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

The aim of this study was to determine noninvasive predictive factors of significant liver fibrosis in patients with increased serum aminotransferases associated with features of metabolic syndrome (abdominal obesity, systemic hypertension, fasting hyperglycemia, and dyslipidemia). One hundred seventy-three patients were prospectively examined, regardless of alcohol consumption. Biometric, metabolic, and hepatic biochemical variables were tested for association with fibrosis assessed on liver biopsy according to the Metavir score system. Significant fibrosis, defined as Metavir scores F2, F3, or F4, was observed in 42 of 173 patients (24%). A logistic regression model and receiver operating characteristic curve were used to construct a simple index predictive of significant fibrosis. None of the patients with serum hyaluronate levels of 35 microg/L or less had significant fibrosis. In patients with serum hyaluronate levels >35 microg/L, no case of fibrosis stage F3 or F4 was found when serum carbohydrate-deficient transferrin/transferrin ratio was less than 0.9. In conclusion, in patients with increased serum aminotransferases associated with features of metabolic syndrome, a simple algorithm, including serum hyaluronate and serum carbohydrate-deficient transferrin/transferrin ratio, allows the exclusion of clinically relevant hepatic fibrosis, regardless of current or past alcohol consumption.
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PMID:Prediction of liver fibrosis in patients with features of the metabolic syndrome regardless of alcohol consumption. 1644 Mar 40

Decreased insulin sensitivity(insulin resistance) has recently attracted attention as a factor which may relate obesity, impaired glucose tolerance, abnormal lipid metabolism and hypertension. Our epidemiologic study, mostly the 20% of general population has insulin resistance, and insulin resistance is enhanced in elderly subjects. Recently, NCEP-ATP III(2001) proposed the new clinical identification criteria for metabolic syndrome, which is a similar concept for insulin resistance syndrome and multiple risk factor syndrome. In NCEP-ATP III criteria, abdominal circumferences of over 102 cm in male, and over 88 cm in female were used as the index of abdominal obesity. However, in Japanese guideline, abdominal circumferences over 85 cm in male and 90 cm in female have been proposed as the abdominal obesity. Thus, the abdominal obesity criteria is one of the big differences between Japan and Western countries. Moreover, the capacity of insulin secretion is also very different between the diabetes patients in Japanese and Western countries people. The background characteristics and prognosis of metabolic syndrome are mostly the same in Japan and other countries. Thus, the concept of metabolic syndrome seems to be very significant to prevent and control the athelosclerotic cardiovascular diseases even in the case of Japan.
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PMID:[Epidemiologic study on metabolic syndrome--comparison between Japan and western countries]. 1520 41

The metabolic syndrome is a cluster of risk factors for coronary heart disease that seemingly have an underlying metabolic causation. Central obesity is the centerpiece of the metabolic alterations. Accordingly, increased abdominal adiposity contributes to dyslipidemia, hyperglycemia, and hypertension. In about 20% of the cases with metabolic syndrome, there is also beta-cell dysfunction that leads to the clinical manifestation of diabetes mellitus. Recent evidence suggests that increased obesity is also associated with inflammation. The role of adipose tissue in the causation of metabolic alterations that lead to the clinical manifestation of the metabolic syndrome has become a focus of active research. Adipose tissue not only secretes non-esterified fatty acids that contribute to atherogenic dyslipidemia, steatosis and lipotoxicity. This organ is also an active endocrine and paracrine system. It can secrete pro-inflammatory factors, pro-insulin resistance factors, and other cytokines and hormones that can contribute to hypertension and impaired fibrinolysis. Therefore, the metabolic alterations commonly associated with increased central obesity of the metabolic syndrome are pro-atherogenic partly because the metabolites are proinflammatory.
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PMID:Obesity and the metabolic syndrome. 1525 55

The National Cholesterol Education Program's Adult Treatment Panel III identifies persons with multiple metabolic risk factors or "metabolic syndrome" as candidates for intensified therapeutic lifestyle changes. This article reviews the important role of weight reduction,diet, and exercise in improving the metabolic syndrome and its risk factors of abdominal obesity, impaired fasting glucose,dyslipidemia, and coagulation/inflammatory factors. The article also provides practical strategies.
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PMID:Focus on lifestyle change and the metabolic syndrome. 1526 93

Metabolic syndrome is a term linking the clinical profiles of some of the world's major health problems today: obesity, heart disease, and diabetes. It is predicated on dietary patterns, and particularly on the delivery of fuel. The effects may be seen first in the development of abdominal obesity and insulin resistance leading to Type 2 diabetes mellitus and coronary heart disease. This review examines the role resistant starch might play in the prevention and management of these conditions. Beginning with a definition of resistant starch, a critical review of the scientific literature is presented. Current knowledge suggests that resistant starch in the diet may assist in the prevention and management of conditions associated with the metabolic syndrome via its potential effects on delaying the delivery of glucose as fuel with subsequent fat utilization and appetite control benefits. There is still a great deal of research to be undertaken in this area, but it is clearly warranted, given the position of starches in the global food supply and the potential impact on population health.
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PMID:Diet and metabolic syndrome: where does resistant starch fit in? 1528 76

The inflammatory marker C-reactive protein (CRP) is a highly promising cardiovascular risk factor. The data associating high sensitivity CRP (hsCRP) to atherosclerotic vascular disease, especially coronary artery disease, are strong, consistent and have been tested across many populations. Multivariate analysis shows that hsCRP has an independent predictive value to the prediction of coronary artery disease along with the conventional cardiovascular risk factors such as sex, age, cigarette smoking, blood pressure, diabetes, elevated total cholesterol (or low density lipoprotein cholesterol) and high density lipoprotein cholesterol. Retrospective analysis of published clinical trials show that individuals with elevated hsCRP benefit from the use of acetylsalicylic acid and/or the statin class of medication. Before implementing a public health policy that includes the measurement and clinical decision-making algorithm using hsCRP, several conditions must be met. Among them, a better understanding of the biology of CRP, an indepth scrutiny at the link between hsCRP levels, the metabolic syndrome, and abdominal obesity and finally, clinical trials, currently underway that will test the hypothesis that patients with elevated levels of hsCRP but a normal low density lipoprotein-cholesterol benefit from a pharmacological intervention for cardiovascular prevention in a primary prevention setting.
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PMID:Preventive cardiology: move over low density lipoprotein cholesterol, hello C-reactive protein? 1530 11

Genetic factors, alone or in interaction with components of the diet, are thought to be involved in the development of the metabolic syndrome. The objective of our study was first to compare the frequency of the peroxisome proliferator-activated receptor (PPAR)alpha-L162V polymorphism in a sample of men with and without the metabolic syndrome as defined by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) guidelines, and secondly, to evaluate gene-diet interaction effects on features of the metabolic syndrome. The PPARalpha-L162V genotype was determined in a sample of 632 men by a polymerase chain reaction-restriction length polymorphism (PCR-RFLP)-based method; fat as well as saturated fat intakes were evaluated by a dietitian-administered food frequency questionnaire. The frequency of the V162 allele was similar in men with ( n=281) and without ( n=351) the metabolic syndrome ( chi(2)=0.03, p=0.84) but was higher in subjects having simultaneously abdominal obesity, hypertriglyceridemia, and low high-density lipoprotein cholesterol (HDL-C) levels ( chi(2)=3.73, p=0.05). Carriers of the V162 were characterized by higher plasma apolipoprotein B and triglyceride (TG) levels ( p=0.10, p=0.004). In a model including the PPARalpha-L162V polymorphism, fat or saturated fat, its interaction, and covariates (smoking habits, and energy and alcohol intake), the interaction explained a significant percentage of the variance observed in waist circumference ( p<0.05). In conclusion, the PPARalpha-L162V polymorphism alone or in interaction with dietary fat intake is associated with components of the metabolic syndrome.
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PMID:Association between the PPARalpha-L162V polymorphism and components of the metabolic syndrome. 1530 80

Recent studies have shown that approximately 22% of adults in the United States have metabolic syndrome, a loosely defined clustering of cardiovascular risk factors, including abdominal obesity, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol (HDL-C), hypertension, and insulin resistance. With this syndrome looming as one of the most prevalent diseases of mankind (as well as one of the most preventable), it is imperative that practitioners have a thorough understanding of this condition so that they can effectively diagnose and appropriately manage it in their practices.
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PMID:Diagnosing and treating metabolic syndrome. 1531 Nov 97

Although elevated low-density lipoprotein (LDL)-cholesterol is a well established coronary heart disease (CHD) risk factor, the ability to adequately discriminate high-risk individuals by this risk factor alone is limited and other metabolic risk variables are known to modulate CHD risk. For instance, it has been reported that the cluster of metabolic disturbances observed among individuals with abdominal obesity, the so-called metabolic syndrome, is associated with a substantially increased risk of CHD. Among the features of the dyslipidaemic profile observed in these individuals, the high triglyceride-low high-density lipoprotein (HDL)-cholesterol dyslipidaemia is predictive of an elevated risk of CHD. Fibric acid derivatives (fibrates) have been used in clinical practice for more than 2 decades as a class of agents known to decrease triglyceride levels while substantially increasing HDL-cholesterol levels, with a limited but significant additional lowering effect on LDL-cholesterol levels. Although the clinical benefits of HMG-CoA reductase inhibitors (statins) have been well documented by primary and secondary prevention trials that justify their widespread use, it was not until the publication of the VA-HIT (Veterans Affairs High-Density Lipoprotein Intervention Trial) that the relevance of identifying HDL-cholesterol as a therapeutic target to reduce the risk of recurrent CHD events was finally confirmed. The clinical benefits of fibrate therapy are especially important in the subpopulation of patients with low HDL-cholesterol levels with the metabolic syndrome, particularly in patients with type 2 diabetes mellitus or in abdominally obese, hyperinsulinaemic patients. Evidence also suggests that there is a 'fibrate effect' that mediates the reduction in CHD risk beyond the favourable impact of these agents on HDL-cholesterol levels. This last notion is consistent with the pleiotropic effects of fibrates which are known to be related to their mechanisms of action. Through peroxisome proliferator-activated alpha-receptors, fibrates have a significant impact on the synthesis of several apolipoproteins (apo) and enzymes of lipoprotein metabolism as well as on the expression of several genes involved in fibrinolysis and inflammation. Fibrate therapy has been reported to decrease apo CIII levels (a powerful inhibitor of lipoprotein lipase) and increase apo AI levels, as well as to increase lipoprotein lipase activity. Such changes contribute to improve the catabolism of triglyceride-rich lipoproteins, leading to a substantial increase in HDL-cholesterol levels accompanied by a shift in the size and density of LDL particles (from small, dense LDL particles to larger, more buoyant cholesteryl ester-rich LDL). It is proposed that some of these pleiotropic effects could explain some of the clinical benefits of fibrate therapy beyond its HDL-raising properties, particularly among patients with abdominal obesity, hyperinsulinaemia or type 2 diabetes with both low HDL- and low/normal LDL-cholesterol levels.
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PMID:Role of fibric acid derivatives in the management of risk factors for coronary heart disease. 1545 34

The metabolic syndrome is a widespread clinical condition and an important cluster of atherothrombotic disease risk factors. The inclusion of this syndrome in the recently published Adult Treatment Panel III (ATP III) guidelines focused the attention of the physicians on this entity. Abdominal obesity, PPAR modulation, insulin resistance (with or without glucose intolerance), atherogenic dyslipidemia, elevated blood pressure, prothrombotic and proinflammatory states are the principal factors of this multifaceted syndrome. There are two major pathways of metabolic syndrome progress: (1) With preserved pancreatic beta cells function and insulin hypersecretion, which can recompense for insulin resistance. This pathway leads mostly to the macrovascular complications of metabolic syndrome. (2) With substantial injure of pancreatic beta cells leading to gradually reduced insulin secretion and to hyperglycemia (e.g. overt type 2 diabetes). This pathway leads to both microvascular and macrovascular complications. Because macrovascular complications of insulin resistance state precede the onset of hyperglycemia, early intervention in patients with metabolic syndrome is particularly important. Since central obesity (accompanied by insulin resistance even in the absence of hyperglycemia) is the key factor leading to development of metabolic syndrome and its future macrovascular complications, we assume that next logical step is the recognition of central obesity itself as a major risk factor for cardiovascular diseases.
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PMID:Macrovascular complications of metabolic syndrome: an early intervention is imperative. 1545 79


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