Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0948265 (metabolic syndrome)
 24,271 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bariatric surgery is widely accepted as first-choice treatment of morbid obesity and has also shown promising results in the treatment of diabetes and the metabolic syndrome. The number of operations each year is increasing, as well as, consequently, the urgent need for a coordinated nutritional approach, as micronutrient deficiencies occur frequently in these patients. Official guidelines on chronic use of multivitamins and minerals are, yet, unavailable in bariatric medicine. The current review provides an algorithm that supports bariatric teams to guarantee adequate nutrition after the operation.
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PMID:Prevention of vitamin and mineral deficiencies after bariatric surgery: evidence and algorithms. 1836 80

Severe obesity is increasingly common in the United States. Very obese persons are at increased risk for the metabolic consequences of obesity. A common multidimensional risk condition associated with obesity is the metabolic syndrome. It is accompanied by increased risk for cardiovascular disease and type 2 diabetes. Clinical manifestations of the metabolic syndrome can vary among obese individuals depending on ethnicity and gender. This study was carried out to determine the pattern of metabolic risk factors in very obese women who were considered candidates for bariatric surgery. Twenty-eight women of this type were compared to 28 nonobese women. Among the former, 11 had categorical hyperglycemia (type 2 diabetes), and 26 had metabolic syndrome by current criteria. Both those with and without diabetes had higher triglycerides and lower high-density lipoprotein (HDL) cholesterol levels than nonobese, but their levels were not categorically abnormal. These changes may have been related to observed lower postheparin lipoprotein lipase activities and higher hepatic lipase activities. In spite of lipid changes, apolipoprotein B levels were only marginally higher in very obese women. In contrast to small changes in lipoprotein metabolism, the obese women were severely insulin resistant, as indicated by hyperglycemia and elevated insulin levels. In addition, they had very high C-reactive protein levels. Thus, the metabolic syndrome, which appears to be typical of very obese women, is characterized by insulin resistance, glucose intolerance and a proinflammatory state. Atherogenic dyslipidemia as a metabolic risk factor in contrast is relatively mild. This pattern is more likely to lead to type 2 diabetes prior to development of clinically evident cardiovascular disease.
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PMID:Metabolic syndrome phenotype in very obese women. 1837 Aug 9

The increasing prevalence of metabolic syndrome (MS) with age in older men has been linked with decreasing testosterone levels. Interestingly, while testosterone levels decline with age, estradiol (E2) levels remain relatively stable, resulting in a decreased testosterone:E2 ratio. Because E2 levels tend to be elevated in morbid obesity, insulin resistance, and diabetes, it is reasonable to hypothesize that high E2 levels are associated with MS in older men. We studied the relationship of total and free E2 with MS after adjustment for multiple confounders, including age, BMI, smoking, alcohol consumption, physical activity, interleukin-6 (IL-6), fasting insulin, and testosterone. Men 65 years or older (age range, 65-96; n = 452) had complete data on E2, testosterone, fasting insulin, sex hormone-binding globulin, IL-6, and albumin. Concentrations of free E2 and free testosterone were calculated using the mass action equations. MS was defined according to Adult Treatment Panel III (ATP-III). Participants with MS had significantly higher serum free and total E2 (P < .001) (P = .003). After adjusting for confounders, including age, smoking, alcohol consumption, physical activity, log(IL-6), and log(insulin), participants with higher log(total E2) (odds ratio [OR], 2.31; 95% confidence interval [95% CI], 1.39-4.70; P = .02) and higher log(free E2) (OR, 2.69; 1.38-5.24; P < .001) had an increased risk of having MS. Log(free E2) (P = .04) maintained significant correlation with MS, even after further adjustment for BMI. In older men, high E2 is independently associated with MS. Whether confirmed in other studies, assessment of E2 should be also considered in older men. Whether changes in this hormonal pattern play a role in the development of MS should be further tested in longitudinal studies.
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PMID:Estradiol and metabolic syndrome in older italian men: The InCHIANTI Study. 1905 4

The prevalence of morbid obesity and its associated metabolic complications has risen rapidly in the past decade. Recently, we have established the transcriptome of the visceral adipose tissue of nondiabetic severely obese men with and without metabolic syndrome (MetS) that provided new candidate genes for cardiovascular disease (CVD) risk factors. The oxysterol-binding protein-like protein 11 (OSBPL11) that belongs to the OSBP family of intracellular receptors was one of the genes found to be significantly overexpressed in the MetS group. To determine whether OSBPL11 gene polymorphisms are associated with CVD risk factors and diabetes, OSBPL11 gene promoter and coding regions were sequenced in 25 individuals and six tagging single-nucleotide polymorphisms (SNPs) capturing 85% of gene sequence-derived common genetic variability (minor allele frequency (MAF) > 5%) were genotyped in two samples for a total of 962 obese individuals. Using a multistage experimental design, chi(2)-tests and logistic regressions were applied to compare genotype frequencies and to compute odds ratios (ORs) for low and high CVD risk groups. Significant associations between rs1055419 and diastolic blood pressure (OR = 0.53; P = 0.01) were found whereas IVS12+95 T>C, a newly discovered SNP, was associated with low-density lipoprotein-cholesterol levels (OR = 1.63; P < 0.001), hyperglycemia/diabetes (OR = 1.48; P < 0.004) as well as with MetS per se (OR = 1.56; P < 0.01). These results suggest that the OSBPL11 gene is involved in cholesterol and glucose metabolism in obese individuals.
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PMID:Association of OSBPL11 gene polymorphisms with cardiovascular disease risk factors in obesity. 1932 44

Weight loss favorably modifies most cardiovascular risk factors, in particular the diagnostic criteria for metabolic syndrome, type 2 diabetes mellitus, and hypertension. Treating the spectrum of diabetes by promoting disease control or resolution invariably improves cardiovascular outcomes. However, in clinical trials and routine medical practice, long-term weight loss has been difficult to achieve due to wavering patient motivation, inadequate resources, ineffective medical treatments, lack of psychosocial support, recidivism, or combinations thereof. The issue is not information but rather methods, motivation, and behavioral changes. This article reviews surgical and nonsurgical methods of weight loss and their impact on cardiovascular risk factors, especially the resolution of type 2 diabetes mellitus, and the implications for cardiovascular event reduction in patients with morbid obesity.
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PMID:Impact of surgical and nonsurgical weight loss on diabetes resolution and cardiovascular risk reduction. 1949 Aug 24

Morbid obesity and diabetes cause diastolic dysfunction that can be detected by Doppler echocardiography. Patients with the metabolic syndrome could demonstrate early diastolic dysfunction that may influence effort tolerance. A total of 32 patients (17 men) who fulfilled >/=2 of the 5 metabolic syndrome criteria were studied. The average age of patients was 37+/-2 years. All patients were overweight/obese (mean body mass index of 34.4+/-0.7 kg/m(2)), 15 had blood pressure >130/85 mm Hg, 19 had elevated triglyceride levels (>150 mg/dL), and 17 had low high-density lipoprotein cholesterol levels (men <40 mg/dL, women <50 mg/dL). Maximal exercise was performed using Bruce treadmill protocol with standard stress echocardiography and tissue Doppler. Maximal oxygen consumption (VO(2max)) was measured using indirect calorimetry. Left ventricular filling pressure was indirectly derived from dividing pulse Doppler early mitral inflow velocity (E) by tissue Doppler early diastolic mitral annular motion (E') or E/E'. The group's average treadmill time was 8.06+/-0.28 minutes, VO(2max) was 28.6+/-1.1 mL/kg/min, and 8.2+/-0.3 metabolic equivalents. None had evidence of myocardial ischemia or systolic or diastolic dysfunction with exercise. Mean "resting" E/E' and "post-exercise" E/E' were 7.01+/-0.04 and 7.41+/-0.41, respectively. There was no significant correlation between resting E/E' and VO(2max) (r=-0.266; P=.14). The post-exercise E/E' significantly correlated with VO(2max) (r=-0.483; P=.005) and metabolic equivalents (r=-0.487; P=.005). Diastolic function is preserved in early metabolic syndrome. Even in the normal diastolic function range, exercise E/E' is inversely related to VO(2max). Further longitudinal studies are needed to determine whether they develop diastolic dysfunction and related heart failure.
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PMID:Correlation of Normal Diastolic Cardiac Function With VO in the Metabolic Syndrome. 1952 60

Bariatric surgery for children and adolescents with morbid obesity has not gained broad acceptance in Germany yet.Nevertheless, these children often fail to reduce weight despite intensive weight loss programmes and suffer from an associate metabolic syndrome, just like adults. Thus, bariatric surgery may be a favourable option. The present article compares national and international experiences concerning guidelines, surgical procedures, and results. It becomes obvious that Germany has neither specific guidelines for children and adolescents nor a central registry. Internationally,the recommendation from the Bariatric Scientific Collaborative Group (BSCG) should be taken as the standard. As in adults, most surgeons perform Roux-Y gastric bypass or gastric banding. Additionally, sleeve gastrectomy is gaining some popularity. These procedures are performed in designated pediatric centres especially in the US. Their success and complication rates are similar to those found in adults.The overall long-term consequences, however, remain unclear.Thus, for bariatric surgery in children and adolescents it may be concluded that a) these patients should be treated in designated centres that offer the full range of therapeutic options,b) specific guidelines should be established, especially in Germany, and c) a long-term postoperative study of all patients is necessary to collect all data and refine the techniques used.
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PMID:[Bariatric surgery for morbid obesity in childhood and adolescence: where do we stand in 2008?]. 2012 76

Obesity is fast becoming a bane for the present civilization, as a result of sedentary lifestyle, atherogenic diet, and a susceptible thrifty genotype. The concept of metabolic syndrome, which is a constellation of metabolic disturbances, has crystallized over the last 80 years with the aim of identifying those at greater risk of developing type 2 diabetes and cardiovascular disease. These patients have visceral obesity and insulin resistance characterized by hypertyriglyceridemia. Recently, it has been realized that they are also at an increased risk of chronic renal disease. Release of adipocytokines leads to endothelial dysfunction. There is also activation of systemic and local renin-angiotensin-aldosterone system, oxidative stress, and impaired fibrinolysis. This leads to glomerular hyperfiltration, proteinuria, focal segmental glomerulosclerosis (FSGS), and ultimately end-stage renal disease (ESRD). Treatment consists of lifestyle modifications along with optimal control of blood pressure, blood sugar and lipids. Metformin and thiazolidenidiones reduce insulin resistance; while angiotensin converting enzyme inhibitors and angiotensin receptor blockers reduce proteinuria and have a renoprotective effect. Exciting new medical therapies on the horizon include rimonabant a cannabinoid receptor type 1 antagonist, soy proteins, and peroxisome proliferator-activated receptor (PPAR) agonist. Bariatric surgery for morbid obesity has also been shown to be effective in treating metabolic syndrome.
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PMID:Metabolic syndrome and chronic kidney disease. 2036 11

Bariatric surgical procedures have become important therapeutic options for treatment of morbid obesity in both adults and adolescents co-morbidities of obesity such as glucose intolerance, type 2 diabetes (T2DM), metabolic syndrome, steatohepatitis, hyperlipidemia and cardiovascular disease. These co-morbidities of obesity have significant impacts on the overall quality of life of the individual and our society at large. Roux-en-Y gastric bypass (RYGB) and the relatively newer procedures of gastric banding (GB) and vertical sleeve gastrectomy (VSG) have proven to be efficacious in achieving rapid weight loss and reversing the comorbidities of obesity. Unfortunately, bariatric procedures are not without risks including micronutrient deficiency, failure to maintain lost weight, and mortality. Further, the resolution of T2DM has long been understood to precede weight loss, and this finding provides important clues about the physiologic underpinnings of the observation. In order to design more effective, safe, and widely available therapeutics for obesity, important and highly relevant questions need to be addressed regarding mechanisms behind the weight-loss-independent benefits of bariatric surgical procedures. This review will provide an overview of the molecular changes occurring across all biological systems after bariatric surgery including the changes in hepatic, adipocyte and gut derived signals after surgery. We will also discuss existing literature regarding the weight-loss-independent metabolic benefits including improvement in insulin sensitivity and central nervous system integration of these signals.
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PMID:Molecular insights from bariatric surgery. 2133 43

Morbid obesity is associated with increased morbidity and represents a major healthcare problem with increasing incidence worldwide. Bariatric surgery is considered an effective option for the management of morbid obesity. We searched MEDLINE, Current Contents and the Cochrane Library for papers published on bariatric surgery in English from 1 January 1990 to 20 July 2010. We also manually checked the references of retrieved articles for any pertinent material. Bariatric surgery results in resolution of major comorbidities including type 2 diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, non-alcoholic fatty liver disease, nephropathy, left ventricular hypertrophy and obstructive sleep apnea in the majority of morbidly obese patients. Through these effects and possibly other independent mechanisms bariatric surgery appears to reduce cardiovascular morbidity and mortality. Laparoscopic Roux-en-Y gastric bypass (LRYGB) appears to be more effective than laparoscopic adjustable gastric banding (LAGB) in terms of weight loss and resolution of comorbidities. Operation-associated mortality rates after bariatric surgery are low and LAGB is safer than LRYGB. In morbidly obese patients bariatric surgery is safe and appears to reduce cardiovascular morbidity and mortality.
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PMID:Cardiovascular benefits of bariatric surgery in morbidly obese patients. 2134 22


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