents and any anaboliic steroids.

This article reviews the results of a school-based self-management intervention for Chinese obese children at risk for metabolic syndrome. Twenty-eight Chinese obese children (M age = 10 years) and their parents participated in the study. Metabolic syndrome risk factors were measured pre- and post-intervention. The risk factors included Body Mass Index, waist circumstance, systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, High-sensitivity C-reactive Protein, fasting plasma glucose, and fasting blood insulin. After 6 months of school-based self-management intervention, all risk factors with the exception of triglycerides and fasting plasma glucose changed significantly in the healthful direction (p < 0.01). This pilot study offers promising implications for school interventions that are delivered by school-based practitioners collaborating with parents, teachers, and children. An individualized program based on a self-care and -management framework may have utility as a relatively cost-effective, school-based intervention to improve children’s health. [ABSTRACT FROM PUBLISHER]

The United States is experiencing its greatest life expectancy ever. Nonetheless, the general health of the US population is far from at an all-time high. An important contributor to the pandemic of cardiovascular disease is that overweight and obesity are also the major determinants of metabolic syndrome, an all too common and all too serious clinical and public health challenge. Clinicians have traditionally evaluated each of the major risk factors contributing to metabolic syndrome on an individual basis. There is evidence, however, that the risk factors are more than additive. The overlap of these factors in each disease state, resulting in increased atherogenic risks, is worth examining as a broader entity rather than separately. While therapeutic lifestyle changes (TLCs) should be strongly recommended, clinicians should not let the perfect be the enemy of the possible. Evidence-based doses of statins, aspirin and angiotensin-converting enzyme inhibitors, or angiotensin II receptor blockers should be prescribed as adjuncts, not alternatives, to TLCs. In fact, there is cogent evidence that the benefits of these pharmacologic therapies may also be at least additive. [ABSTRACT FROM AUTHOR]