Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242339 (dyslipidemia)
 13,927 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metabolic syndrome, indicated by insulin resistance/hyperinsulinemia, obesity, central obesity, atherogenic dyslipidemia, and hypertension, contributes to atherosclerotic cardiovascular disease. However, it is controversial whether the indicators of metabolic syndrome are related to subclinical atherosclerosis collectively or individually. Whether there is any gender-based difference in the mechanisms of metabolic syndrome-induced atherosclerosis progression is also unknown. Two models were compared in this study. Model 1 assumes that a latent factor, metabolic syndrome per se, impacts subclinical atherosclerosis (collective effects model); Model 2 assumes the effect of the syndrome is mediated through its indicators (individual effects model). Data were obtained from the Los Angeles Atherosclerosis Study. The cohort consists of 573 adults (age, 40-60 years) who were asymptomatic for cardiovascular disease. Subclinical atherosclerosis was assessed by measuring common carotid artery intima-media thickness (CCA-IMT) using B-mode ultrasound. Three examinations were completed at 1.5-year intervals from 1995-1999. The analyses were performed with SAS 8.2 and AMOS 4.0. The results showed that atherogenic effects of metabolic syndrome were mediated through its indicators; there were gender-based differences in the mechanisms of metabolic syndrome-induced atherosclerosis. Central obesity was significantly associated with the baseline IMT for men only, whereas triglycerides were significantly associated with the progression of IMT for women only. Systolic blood pressure was significantly associated with the baseline and progression for both men and women. However, fasting insulin was not found to be significantly associated with the baseline and progression of IMT in the multivariate model, although it was significantly associated with other components of metabolic syndrome.
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PMID:Metabolic syndrome and progression of atherosclerosis among middle-aged US adults. 1650 91

The prevalence of metabolic syndrome is increasing worldwide, especially among the elderly. Due to multiple age-related physiologic mechanisms, the elderly are at increased risk of developing intra-abdominal obesity and the metabolic syndrome, including nonalcoholic steatohepatitis. Metabolic syndrome consists of obesity, insulin resistance, dyslipidemia, and hypertension leading to increased risk of cardiovascular disease (CVD) and renal events. With the future population dynamics, the metabolic syndrome should be emphasized among the health care field, researchers, and clinicians. Without proactive and preventative efforts, elderly patients and the health care system will likely experience an epidemic of the metabolic syndrome and the associated CVD.
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PMID:Metabolic syndrome in the elderly. 1652 83

High blood pressure is often associated with various metabolic abnormalities, including abdominal obesity, dyslipidemia, elevated plasma glucose, and insulin resistance, which are the main features of the metabolic syndrome. The metabolic syndrome is extremely common worldwide. This high prevalence is of considerable concern because several studies suggest that the metabolic syndrome carries an increased risk for cardiovascular events. Several lines of evidence seem to indicate that the metabolic syndrome is associated with an increased prevalence of preclinical cardiovascular and renal changes, such as left ventricular hypertrophy, microalbuminuria, impaired aortic elasticity, and early carotid atherosclerosis, most of which are recognized as significant independent predictors of adverse cardiovascular outcomes. It is conceivable that these data may partly explain the high rates of cardiovascular morbidity and mortality that are observed in patients with the metabolic syndrome.
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PMID:The metabolic syndrome and its relationship to hypertensive target organ damage. 1652 97

Metabolic syndrome affects approximately 44% of the US population over the age of 50 years. Although conflicting definitions exist, the syndrome is typically characterized by abdominal obesity, dyslipidemia, hypertension, and insulin resistance. Thus, it is a major risk factor for both coronary heart disease and type 2 diabetes. Furthermore, the risk of cardiovascular (CV) death is significantly increased in patients with diabetes and/or the metabolic syndrome. Although very few studies exist in patients with the metabolic syndrome, lifestyle changes and drug intervention targeted at the individual components have been shown to reduce the risk of developing diabetes and the incidence of CV disease in high-risk patients. Because many of the conventional antihypertensive drugs may affect the development of new onset diabetes, both positively and negatively, the choice of therapy is particularly important in this population. However, the long-term clinical trials to date have either not included new onset diabetes as a protocol end point or used various different criteria, making comparisons difficult. This review assesses the need for future research into metabolic syndrome and discusses whether clinical surrogates for CV end points, such as new onset diabetes, should be included in clinical trials of new drugs, new regimens, or new indications.
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PMID:Metabolic syndrome, new onset diabetes, and new end points in cardiovascular trials. 1663 92

In the past two decades, the 'metabolic syndrome' has raised much clinical and research interest and remains a controversial topic. The constellation of commonly coexisting cardiovascular risk factors, now known as the metabolic syndrome, has had many definitions which has added to the confusion surrounding the syndrome. Recently, the controversy has been escalated by a joint statement from the American Diabetes Association and the European Association for the Study of Diabetes calling into question the existence and clinical utility of the metabolic syndrome as a discrete clinical entity. Despite the controversy, there is agreement that the risk factors of abdominal obesity, hypertension, elevated glucose and dyslipidemia commonly coexist in the same patient, and are important to identify when assessing an individual patient's risk. Therefore, whether the 'syndrome' is a distinct clinical entity is not important. By definition, a syndrome is a group of signs or symptoms that commonly group together. It remains a useful clinical tool to raise awareness among health care professionals to look for 'nontraditional' cardiovascular risk factors, such as glucose intolerance or elevated waist circumference, in patients with other components of the syndrome, without negating the importance of identifying and treating the other 'traditional' risk factors not identified in the syndrome. It also reminds clinicians of the importance of lifestyle interventions to treat all of the components of the syndrome. Therefore, the 'metabolic syndrome' continues to serve a useful clinical purpose to raise awareness among health care professionals and aid in identifying high-risk individuals.
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PMID:Metabolic syndrome under fire: weighing in on the truth. 1663 71

The number of cases of the metabolic syndrome is increasing dramatically in Western countries. However, the evaluation of the metabolic syndrome is limited in Asian countries. Thus, our objectives were: 1) to investigate parameters of the metabolic syndrome defined by the National Cholesterol Education Program (NCEP)-Adult Treatment Panel III (ATPIII) in the subjects representing Korean general population and 2) the modification of which factor is most effective in reducing the metabolic syndrome. A total of 10,044 (5024 rural and 5020 urban) Korean men and women in the age range 40-69 yr voluntarily participated in this community-based cross-sectional study (a rural and an urban community was selected). Anthropometric parameters (weight, height, waist and hip circumference and blood pressure), social factors (smoking, alcohol, exercise and education status) as well as biochemical parameters (fasting glucose and insulin, lipids and body composition) were measured. Twenty-six point one per cent of the total subjects were classified as having the metabolic syndrome. Age- and sex-adjusted prevalences were 29.3 and 22.3% in the rural and urban community, respectively (p< 0.01). Abdominal obesity (46.9%) and high blood pressure (45.2%) were major components in the rural community; hypertriglyceridemia (37.6%) and low HDL-cholesterolemia (37.0%) in the urban community. In conclusion, abdominal obesity in the rural community and dyslipidemia in the urban community should be a main subject of intervention, aimed at reducing the prevalence of the metabolic syndrome in Korea. Given the rapid progression of the Korean economy over the past 30 yr, the prevalence of the metabolic syndrome is expected to increase continuously. A strategy to prevent this expected extraordinary event should be conducted at a national level.
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PMID:A rural-urban comparison of the characteristics of the metabolic syndrome by gender in Korea: the Korean Health and Genome Study (KHGS). 1669 97

The metabolic syndrome, defined as the association of abdominal obesity, insulin resistance, dyslipidemia and hypertension, is a very prevalent disorder. Moreover, it identifies patients with a high cardiovascular risk, and when diagnosed, life style modifications and/or drug therapy can be initiated in these patients with the aim to reduce their cardiovascular risk. In the last few years, there has been much interest on drugs that lower insulin resistance, a central component of the metabolic syndrome as well as drugs that interrupt the renin-angiotensin system (achieved by angiotensive converting enzyme inhibitors and angiotensin II receptor blockers), due to their beneficial metabolic effects. Of special interest are the so-called selective PPARg modulators, such as telmisartan or the nTZDpa compound. In the future, they may show important benefits in the treatment of patients with the metabolic syndrome.
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PMID:[Role of angiotensin II receptor antagonists in the treatment of metabolic syndrome]. 1676 93

Diabetes mellitus (DM) is considered a major public health problem in both developed and developing countries due to its chronic complications, at the macro or microcirculation, with great impact on mortality and morbidity in all patients. The disease is considered the end of a pathophysiologic process involving peripheral and hepatic insulin resistance and reduced insulin secretion that have been started years before the clinical diagnosis. Metabolic syndrome (MS) is a disorder that results from the increasing prevalence of obesity worldwide. DM is frequently associated with clinical and laboratory features of MS, like abdominal obesity, hypertension, dyslipidemia and microalbuminuria that are also risk factors for cardiovascular disease. Populational studies have demonstrated increasing prevalence of all the features of MS from pre-diabetes to clinical DM resulting in a great risk of cardiovascular disease. The prevalence of MS in DM type 2 is estimated to be >80%. Glitazones are PPAR-gamma agonists that improve insulin sensitivity. These drugs induce the transcription of genes related to glucose and lipid metabolism, and expression of inflammatory and endothelial proteins associated with atherosclerosis process resulting in an improvement in endothelial function. However several questions need to be clarified regarding the glitazones, in special those associated with their adverse effects such as weight gain, edema and heart failure.
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PMID:[Glitazones and the metabolic syndrome: mechanism of action, pathophysiology and therapeutic indications]. 1676 93

The metabolic syndrome comprises a cluster of metabolic anomalies including insulin resistance, abdominal obesity, dyslipidemia, and hypertension. Previous studies suggest that impaired dopamine D2 receptor (D2R) signaling is involved in its pathogenesis. We studied the acute effects of bromocriptine (a D2R agonist) on energy metabolism in obese women; body weight and caloric intake remained constant. Eighteen healthy, obese women (BMI 33.2 +/- 0.6 kg/m(2), mean age 37.5 +/- 1.7, range 22-51 yr) were studied twice in the follicular phase of their menstrual cycle in a prospective, single-blind, crossover design. Subjects received both placebo (P; always first occasion) and bromocriptine (B; always second occasion) on separate occasions for 8 days. At each occasion blood glucose and insulin were assessed every 10 min for 24 h, and circadian plasma free fatty acid (FFA) and triglyceride (TG) levels were measured hourly. Fuel oxidation was determined by indirect calorimetry. Body weight and composition were not affected by the drug. Mean 24-h blood glucose (P < 0.01) and insulin (P < 0.01) were significantly reduced by bromocriptine, whereas mean 24 h FFA levels were increased (P < 0.01), suggesting that lipolysis was stimulated. Bromocriptine increased oxygen consumption (P = 0.03) and resting energy expenditure (by 50 kcal/day, P = 0.03). Systolic blood pressure was significantly reduced by bromocriptine. Thus these results imply that short-term bromocriptine treatment ameliorates various components of the metabolic syndrome while it shifts energy balance away from lipogenesis in obese humans.
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PMID:Activation of dopamine D2 receptors simultaneously ameliorates various metabolic features of obese women. 1680 51

Metabolic syndrome refers to a constellation of risk factors for cardiovascular disease. They include elevated plasma glucose concentrations, dyslipidemia, hypertension, and abdominal obesity. These conditions typically occur during middle age or later in life. Although there is no clear consensus on the diagnosis of metabolic syndrome, it is a potentially important entity to recognize and manage once traditional cardiovascular risk factors, such as smoking, hypertension, dyslipidemia, and diabetes, have been treated individually. This Perspective summarizes our current knowledge of the metabolic syndrome. Lifestyle change, including diet and exercise, is probably the best available option for treating the metabolic syndrome. However, rigorous lifestyle interventions are difficult to implement outside of a clinical trial setting, especially among elderly patients.
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PMID:A work in progress: the metabolic syndrome. 1680 83


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