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Metabolic Syndrome (metabolic + syndrome)
Terms modified by Metabolic Syndrome Selected AbstractsMETABOLIC SYNDROME AND PHYSICAL ACTIVITY IN SOUTHERN BRAZILIAN COMMUNITY-DWELLING ELDERLY PEOPLEJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2008Roberta R. Dalacorte MD No abstract is available for this article. [source] INCREASED SYSTEMIC OXIDATIVE AND NITRATIVE STRESS IN A NEW CONGENIC MODEL OF METABOLIC SYNDROME DERIVED FROM STROKE-PRONE SPONTANEOUSLY HYPERTENSIVE RATS AND ZUCKER FATTY RATSCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 2007Yu Yamaguchi SUMMARY 1Oxidative stress has been recognized as an important factor in the biology of lifestyle-related diseases. Systemic oxidative stress may increase in metabolic syndrome characterized by a cluster of metabolic risk factors. To confirm this hypothesis, we investigated systemic oxidative/nitrative stress in a new congenic model of metabolic syndrome, namely SHRSP/ZF rats, which are derived from stroke-prone spontaneously hypertensive (SHRSP) and Zucker fatty (Zucker) rats. 2The SHRSP/ZF rats display obesity, hypertension, hyperlipidaemia, hyperglycaemia and glucose intolerance. At 6 weeks of age, SHRSP/ZF rats already showed increases in serum levels of thiobarbituric acid-reactive substances (TBARS) and oxidatively modified low-density lipoprotein (Ox-LDL) compared with lean SHRSP littermates and Zucker rats, whereas serum levels of 8-hydroxy-2,-deoxyguanine (8-OHdG), 3-nitrotyrosine, 3-chlorotyrosine and high-sensitivity C-reactive protein (hsCRP), an inflammatory marker, did not differ significantly among the three rat strains. However, levels of these oxidative/nirative stress markers in SHRSP/ZF rats, as well as in SHRSP, increased gradually with age. After 36 weeks of age, the levels of TBARS, 8-OHdG, 3-nitrotyrosine and hsCRP in SHRSP/ZF rats increased rapidly and three of six rats died thereafter. Increased oxidative/nitrative stress may be associated with death in these rats. 3Our findings indicate that systemic oxidative/nitrative stress is evidently increased in metabolic syndrome. [source] RELATIONSHIP BETWEEN ARTERIAL STIFFNESS AND GLUCOSE METABOLISM IN WOMEN WITH METABOLIC SYNDROMECLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 9 2006Paul Nestel SUMMARY 1Cardiovascular risk factors associated with the metabolic syndrome affect vascular functions adversely. The aim of the present study was to assess the relationship between parameters of glucose homeostasis and arterial stiffness in women with characteristics of the metabolic syndrome. 2Twenty post-menopausal women participated in a cross-sectional study in which systemic arterial compliance (SAC) and plasma glucose, lipids and glycosylated haemoglobin (HbA1c) were measured while subjects were maintained on a diet high in fibre, raised in protein and reduced in saturated fat. 3Regression analysis suggested that mean ( SD) fasting glucose of 5.9 ± 1.7 mmol/L, glucose levels 2 h after a 75 g glucose load of 6.8 ± 3.6 mmol/L, systolic blood pressure of 131 ± 12 mmHg and HbA1c of 5.3 ± 1.7% predicted SAC negatively. The following correlations were obtained between SAC and: (i) fasting glucose: R = -0.49, P = 0.028; (ii) 2 h glucose level post-glucose load: R = -0.42, P = 0.064; (iii) HbA1c: R = -0.42, P = 0.056; and (iv) systolic blood pressure: R = -0.55, P = 0.012. 4Relationships between SAC and fasting glucose and systolic blood pressure were significantly independent of each other. There was no evidence of relationships between SAC and any plasma lipid parameter (other than a trend in relation to plasma triglyceride), bodyweight or waist circumference. 5In conclusion, in post-menopausal women with metabolic syndrome, fasting plasma glucose and systolic blood pressure, and possibly HbA1c and the 2 h glucose post-glucose load, predicted increased arterial stiffness. [source] Diabetic Nephropathy, Chronic Kidney Disease and Metabolic Syndrome in Type 2 Diabetes: answers or more questions?DIABETIC MEDICINE, Issue 12 2008P. A. Senior No abstract is available for this article. [source] C-reactive protein, its role in inflammation, Type 2 diabetes and cardiovascular disease, and the effects of insulin-sensitizing treatment with thiazolidinedionesDIABETIC MEDICINE, Issue 8 2004R. Nesto Abstract Increased concentrations of the marker of inflammation, C-reactive protein (CRP), are associated with insulin resistance, Type 2 diabetes and the development of cardiovascular disease. In particular, inflammation is closely associated with endothelial dysfunction and is recognized as one of the cardiovascular risk factors clustering in the Insulin Resistance Syndrome or Metabolic Syndrome. The exact mechanisms linking insulin resistance and inflammation remain unclear. However, the close association between insulin resistance and inflammation in atherogenesis suggests that therapies that address both parameters may have benefits in reducing diabetes-related macrovascular complications. The thiazolidinedione class of oral anti-diabetic agents are powerful insulin sensitizers that also have anti-inflammatory properties. Treatment with these agents has a range of anti-atherogenic effects, including reduced levels of CRP, plasminogen activator inhibitor-1 (PAI-1), TNF-, and reactive oxygen species. Additionally, the insulin-sensitizing effect of thiazolidinediones improves other factors of the Insulin Resistance Syndrome, including dyslipidaemia and hypertension. Outcome studies are underway to determine if the effects of improving insulin sensitivity and reducing inflammation will translate into clinical benefits and reduce the cardiovascular morbidity and mortality associated with insulin resistance and Type 2 diabetes. [source] Trends and opportunities in the metabolic syndromeDRUG DEVELOPMENT RESEARCH, Issue 7 2006John H. "Wick" JohnsonArticle first published online: 16 NOV 200 Abstract Metabolic Syndrome consists of a multifactoral set of indications and, unfortunately, definitions. There is, at present, no consensus definition for Metabolic Syndrome and physicians who recognize the syndrome use different definitions. Some of the major stakeholder associations do not believe that Metabolic Syndrome is an approvable indication and no regulatory agency has weighed in on the matter. This has been the cause of confusion among many physicians resulting in different emphasis on intervention. However, there is close agreement between physicians surveyed in major markets as to the top three indications. The largest unmet medical need among these indications is obesity and obesity represents the largest opportunity. However, any single NCE or combination of existing drugs that can treat 3 indications will be a major advance. Any therapy will be an intervention and will have to have a very clean safety profile. Morbidity and mortality studies with existing therapies and combinations will be needed to establish outcomes. Drug Dev. Res. 67:539,544, 2006. © 2006 Wiley-Liss, Inc. [source] The metabolic syndrome and the clinicianDRUG DEVELOPMENT RESEARCH, Issue 7 2006Daniel Einhorn Abstract The diagnosis of the Metabolic Syndrome is somewhat controversial, with many definitions and some arguments as to the need for a diagnosis. From the viewpoint of clinical medicine, however, the concept is highly useful in organizing our interest in prevention of the consequences of this condition. Drug Dev. Res. 600,601, 2006. © 2006 Wiley-Liss, Inc. [source] Metabolic Syndrome and Cardiovascular Disease in Older People: The Cardiovascular Health StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2006Ann Marie McNeill PhD OBJECTIVES: To assess the prospective association between metabolic syndrome (MetS) and cardiovascular disease (CVD) in older people and to evaluate the effect of lowering the threshold for impaired fasting glucose (IFG) on the prevalence of IFG and MetS and the risk of CVD. DESIGN: Prospective cohort study. SETTING: Four field centers in U.S. communities. PARTICIPANTS: Three thousand five hundred eighty-five subjects in the Cardiovascular Health Study free of diabetes mellitus and CVD at baseline (mean age 72, 62% female, 14% black). MEASUREMENTS: Baseline measures of MetS components and adjudicated incident CVD events. MetS (2001) was defined first using the original criteria from the Third Adult Treatment Panel Report of the National Cholesterol Education Program (,3 of the following: large waist circumference (women >88 cm, men >102 cm), elevated triglycerides (,1.70 mmol/L), low high-density lipoprotein cholesterol (men <1.04 mmol/L, women <1.30 mmol/L), elevated fasting glucose (6.1,6.9 mmol/L), and high blood pressure (,130/85 mmHg or self-reported use of medications for hypertension). Subjects were also classified according to the revised definition of the MetS (2005) that applies the lower threshold for fasting glucose (5.6,6.9 mmol/L). RESULTS: During follow-up (median 11 years), 818 coronary heart disease (CHD), 401 stroke, and 554 congestive heart failure (CHF) events occurred. Age- and race-adjusted hazard ratios (HRs) for CHD, stroke, and CHF were 1.30 (95% confidence interval (CI)=1.07,1.57), 0.94 (95% CI=0.73,1.21), and 1.40 (95% CI=1.12,1.76) for women and 1.35 (95% CI=1.10,1.66), 1.51 (95% CI=1.08,2.12), and 1.47 (95% CI=1.14,1.90) for men, respectively. Overall, women and men with MetS (2005) were 20% to 30% more likely to experience any CVD event than subjects without MetS (2005). Using the lower cut-point for IFG resulted in a near tripling in IFG prevalence (16% to 46%) and an additional 9% classified with MetS (2005) but HRs similar to those estimated from the original MetS (2001) criteria. High blood pressure was the component most strongly associated with incident CHD. CONCLUSION: Results from this study of an elderly, population-based cohort provide support for earlier investigations in primarily middle-aged populations that link the presence of MetS with the development of CVD and further underscore the importance of recognizing and treating its individual components, particularly high blood pressure. [source] Letter to the Editor: Aldosterone Antagonist Decreases Blood Pressure and Improves Metabolic Parameters in Obese Patients With the Metabolic SyndromeJOURNAL OF CLINICAL HYPERTENSION, Issue 9 2010Monica Barros Costa MD No abstract is available for this article. [source] Vascular Function Measured by Fingertip Thermal Reactivity Is Impaired in Patients With Metabolic Syndrome and Diabetes MellitusJOURNAL OF CLINICAL HYPERTENSION, Issue 11 2009Naser Ahmadi MD Digital thermal monitoring (DTM) of vascular function has already been shown to correlate well with coronary artery calcium (CAC) score and coronary artery disease. To determine its utility in the metabolic syndrome (MS) and diabetes mellitus (DM), 233 asymptomatic patients with DM/MS but without coronary artery disease underwent DTM during and after 5 minutes of supra-systolic arm cuff inflation, as well as CAC. Post-cuff deflation adjusted temperature rebound (aTR) was lower in MS and DM compared with the normal group. The odds ratio of lowest vs upper 2 tertiles of aTR was 2.3 for MS and 3.5 for DM compared with the normal group, independent of age, sex, and risk factors. The area under the receiver operating characteristic curve to predict CAC ,100 was 0.69 for metabolic status (DM/MS), 0.79 for aTR, and 0.87 for both. This study demonstrates that vascular dysfunction measured by DTM is associated with DM/MS and could potentially be used to detect asymptomatic individuals with increased subclinical atherosclerosis. [source] Secondary Hypertension: Obesity and the Metabolic SyndromeJOURNAL OF CLINICAL HYPERTENSION, Issue 7 2008Gregory M. Singer MD The epidemic of obesity in the United States and around the world is intensifying in severity and scope and has been implicated as an underlying mechanism in systemic hypertension. Obese hypertensive individuals characteristically exhibit volume congestion, relative elevation in heart rate, and high cardiac output with concomitant activation of the renin-angiotensin-aldosterone system. When the metabolic syndrome is present, insulin resistance and hyperinsulinemia may contribute to hypertension through diverse mechanisms. Blood pressure can be lowered when weight control measures are successful, using, for example, caloric restriction, aerobic exercise, weight loss drugs, or bariatric surgery. A major clinical challenge resides in converting short-term weight reduction into a sustained benefit. Pharmacotherapy for the obese hypertensive patient may require multiple agents, with an optimal regimen consisting of inhibitors of the renin-angiotensin-aldosterone system, thiazide diuretics, ,-blockers, and calcium channel blockers if needed to attain contemporary blood pressure treatment goals. [source] Microalbuminuria, Chronic Renal Disease, and the Effects of the Metabolic Syndrome on Cardiovascular EventsJOURNAL OF CLINICAL HYPERTENSION, Issue 7 2007Marvin Moser MD In March 2007, a panel discussion was held following a hypertension symposium in New York, New York. The panel was moderated by Marvin Moser, MD, Clinical Professor of Medicine at the Yale University School of Medicine, New Haven, Connecticut. Serving on the panel were James R. Sowers, MD, Professor of Medicine and Physiology at the University of Missouri, Columbia, Missouri, and Henry R. Black, MD, Clinical Professor of Medicine at the New York University School of Medicine, New York, New York. This expert panel discussion was supported by Novartis and each author received an honorarium from Novartis for time and effort spent participating in the discussion and reviewing the transcript for important intellectual content prior to publication. The authors maintained full control of the discussion and the resulting content of this article; Novartis had no input in the choice of topic, speakers, or content. [source] Metabolic syndrome, its preeminent clusters, incident coronary heart disease and all-cause mortality , results of prospective analysis for the Atherosclerosis Risk in Communities studyJOURNAL OF INTERNAL MEDICINE, Issue 1 2007Y. Hong Abstract. Objective., To investigate the prospective association between Metabolic Syndrome (MetS) and coronary heart disease (CHD) and all-cause mortality. Subjects and Design., A bi-racial cohort of 14 699 middle-aged Americans from the Atherosclerosis Risk in Communities study were followed for the development of new CHD and death over a period of 9 years. MetS, using the original ATP-III criteria, was defined as having at least three of the following components: elevated blood pressure (BP), elevated plasma glucose, elevated blood triglyceride (TG), increased waist circumference, and low HDL cholesterol (HDL-c). Incident CHD cases included hospitalized myocardial infarction (MI), fatal CHD, revascularization procedures, and silent MI as detected by EKG. Results., The prevalence of the MetS at baseline was 29%, 30%, 40% and 26% among CHD-free white women, white men, black women, and black men, respectively. There were 1018 incident CHD cases and 1039 deaths. The relative risk (RR) and 95% confidence interval (CI) of incident CHD associated with MetS was 2.46 (1.99, 3.03) for women and 1.86 (1.59, 2.18) for men. Clear dose,response relationship between the number of MetS components and incidence of CHD was found (P for linear trend <0.001). The following three clusters of MetS components posed the highest risk for CHD: (i) the elevated BP and glucose and low HDL-c group [RR = 5.68 (3.44, 9.37)]; (ii) the elevated BP and glucose and TG group [RR = 5.08 (2.96, 8.70)]; and (iii) the elevated BP and TG and low HDL-c group [RR = 3.98 (2.75, 5.77)]. When all five components co-existed, the risk was the highest [RR = 6.24 (4.65, 8.36)]. Similar results with attenuated RR were found for all-cause mortality. Conclusions., Individuals, especially women, with the MetS have significantly higher risk of developing CHD. The riskiest combination is high-BP and glucose clustered with low HDL-c or high TG. These data highlight the importance of targeting MetS in the prevention of CHD and premature death. [source] Integrating the Principles of Evidence-Based Practice: Prognosis and the Metabolic SyndromeJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2004APRN-C, Mary Jo Goolsby EdD Current health care trends and pressures have based decision making and practice of practitioners. Evidence-based practice has evolved in response to these trends. Evidence-based practice requires providers to be proficient in statistical analysis and critique of the evidence. This article user a hypothetical patient's prognostic concerns to depict a practitioner's integration of the principles of evidence-based practice as she considers clinical practice guidelines, expert opinion, and a prognostic study relative to her patient's prognosis. Statistical measures evident in a prognostic study, such as a absolute risk, baseline risk, relative risk, survival curves, and hazard ratios are defined. [source] Impact of Chronic Anticholesterol Therapy on Development of Microvascular Rarefaction in the Metabolic SyndromeMICROCIRCULATION, Issue 8 2009Adam G. Goodwill ABSTRACT Objective: The obese Zucker rat (OZR) model of the metabolic syndrome is partly characterized by moderate hypercholesterolemia, in addition to other contributing comorbidities. Previous results suggest that vascular dysfunction in OZR is associated with chronic reduction in vascular nitric-oxide (NO) bioavailability and chronic inflammation, both frequently associated with hypercholesterolemia. As such, we evaluated the impact of chronic cholesterol-reducing therapy on the development of impaired skeletal muscle arteriolar reactivity and microvessel density in OZR and its impact on chronic inflammation and NO bioavailability. Materials and Methods: Beginning at seven weeks of age, male OZR were treated with gemfibrozil, probucol, atorvastatin, or simvastatin (in chow) for 10 weeks. Subsequently, plasma and vascular samples were collected for biochemical/molecular analyses, while arteriolar reactivity and microvessel network structure were assessed by using established methodologies after 3, 6, and 10 weeks of drug therapy. Results: All interventions were equally effective at reducing total cholesterol, although only the statins also blunted the progressive reductions to vascular NO bioavailability, evidenced by greater maintenance of acetylcholine-induced dilator responses, an attenuation of adrenergic constrictor reactivity, and an improvement in agonist-induced NO production. Comparably, while minimal improvements to arteriolar wall mechanics were identified with any of the interventions, chronic statin treatment reduced the rate of microvessel rarefaction in OZR. Associated with these improvements was a striking statin-induced reduction in inflammation in OZR, such that numerous markers of inflammation were correlated with improved microvascular reactivity and density. However, using multivariate discriminant analyses, plasma RANTES (regulated on activation, normal T-cell expressed and secreted), interleukin-10, monocyte chemoattractant protein-1, and tumor necrosis factor alpha were determined to be the strongest contributors to differences between groups, although their relative importance varied with time. Conclusions: While the positive impact of chronic statin treatment on vascular outcomes in the metabolic syndrome are independent of changes to total cholesterol, and are more strongly associated with improvements to vascular NO bioavailability and attenuated inflammation, these results provide both a spatial and temporal framework for targeted investigation into mechanistic determinants of vasculopathy in the metabolic syndrome. [source] Vitamin D Status and the Metabolic SyndromeNUTRITION REVIEWS, Issue 11 2006Ligia A. Martini PhD ABSTRACT The identification of vitamin D receptor expression in different tissues suggests a widespread role for vitamin D action beyond its classical function in bone and mineral metabolism. Recently, the importance of vitamin D status as a risk factor in the development of metabolic syndrome has been the focus of several studies [source] Genetic studies of common types of obesity: a critique of the current use of phenotypesOBESITY REVIEWS, Issue 8 2010M. J. Müller Summary Recent research into the genetic basis of obesity has focused upon the study of candidate genes, both functional and positional, of genes underlying weight-related Mendelian disorders and of susceptibility loci identified in genome-wide association studies. Three large genome-wide association studies on obesity, together involving more than 150 000 individuals, were published in Nature Genetics last year. The results suggested the involvement of a large number of genetic variants in disease susceptibility. Most genetic effects upon body weight are likely to become obscured by the use of inappropriate phenotypes. In particular, clinical categories such as the body mass index and Metabolic Syndrome do not provide sufficient etiological information for them to be used sensibly in genetic studies on obesity or obesity-related disease. Alleviation of this situation will not come from new genomic research tools, sophisticated statistical algorithms or ever larger sample sizes. Instead, the above notions argue in favour of so-called ,deep phenotyping'. [source] The Impact of the Components of Metabolic Syndrome on Heart Rate Variability: Using the NCEP-ATP III and IDF DefinitionsPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 5 2008KYOUNG-BOK MIN M.D., Ph.D. Background: This study examined the relationship between metabolic syndrome (MetS) and heart rate variability (HRV) in Korean adults. Methods: Data were collected from family health examinations performed from December 2003 through January 2004, and 1,041 subjects consisting of males and females aged 20,87 years were included in this study. Measurement of the 5-minute HRV and several examinations for MetS were completed. The HRV was analyzed in both the time domain with the standard deviation of NN (SDNN) intervals and the frequency domain with the low frequency (LF) and high frequency (HF) components. MetS was defined by the criteria of the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation (IDF). Results: There were significant differences in the MetS components and HRV indices between the two groups (with vs without MetS). The adjusted means of the HRV indices in the group with MetS were significantly lower than those in the group without MetS (P < 0.05). Furthermore, a significant negative correlation was found between all components of MetS and the HRV indices; additionally, as the number of MetS components increased, the HRV indices gradually decreased. Conclusions: Decreased cardiac autonomic tone was strongly associated with an increased cardiovascular risk, and HRV measurement could become an indispensable part of evaluating one's risk of cardiovascular disease, though we currently do not have sufficient information to identify the cutoff values for the HRV indices. [source] Type 2 diabetes, cardiovascular disease, and the evolutionary paradox of the polycystic ovary syndrome: A fertility first hypothesisAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2009Stephen J. Corbett Worldwide, the high prevalence of the Polycystic Ovary Syndrome (PCOS), a heritable cause of ovarian infertility, is an evolutionary paradox, which provides insight into the susceptibility of well-fed human populations to cardiovascular disease and diabetes. We propose that PCOS, Type 2 diabetes (T2D) and the Metabolic Syndrome are modern phenotypic expressions of a metabolic genotype attuned to the dietary and energetic conditions of the Pleistocene. This metabolic "Fertility First" rather than "Thrifty" genotype persisted at high prevalence throughout the entire agrarian period,from around 12,000 years ago until 1800 AD,primarily, we contend, because it conferred a fertility advantage in an environment defined by chronic and often severe seasonal food shortage. Conversely, we argue that genetic adaptations to a high carbohydrate, low protein agrarian diet, with increased sensitivity to insulin action, were constrained because these adaptations compromised fertility by raising the lower bound of body weight and energy intake optimal for ovulation and reproduction. After 1800, the progressive attainment of dietary energy sufficiency released human populations from this constraint. This release, through the powerful mechanism of fertility selection, increased, in decades rather than centuries, the prevalence of a genotype better suited to carbohydrate metabolism. This putative mechanism for rapid and recent human evolution can explain the lower susceptibility to T2D of today's Europid populations. This hypothesis predicts that the increasing rates of diabetes and cardiovascular disease, which typically accompany economic development, will be tempered by natural, but particularly fertility, selection against the conserved ancestral genotypes that currently underpin them. Am. J. Hum. Biol. 2009. © 2009 Wiley-Liss, Inc. [source] Intensified Screening and Treatment of the Metabolic Syndrome for Cardiovascular Risk ReductionPREVENTIVE CARDIOLOGY, Issue 1 2005Nathan D. Wong PhD The metabolic syndrome (MetS), characterized by a clustering of risk factors associated with insulin resistance and abdominal obesity, is associated with an increased risk of coronary heart disease and cardiovascular disease mortality. Persons with MetS have a wide spectrum of coronary heart disease risk and appropriate evaluation of risk using global risk algorithms. Measurement of other risk markers and subclinical disease is potentially needed to best set treatment goals and accompanying treatment regimens. The presence of MetS risk factors should be considered in global risk assessment. Clinical management emphasizes addressing underlying risk factors predisposing to MetS-specifically overweight/obesity and physical inactivity. Further recommendations are given for clinical risk factors, including atherogenic dyslipidemia, elevated blood pressure, insulin resistance/hyperglycemia, prothrombotic state, and proinflammatory state. Clinicians are recommended to assess MetS in their routine practice and to intensify efforts to adequately treat accompanying lifestyle and clinical risk factors. [source] Negative Impact of Metabolic Syndrome on the Responsiveness to Sildenafil in Japanese MenTHE JOURNAL OF SEXUAL MEDICINE, Issue 6 2008Takahiro Suetomi MD ABSTRACT Introduction., Several recent studies suggested that the prevalence of erectile dysfunction (ED) was higher in men with metabolic syndrome (MS). Aim., We analyzed the impact of MS on the responsiveness to sildenafil. Methods., A total of 133 ED patients were evaluated for the prevalence of MS and graded on severity of ED. MS was diagnosed according to the International Diabetes Federation (IDF) definition. The severity of ED was evaluated by the International Index of Erectile Function (IIEF) questionnaire. Hormonal parameters were measured for all patients, and the IIEF questionnaire was conducted after administration of eight tablets of 50-mg doses of sildenafil. If the scores to questions 3 and 4 of the IIEF were 4 or higher after administration, the patients were defined as responders to sildenafil. Main Outcome Measures., To clarify the negative impact of MS on the responsiveness to sildenafil. Results., The mean age of the patients was 56.9 years, and 25 patients were diagnosed with MS. The IIEF-erectile function score and the response rate for sildenafil decreased as the number of MS components increased. Logistic regression analysis showed that the presence of MS along with severity of ED and history of pelvic surgery were significant independent risk factors of nonresponse for sildenafil. The hazard ratio for the presence of MS was 3.30 (95% confidence interval [CI]: 1.17,9.73). No meaningful association was observed between total testosterone or free testosterone levels and MS in this population. Conclusion., We demonstrated the negative impact of MS on the responsiveness to sildenafil. Erectile function and response rate for sildenafil decreased as the number of MS components increased. Suetomi T, Kawai K, Hinotsu S, Joraku A, Oikawa T, Sekido N, Miyanaga N, Shimazui T, and Akaza H. Negative impact of metabolic syndrome on the responsiveness to sildenafil in Japanese men. J Sex Med 2008;5:1443,1450. [source] Metabolic Syndrome and Solid-Organ TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2010A. Sharif The metabolic syndrome is proposed as a cluster of known cardiovascular risk factors, interrelated by a common pathophysiological defect, that symbolize a heightened metabolic burden. Advocates of the concept argue that it is a predictor for both diabetes and cardiovascular disease, complications of great importance posttransplantation. The abundant medical literature on the topic is now expanding into the field of transplantation with evidence linking the metabolic syndrome to adverse patient and graft outcomes. Although the implications posttransplantation are significant, controversy surrounds the concept and the topic has not previously been reviewed in the context of solid-organ transplantation. The purpose of this review is to update transplant clinicians with our current understanding of the metabolic syndrome, review the transplantation literature and examine the controversies surrounding the concept. [source] Markers of the Hepatic Component of the Metabolic Syndrome as Predictors of Mortality in Renal Transplant RecipientsAMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2010D. M. Zelle Cardiovascular disease (CVD) is a leading cause of mortality in renal transplant recipients (RTRs). Metabolic syndrome (MS) is highly prevalent in RTRs. Nonalcoholic fatty liver disease (NAFLD) is considered the hepatic component of MS. We investigated associations of NAFLD markers with MS and mortality. RTRs were investigated between 2001 and 2003. NAFLD markers, alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT) and alkaline phosphatase (AP) were measured. Bone and nonbone fractions of AP were also determined. Death was recorded until August 2007. Six hundred and two RTRs were studied (age 52 ± 12 years, 55% men). At baseline 388 RTRs had MS. Prevalence of MS was positively associated with liver enzymes. During follow-up for 5.3[4.5,5.7] years, 95 recipients died (49 cardiovascular). In univariate Cox regression analyses, GGT (HR = 1.43[1.21,1.69], p < 0.001) and AP (HR = 1.34[1.11,1.63], p = 0.003) were associated with mortality, whereas ALT was not. Similar associations were found for cardiovascular mortality. Adjustment for potential confounders, including MS, diabetes and traditional risk factors did not materially change these associations. Results for nonbone AP mirrored that for total AP. ALT, GGT and AP are associated with MS. Of these three enzymes, GGT and AP are associated with mortality, independent of MS. These findings suggest that GGT and AP are independently related to mortality in RTRs. [source] Hepatic Effects of Rosiglitazone in Rats with the Metabolic SyndromeBASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 2 2010Zvi Ackerman In this study, we characterized the hepatic effects of rosiglitazone in fructose-enriched diet rats. Rats were randomly divided into three groups. One group was maintained on standard rat chow diet for 6 weeks, whereas the other two groups were given fructose-enriched diet for 6 weeks. Four weeks after the initiation of fructose-enriched diet, one of the fructose-enriched diet groups was also given rosiglitazone (10 mg/kg/day) for an additional 2 weeks. Rosiglitazone administration to the fructose-enriched diet rats was associated with decreases in the following parameters: blood pressure (,17%), plasma triglycerides (,62%), hepatic total lipids (,19%), hepatic triglycerides (,61%), hepatic malondialdehyde (,88%), glutathione reductase activity (,84%). An increase in adiponectin plasma levels (+329%), hepatic phospholipids (+46%), hepatic ,-tocopherol concentrations (+24%) and hepatic paraoxonase activity (+68%) was observed. Rosiglitazone caused a decrease in hepatic macrovesicular steatosis score but no change in hepatic fibrosis. Administration of rosiglitazone, to rats with the metabolic syndrome has limited hepatic favourable effects: it improves hepatic lipid metabolism, decreases macrovesicular steatosis and improves some of the hepatic oxidative,anti-oxidative milieu but has no effect on hepatic fibrosis. [source] Patients with Metabolic Syndrome Have Prolonged Corrected QT Interval (QTc)CLINICAL CARDIOLOGY, Issue 12 2009Weiju Li MD Abstract Background Prolongation of corrected QT interval (QTc) increases morbidity and mortality and QTc has been found to be longer in patients with diabetes mellitus than in healthy controls. It is still inconclusive whether the metabolic syndrome results in QTc prolongation. Hypothesis We hypothesized that metabolic syndrome might contribute to risk of QTc prolongation. The hypothesis was tested in a large population. Methods A total of 5,815 individuals (men: 1,950, women: 3,865 aged 20,80 years) were enrolled. Metabolic syndrome was defined according to the revised third National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP III). QTc was calculated by using Bazett and Fridericia equations and the corrected JT interval (JTc) was derived by subtracting the QRS duration from the QTcB. All individuals had physical examinations, electrocardiograms, echocardiography, and blood tests. Results Individuals with metabolic syndrome had longer QTcs and JTc than those without metabolic syndrome (439.84 ms versus 430.90 ms in men, 456.37 ms versus 445.12 ms in women, respectively, p < 0.001 using Bazett formula). The more the number of abnormal metabolic parameters they had, the longer the QTcs and JTc they had. Trend analysis indicated that QTcB, QTcF, and JTc were significantly correlated to the number of abnormal metabolic parameters both in men and in women. After being adjusted for conventional risk factors, QTcB, QTcF, and JTc remained negatively associated with serum potassium concentration and positively associated with interventricular septal thickness. Conclusions Metabolic syndrome is a risk factor for prolonged QTc, which may further increase cardiovascular morbidity and mortality in the subjects with metabolic syndrome. Copyright © 2009 Wiley Periodicals, Inc. [source] Metabolic Syndrome and Cardiovascular Disease: Challenges and OpportunitiesCLINICAL CARDIOLOGY, Issue 12 2007Pharm D, Rhonda M. Cooper-DeHoff Abstract Metabolic syndrome (MetS) has been defined in different ways. However, key components common to most definitions are a constellation of risk factors including abdominal adiposity, impaired fasting glucose, hypertension, and dyslipidemia. A major mediator of MetS appears to be insulin resistance, which relates to the development of the vascular and metabolic dysfunctions that precede overt cardiovascular disease and type 2 diabetes. Evidence suggests that the mechanisms underlying the elevated cardiovascular risk associated with MetS begin with subclinical organ damage. Therapy for MetS targets individual components of the syndrome and includes lifestyle interventions, lipid-modifying therapy, and antihypertensive agents, particularly those that inhibit the renin-angiotensin system. Results of trials of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have demonstrated reductions in new-onset diabetes and cardiovascular events in a wide range of patients. Clinical trials to investigate further the role of these drugs in the primary prevention of type 2 diabetes in patients with MetS are currently under way. The purpose of this paper is to review the MetS from the perspective of the cardiology workforce with the hope that a better understanding of the links between MetS and cardiovascular disease could lead to improved management of persons at risk. Copyright © 2007 Wiley Periodicals, Inc. [source] Cardiovascular metabolic syndrome , an interplay of, obesity, inflammation, diabetes and coronary heart diseaseDIABETES OBESITY & METABOLISM, Issue 3 2007J. S. Rana Cardiovascular disease is currently one of the biggest causes of morbidity and mortality facing humanity. Such a paradigm shift of disease pattern over the last century has only worsened due to the alarming global prevalence of obesity and type 2 diabetes. In recent years there is increasing focus on inflammation as one of the key players in the patho-physiology of these disorders. In addition to these overt risk factors new research is unraveling the significance of a constellation of early metabolic abnormalities that include weight gain, insulin resistance, prehypertension and a specific pattern of dyslipidaemia. There exists a complex interrelationship of these various metabolic disorders and their effect on cardiovascular system. Simplified explanation can be that inflammation increases insulin resistance, which in turn leads to obesity while perpetuating diabetes, high blood pressure, prothrombotic state and dyslipidaemia. While inflammation and insulin resistance have direct adverse effects on cardiac muscle, these metabolic abnormalities as a whole cause causes cardiovascular complications; warranting a multi pronged therapeutic and preventive approach for the ,Cardiovascular Metabolic Syndrome' as an entity. [source] Impact of substance use on the physical health of patients with bipolar disorderACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2010M. P. Garcia-Portilla Garcia-Portilla MP, Saiz PA, Benabarre A, Florez G, Bascaran MT, Díaz EM, Bousoño M, Bobes J. Impact of substance use on the physical health of patients with bipolar disorder. Objective:, To describe the impact of tobacco, alcohol and cannabis on metabolic profile and cardiovascular risk in bipolar patients. Method:, Naturalistic, cross-sectional, multicenter Spanish study. Current use of tobacco, alcohol and cannabis was determined based on patient self-reports. Metabolic syndrome was defined using the National Health and Nutrition Examination Survey 1999,2000 and the American Heart Association/National Heart, Lung and Blood Institute criteria, and cardiovascular risk using the Framingham and the Systematic Coronary Risk Evaluation functions. Results:, Mean age was 46.6 years, 49% were male. Substance use: 51% tobacco, 13% alcohol and 12.5% cannabis. Patients who reported consuming any substance were significantly younger and a higher proportion was male. After controlling for confounding factors, tobacco was a risk factor for coronary heart disease (CHD) (unstandardized linear regression coefficient 3.47, 95% confidence interval 1.85,5.10). Conclusion:, Substance use, mainly tobacco, was common in bipolar patients. Tobacco use negatively impacted CHD risk. [source] What predicts the occurrence of the metabolic syndrome in a population-based cohort of adult healthy subjects?DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 1 2009S. Bo Abstract Background Metabolic syndrome (MS), the concurrence of hyperglycaemia, dyslipidaemia, hypertension and visceral obesity, increases cardiovascular risk and mortality. Predictors of MS were previously evaluated in patients without the full syndrome, but with some of its traits. This might confound the resulting associations. Methods The relationship between baseline variables and MS development was evaluated in healthy middle-aged subjects without any MS component at baseline, over a 4.5-year follow-up. Results From a population-based cohort of 1658 subjects, 241 individuals showed no MS components and 201 (83.4%) of them participated in a follow-up screening. At baseline, patients who developed the MS (n = 28/201; 13.9%) showed significantly higher Homeostasis Model Assessment-Insulin Resistance score (HOMA-IR) and C-reactive protein (CRP) values, and lower exercise level than subjects who did not. In a multiple logistic regression analysis, after multiple adjustments, the only baseline variable significantly (p < 0.01) associated with the MS was CRP (OR = 4.05; 95% CI 2.23,7.38; p < 0.001). Results did not change after adjusting for weight gain. The area under the receiver-operating curve was 0.83 for CRP after multiple adjustments. The optimal cut-off point of baseline CRP values was 2.1 mg/L, with 86% (95% CI 81,90) sensitivity and 75% (69,81) specificity in predicting the MS. Baseline CRP resulted associated with after-study glucose values in a multiple regression model (, = 0.14; 0.08,0.20; p < 0.001). Conclusions Higher baseline CRP values confer a significant increased risk of developing the MS in healthy subjects, independently of weight gain. Copyright © 2009 John Wiley & Sons, Ltd. [source] Metabolic syndrome: collapsing under its own weight?DIABETIC MEDICINE, Issue 5 2009D. Preiss Invited counterview to article by Cameron AJ, Zimmet PZ, Shaw JE, Alberti KGMM. The metabolic syndrome: in need of a global mission statement. Diabet Med 2009;26: 306,309 [source] | |||||||||||||||||||||||||||||||||||||||||||