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Query: UMLS:C0948265 (metabolic syndrome)
 24,271 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The essential hypertension, at present scarcely existing as isolated and unique disease, proves to be one of the main participants in multimorbidity. The evaluation of the own patients of the past 10 years according to the concomitant diseases of hypertension leads unconventionally to a subdivision in two groups: a "coloured" in which hypertension together appears with another chronic disease or also various diseases and a second group, in which the hypertension appears in a constantly composed "standardized" connection of diseases: with adiposis, hyperlipoproteinaemia, diabetes, frequently still with hyperuricaemia and cholelithiasis. In this hypertensive-metabolic syndrome we have to acknowledge a characteristic form of manifestation of hypertension, under simultaneous degradation to the symptom of a more comprehensive complex of disturbances. From the cooperation of the present individual diseases results a unique concentration of arteriosclerotic risk factors, so that course and result in the hypertensive-metabolic syndrome are characterized by the arteriosclerosis with its organ manifestations, above all on heart and brain.
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PMID:[Hypertension as a clinical syndrome]. 721 Jul 53

Obesity poses a serious health hazard and its treatment is often disappointing. Major advances have been made during recent years in the understanding of body weight regulation, with the discovery of leptin, a protein produced by adipocytes and acting on the central nervous system to reduce food intake, and that of beta-3 adrenergic receptors and uncoupling proteins which contribute to stimulate energy expenditure. Numerous metabolic complications are associated with abdominal obesity and most of them, such as diabetes mellitus, dyslipidaemias and arterial hypertension, appear to be linked to insulin resistance and may be part of the socalled metabolic syndrome or syndrome X. While very-low-calorie diets are usually effective in the short-term, they cannot, in the long-term and for most patients, solve the problem of severe obesity. Pharmacological antiobesity treatment may include drugs that reduce food intake, drugs that increase energy expenditure and drugs that affect nutrient partitioning or metabolism. All of these pharmacological approaches have potential efficacy, but unfortunately serious limitations. This is also the case of mechanical means, such as intragastric balloons. Consequently, bariatric surgery may be considered as a valuable alternative therapy in well-selected patients with morbid obesity refractory to classical treatments. In conclusion, obesity is a chronic disease and should be treated as such with reasonable expectations.
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PMID:Medical aspects of obesity. 1042 50

Previous epidemiological studies have demonstrated relationships between individual nutrients and glucose intolerance and type 2 diabetes, but the association with the overall pattern of dietary intake has not previously been described. In order to characterize this association, 802 subjects aged 40-65 years were randomly selected from a population-based sampling frame and underwent a 75 g oral glucose-tolerance test. Principal component analysis was used to identify four dietary patterns explaining 31.7% of the dietary variation in the study cohort. These dietary patterns were associated with other lifestyle factors including socio-economic group, smoking, alcohol intake and physical activity. Component 1 was characterized by a healthy balanced diet with a frequent intake of raw and salad vegetables, fruits in both summer and winter, fish, pasta and rice and low intake of fried foods, sausages, fried fish, and potatoes. This component was negatively correlated with central obesity, fasting plasma glucose, 120 min non-esterified fatty acid and triacylglycerol, and positively correlated with HDL-cholesterol. It therefore appears to be protective for the metabolic syndrome. Component 1 was negatively associated with the risk of having undiagnosed diabetes, and this association was independent of age, sex, smoking and obesity. The findings support the hypothesis that dietary patterns are associated with other lifestyle factors and with glucose intolerance and other features of the metabolic syndrome. The results provide further evidence for the recommendation of a healthy balanced diet as one of the main components of chronic disease prevention.
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PMID:A cross-sectional study of dietary patterns with glucose intolerance and other features of the metabolic syndrome. 1088 14

Hyperglycemia and hyperinsulinemia are central features of the metabolic syndrome and type 2 diabetes mellitus, which contribute to the pathogenesis of coronary heart disease (CHD). Recent data indicate that increased dietary glycemic load (GL) due to replacing fats with carbohydrates or increasing intake of rapidly absorbed carbohydrates (ie, high glycemic index) can create a self-perpetuating insulin resistance state and predicts greater CHD risk. In this paper, we discuss the historic development of the GI and GL concepts and summarize metabolic experiments and epidemiologic observations relating to clinical utilities of these measures. On balance, increased consumption of low-GI foods leads to improvements in glycemia and dyslipidemia in metabolic studies, and a low-GL diet has been associated with lower risk of type 2 diabetes and CHD in prospective cohort studies. We conclude that decreasing dietary GL by reducing the intake of high-glycemic beverages and replacing refined grain products and potatoes with minimally processed plant-based foods such as whole grains, fruits, and vegetables may reduce CHD incidence in sedentary individuals and populations with a high prevalence of overweight. Because of advances in food-processing technologies and changes in ingredients in our food supply, the composition and physiologic effects of foods are likely to change over time. Future efforts should continue to quantify and monitor the metabolic impacts of different foods, and such information should be routinely incorporated into long-term prospective studies to allow for the assessment of the interactive effects of diets and other metabolic determinants on chronic disease risk.
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PMID:Dietary glycemic load and atherothrombotic risk. 1236 93

The developing world is experiencing a rise in the prevalence of obesity, diabetes and cardiovascular disease to such an extent that it is often described as an epidemic. The most common explanation advanced for this phenomenon is the so-called epidemiological transition, with the biological basis of the thrifty genotype. The thrifty genotype theory suggests that genes derived from times of deprivation may result in adaptations that have adverse effects in times of plenty. However, a divergent theory is the so-called foetal origins of chronic disease, which ascribes the epidemic, in part, to an adverse intrauterine environment. There is compelling evidence, based on large numbers of epidemiological studies conducted in both developing and developed countries, that small size at birth in full-term pregnancies is linked with the subsequent development of the major features of the metabolic syndrome, namely glucose intolerance, increased blood pressure, dyslipidaemia and increased mortality from cardiovascular disease.
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PMID:The foetal origins of the metabolic syndrome--a South African perspective. 1238 59

Cardiovascular complications are frequently encountered in the HIV-infected population. Cardiac care providers should implement appropriate preventive, screening, and therapeutic strategies to maximize survival and quality of life in this increasingly treatable, chronic disease. All HIV-infected individuals should undergo periodic cardiac evaluation, including echocardiography, in order to identify subclinical cardiac dysfunction. Left ventricular (LV) dysfunction can result from, or be exacerbated by, a variety of treatable infectious, endocrine, nutritional, and immunologic disorders. Aggressive diagnosis and treatment of these conditions may lead to improvement or even normalization of myocardial function. Endomyocardial biopsy should be considered to direct etiology-specific therapy. Standard measures for the prevention and treatment of congestive heart failure are recommended for HIV-infected patients. Afterload reduction with angiotensin-converting enzyme inhibitors may be indicated for patients with elevated afterload and preclinical LV dysfunction diagnosed by echocardiogram. However, judicious drug selection and titration are necessary in this cohort of patients with frequent autonomic dysfunction, at risk for a number of potentially lethal drug interactions. Carnitine, selenium, and multivitamin supplementation should be considered, especially in those with wasting or diarrhea syndromes. Monthly intravenous immunoglobulin (IVIG) infusions have been demonstrated to preserve LV parameters in HIV-infected children; ventricular recovery has been documented in some children with recalcitrant HIV-related cardiomyopathy following IVIG infusion. We support the use of immunomodulatory therapy in the pediatric population, and look forward to further study into the efficacy and broader application of this approach. Highly active antiretroviral therapy (HAART) may be associated with dyslipidemia and the metabolic syndrome. This should be treated with dietary and possibly with pharmacologic interventions. Drug interactions need to be considered when instituting pharmacologic therapies. Pericardial effusions are often seen in patients with advanced HIV infection. Asymptomatic effusions are most often nonspecific in nature, related to the proinflammatory milieu found in advanced AIDS. Nonspecific effusions are a marker of advanced disease and do not require exhaustive etiologic evaluation. In contrast, large or symptomatic effusions are often associated with infection or malignancy, and warrant thorough investigation and etiology-specific treatment.
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PMID:Myocardial and Pericardial Disease in HIV. 1240 91

The worldwide epidemic of obesity is being mirrored in worldwide epidemics of metabolic syndrome and of type 2 diabetes. The theme of the 2002 Future Forum conference is that these conditions are a certainty, given that the changing worldwide environment requires less physical activity for daily living and assures an abundant, energy-dense food supply at all times. This paper focuses on the roles of physical activity and weight reduction in reducing the risk for development of type 2 diabetes and the metabolic syndrome. The mechanisms by which obesity and detraining lead to insulin resistance and type 2 diabetes are discussed and, conversely, the mechanisms by which insulin resistance might be reversed by physical activity are addressed. Finally, the evidence from recent randomised clinical trials is reviewed. The Finnish Diabetes Prevention Study and the Diabetes Prevention Program in the USA both demonstrate that lifestyle change can significantly reduce the risk of development of type 2 diabetes in individuals with impaired glucose tolerance. Furthermore, these studies demonstrate that modest weight change and achievable physical activity goals can translate into significant risk reduction. Societies cannot afford to ignore the evidence of health benefit associated with physical activity and healthy weight in favour of medicating when morbidities develop. For a successful public health approach to chronic disease prevention, we cannot rely completely on pharmaceuticals, but must implement environmental changes to encourage healthy lifestyles.
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PMID:Diet and exercise in the prevention of diabetes. 1279 95

The prevalence of the metabolic syndrome is highest among Hispanic adults. However, studies exploring the metabolic syndrome in overweight Hispanic youth are lacking. Subjects were 126 overweight children (8-13 yr of age) with a family history for type 2 diabetes. The metabolic syndrome was defined as having at least three of the following: abdominal obesity, low high-density lipoprotein (HDL) cholesterol, hypertriglyceridemia, hypertension, and/or impaired glucose tolerance. Insulin sensitivity was determined by the frequently sampled iv glucose tolerance test and minimal modeling. The prevalence of abdominal obesity, low HDL cholesterol, hypertriglyceridemia, systolic and diastolic hypertension, and impaired glucose tolerance was 62, 67, 26, 22, 4, and 27%, respectively. The presence of zero, one, two, or three or more features of the metabolic syndrome was 9, 22, 38, and 30%, respectively. After controlling for body composition, insulin sensitivity was positively related to HDL cholesterol (P < 0.01) and negatively related to triglycerides (P < 0.001) and systolic (P < 0.01) and diastolic blood pressure (P < 0.05). Insulin sensitivity significantly decreased (P < 0.001) as the number of features of the metabolic syndrome increased. In conclusion, overweight Hispanic youth with a family history for type 2 diabetes are at increased risk for cardiovascular disease and type 2 diabetes, and this appears to be due to decreased insulin sensitivity. Improving insulin resistance may be crucial for the prevention of chronic disease in this at-risk population.
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PMID:The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. 1471 36

Immune activation occurs in response to noxious stimuli such tissue injury, infection, inflammation and malignant neoplasia with the production of cytokines both in the circulation and the central nervous system (CNS). In addition to their fundamental immune functions, cytokines such as the interleukins (ILs), interferons (IFNs) and tumour necrosis factor-alpha also elicit significant pathophysiological effects on feeding behaviour and play prominent roles in the anorexia and cachexia syndrome often seen in chronic disease states. There is now compelling evidence that demonstrates that an important site of cytokine bioactivity is located within the hypothalamus where they appear to modulate appetite and energy homeostasis. Hypercytokinaemia has also been observed in the obese state where it has been proposed that they may play pivotal roles in mediating the detrimental components of the metabolic syndrome including insulin resistance, impaired glucose tolerance, hypertension. dyslipidaemia and increased cardiovascular risk. This review summarises these putative roles of various cytokines in the regulation of feeding in the setting of anorexia-cachexia and obesity.
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PMID:Role of cytokines in regulating feeding behaviour. 1505 11

Obesity is a multifactorial, chronic disorder that has reached epidemic proportions in most industrialized countries and is threatening to become a global epidemic. Obese patients are at higher risk from coronary artery disease, hypertension, hyperlipidemia, diabetes mellitus, cancers, cerebrovascular accidents, osteoarthritis, restrictive pulmonary disease, and sleep apnoea. In particular, visceral fat accumulation is usually accompanied by insulin resistance or type 2 diabetes mellitus, hypertension, hypertriglyceridemia, high uremic acid levels, low high density lipoprotein (HDL) cholesterol to define a variously named syndrome or metabolic syndrome. Metabolic syndrome is now considered a major cardiovascular risk factor in a large percentage of population in worldwide. Both obesity and metabolic syndrome are particularly challenging clinical conditions to treat because of their complex pathophysiological basis. Indeed, body weight represents the integration of many biological and environmental components and relationships among fat and glucose tolerance or blood pressure are not completely understood. Efforts to develop innovative anti-obesity drugs, with benefits for metabolic syndrome, have been recently intensified. In general two distinct strategies can be adopted: first, to reduce energy intake; second, to increase energy expenditure. Here we review some among the most promising avenues in these two fields of drug therapy of obesity and, consequently, of metabolic syndrome.
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PMID:Emerging aspects of pharmacotherapy for obesity and metabolic syndrome. 1545 65


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