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Query: UMLS:C0311277 (abdominal obesity)
 2,792 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metabolic syndrome is a cluster of cardiovascular risk factors. Pathogenesis of metabolic syndrome implies 3 potential etiological mechanisms: obesity and adipose tissue disorders, insulin resistance, and a constellation of independent factors. Clinical recognition of the metabolic syndrome is based on finding several well-recognized signs in clinical practice: abdominal obesity, elevated triglycerides, reduced HDL cholesterol, raised blood pressure, and elevated plasma glucose. In addition, other components commonly aggregate with the major components: elevated apolipoprotein B, small LDL particles, insulin resistance and hyperinsulinemia, impaired glucose tolerance (IGT), elevated C-reactive protein (CRP), and variation in coagulation factors (plasminogen activator inhibitor [PAI]-I and fibrinogen). Cardiovascular disease (CVD) is the primary clinical outcome of metabolic syndrome. Additionally, risk for type 2 diabetes is higher. Diabetes is itself a major risk factor for CVD. ATP III criteria for diagnosis of metabolic syndrome provide a practical tool to identify patients at increased risk for CVD. World Health Organization (WHO) and American Association of Clinical Endocrinologists (AACE) criteria require further oral glucose testing if IFG and diabetes are absent. IGT on OGTT denotes greater risk for diabetes than does metabolic syndrome without elevated fasting glucose.
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PMID:Metabolic syndrome--new insights into a growing entity. 1552 16

Central obesity, insulin resistance, inflammation, as well as vascular changes are common in patients with type 2 diabetes. In this study we assessed the relationship among stiffness of the carotid artery, visceral fat, and circulating inflammatory markers in type 2 diabetic subjects. Carotid stiffness, quantified as the distensibility coefficient (DC), was measured by ultrasound in asymptomatic, normotensive patients with uncomplicated, well-controlled type 2 diabetes and in controls. Body fat distribution was quantified by magnetic resonance imaging. In patients, the carotid DC was inversely associated with visceral fat area (r = -0.660; P = 0.005) and plasma levels of C-reactive protein (CRP; r = -0.687; P = 0.002), but most strongly with plasma IL-6 (r = -0.766; P < 0.001). In multivariate analysis, the association between DC and visceral fat disappeared after adjustment for CRP and IL-6. Correction for age, body mass index, blood pressure, glycosylated hemoglobin, or fasting plasma glucose did not affect the association between carotid DC and inflammatory markers. Thus, carotid stiffness is associated with visceral obesity in patients with uncomplicated type 2 diabetes, but this association seems to be mediated by circulating IL-6 and CRP, of which IL-6, at least in part, originates from adipose tissue and stimulates hepatic CRP production.
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PMID:The association between abdominal visceral fat and carotid stiffness is mediated by circulating inflammatory markers in uncomplicated type 2 diabetes. 1561 16

Elevated C-reactive protein concentration, measured by an ultrasensitive method (hsCRP), has been proved to be a risk factor for atherosclerosis progression and its complications (myocardial infarction and stroke) in otherwise healthy men and women. In patients with already diagnosed atherosclerotic disease elevated concentration of hsCRP predicts prognosis. There are multiple causes of elevated hsCRP concentration: metabolic changes (e.g. as a part of metabolic syndrome), genetic background and chronic infections. Proinflammatory effect of adipose tissue in obese individuals seems to play an important role, hsCRP levels correlate with markers of abdominal obesity. Elevated hsCRP concentrations can be lowered both pharmacologically and by a lifestyle change. This review covers current knowledge of pathophysiology of elevated hsCRP concentration and possible use of this method in clinical medicine.
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PMID:[An ultrasensitive C-reactive protein assay--a new parameter in cardiovascular risk]. 1564 58

Persistent low-grade inflammation, as indicated by higher circulating levels of inflammatory mediators such as C-reactive protein, interleukin-6 and tumour necrosis factor-alpha, is a strong risk factor for several chronic diseases. There are data indicating that decreasing energy intake and increasing physical activity may be effective therapies for reducing overall inflammation. Evidence is strong that circulating levels of inflammatory markers are elevated with total and abdominal obesity, possibly owing to a higher secretion rate of cytokines by adipose tissue in obese people. Moreover, very-low-energy dietary weight loss reduces both circulating markers of inflammation and adipose-tissue cytokine production. Data from several large population-based cohorts show an inverse association between markers of systemic inflammation and physical activity or fitness status; small-scale intervention studies support that exercise training diminishes inflammation. Dietary weight loss plus exercise is likely more effective than weight reduction alone in reducing inflammation. To date, data from randomized, controlled trails designed to definitively test the effects of weight loss or exercise training, or both, on inflammation are limited. Future studies are required to define the amount of weight loss needed for clinically meaningful reductions of inflammation; in addition, fully powered and controlled studies are necessary to clarify the effect of exercise training on chronic, systemic inflammation.
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PMID:Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training. 1624 6

The associations of inflammatory markers (high-sensitivity C-reactive protein [hs-CRP], interleukin-6 [IL-6], tumor necrosis factor-alpha, and fibrinogen) with anthropometric and metabolic variables were examined in a sample of 112 postmenopausal women not receiving hormone therapy. Body fat distribution was measured by computed tomography, and insulin sensitivity was determined by an euglycemic-hyperinsulinemic clamp. hs-CRP (0.10 < or = r(2) < or =0.37) and IL-6 (0.06 < or = r(2) < or =0.31) were significantly associated with anthropometric and metabolic variables, including visceral and subcutaneous adipose tissue, systolic and diastolic blood pressure, triglycerides, high-density lipoprotein (HDL) cholesterol, and insulin sensitivity (p <0.05). Women with greater hs-CRP concentrations showed deterioration in their metabolic risk profiles, including abdominal obesity, greater triglyceride and lower HDL cholesterol concentrations, and lower insulin sensitivity compared with women with lower hs-CRP levels. Fifty-nine percent of women with high hs-CRP concentrations had the metabolic syndrome as recently defined by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. After adjustment for visceral adipose tissue, most of the differences in the plasma lipid-lipoprotein profile were eliminated between women with high hs-CRP levels and women with low hs-CRP levels, whereas some differences in blood pressure variables, insulin sensitivity, and inflammatory markers (IL-6 and fibrinogen) remained significant. In conclusion, these results suggest that increased visceral adipose tissue levels appear to be a determinant covariable of the association between high hs-CRP concentrations and alteration in the metabolic profile.
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PMID:Relation of high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and fibrinogen to abdominal adipose tissue, blood pressure, and cholesterol and triglyceride levels in healthy postmenopausal women. 1597 42

C-reactive protein (CRP) is associated with increased risk for cardiovascular disease and diabetes. Few studies have evaluated the importance of CRP in those with the cluster of cardiovascular risk factors known as the metabolic syndrome (MS). We studied 190 overweight subjects (83 men and 107 women), aged 25-75 years, screened for glucose intolerance, in order to assess whether CRP levels vary according to the presence of MS, and to examine the relationship between CRP levels and metabolic variables. The prevalence of the Adult Treatment Panel III MS was 36.8%. Subjects with the MS had a higher degree of insulin resistance (IR), measured by the homeostasis model assessment (HOMA) method (5.4+/-0.4 versus 3.6+/-0.3, p<0.001) and higher frequency of glucose intolerance (78.3% versus 44.4%, p<0.001) than those without the MS. CRP values were increased among those with the MS (4.85+/-0.47 mg/l versus 3.34+/-0.36 mg/l, p<0.05). CRP correlated with waist circumference (r=0.28, p<0.001) and body mass index (r=0.38, p<0.001) in both men and women; however the relationship of CRP with HOMA(IR) was only evident in men (r=0.37, p<0.01) while the association with free fatty acids (FFA) was only significant in women (r=0.20, p<0.05), even after adjusting for age, hispanic ethnicity and glucose tolerance status. Abdominal obesity (elevated waist circumference) was the single most important MS component associated with increased CRP levels (>3mg/dl) (OR=3.1, 95% C.I.: 1.4-10.1), followed by female gender and smoking. These results confirm that CRP levels are elevated in MS subjects at risk for glucose intolerance. In addition waist circumference, HOMA(IR) and FFA levels are associated with CRP levels, suggesting potential roles of obesity, insulin resistance and lipolysis in the development of the subclinical inflammation associated with the MS.
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PMID:C-reactive protein is elevated in obese patients with the metabolic syndrome. 1600 76

Menopause-related oestrogen deficiency increases the risk of cardiovascular disease (CVD). The presence of abdominal obesity, dyslipidemia, hypertension, fasting hyperglycaemia or impaired glucose tolerance further aggravates the CVD risk imposed by menopause. A detailed personal history should be recorded, covering PCOS, gestational diabetes mellitus, alcohol intake and smoking, as well as a family history of cardiovascular disease. Screening of the a-symptomatic post-menopausal woman should include fasting lipid profile, plasma glucose and liver, renal and thyroid function tests. Serum low-density lipoprotein cholesterol (LDL-c)>130 mg/dL is associated with an increased risk of CVD. Levels of triglycerides (TG)>or=150 mg/dL and high-density lipoprotein cholesterol (HDL-c)<or=50 mg/dL coupled with an increase in small dense LDL and very low-density lipoprotein (VLDL) particles constitute the atherogenic dyslipidemia, which characterizes the metabolic syndrome. In women with previous VTE episodes, screening for thrombophilia is advisable, as well as an estimation of baseline homocysteine and C-reactive protein (CRP). Non-pharmacological intervention should be targeted towards smoking cessation, a low-salt, low-fat, high-fibre diet and increased physical activity.
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PMID:Cardiovascular disease: screening and management of the a-symptomatic high-risk post-menopausal woman. 1614 Apr 82

Metabolic syndrome is a constellation of clinical findings that identify individuals at higher than normal risk of developing diabetes mellitus or cardiovascular disease. There are two principal definitions, one emerging from the American National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, and the other from the World Health Organization. Both definitions share the common elements of abdominal obesity, hypertriglyceridaemia, low HDL-cholesterol, hypertension and abnormal glucose regulation. The syndrome is relatively common across continents, and also among those without marked obesity. It is even more common among patients with major mental health disorders such as schizophrenia. Metabolic syndrome can be used to assess risk for cardiovascular disorder and death, and is an alternative to Framingham Risk Calculations. C-reactive protein may play an additional role in risk prediction. Ongoing monitoring for all components of the metabolic syndrome is necessary. Individuals at high risk require multimodal interventions, including lifestyle interventions and targeted medications as appropriate.
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PMID:Metabolic syndrome and cardiovascular disease. 1628 Mar 41

The metabolic syndrome, which is very common in the general population, is defined by the clustering of several classic cardiovascular risk factors, such as type 2 diabetes, hypertension, high triglycerides and low high-density lipoprotein cholesterol (HDL). Central obesity and insulin resistance, which are the two underlying disorders of the syndrome, are further risk factors for cardiovascular disease. Moreover, a panel of novel (non-traditional) risk factors are ancillary features of the metabolic syndrome. They include biomarkers of chronic mild inflammation (e.g. C-reactive protein, CRP), increased oxidant stress (e.g. oxidized low density lipoprotein, LDL), thrombophilia (e.g. plasminogen activator inhibitor-1, PAI-1) and endothelial dysfunction (e.g. E-selectin). Therefore, subjects with the metabolic syndrome are potentially at high risk of developing atherosclerosis and clinical cardiovascular events.In recent years several longitudinal studies have confirmed that subjects with the metabolic syndrome present with atherosclerosis and suffer from myocardial infarction and stroke at rates higher than subjects without the syndrome. The risk of cardiovascular disease (CVD) is particularly high in women with the syndrome and in subjects with pre-existing diabetes, CVD and/or high CRP. However, an increased risk is already present in subjects with a cluster of multiple mild abnormalities. The risk related to the metabolic syndrome is definitely higher when subjects affected are compared to subjects free of any metabolic abnormality.
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PMID:The metabolic syndrome and cardiovascular disease. 1644 90

We investigated the relationship between the clustering of risk factors for metabolic syndrome and the plasma C-reactive protein (CRP) concentration as measured by high-sensitive CRP assay. Body mass index, waist circumference, triglycerides (TGs), high-density lipoprotein cholesterol, fasting glucose, systolic and diastolic blood pressures, insulin, and CRP were measured in 1046 Korean adults (560 males; age, 18-64 years) in 2003 to 2004. There were statistically significant positive correlations for log CRP with body mass index, waist circumference, log TG, log insulin, and log homeostasis model assessment in both sexes after adjusting for age and smoking status. High-density lipoprotein cholesterol showed a significant negative correlation with log CRP in both sexes. For both sexes, the mean level of log CRP increased with increasing number of risk factors of metabolic syndrome (P for trend <.01 for males and <.001 for females). Stepwise multivariate linear regression analysis showed that waist circumference contributed the largest portion of the variance in CRP levels in both sexes. Log homeostasis model assessment and log TG were independently associated with log CRP levels only in females. These results indicate that CRP, a marker of inflammation that underlies atherosclerosis, is associated with the clustering of each metabolic syndrome risk factor and, furthermore, that abdominal obesity is the strongest predictor of CRP level in the Korean adult population.
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PMID:Association of C-reactive protein with the metabolic risk factors among young and middle-aged Koreans. 1704 62


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