Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Target Concepts:
Gene/Protein
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Query: UMLS:C0948265 (
metabolic syndrome
)
24,271
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The prevention of cardiovascular diseases, and more generally of
metabolic syndrome
, goes with a well chosen diet. However, faced with a raft of often contradictory information, many patients can become disorientated. The role of the practitioner is to supply adapted, personaliZed and scientifically consensual advice. The consumption of certain types of foods naturally concentrated in protective elements should be favoured, such as those rich in folates, omega 3 fatty acids, and potassium, and low in sodium chloride. Furthermore, some new foodstuffs are appearing which have been subjected to modifications in their composition: enriched with certain nutrients or micronutrients, low in sugar and certain fats.... Thus, for example, margarines rich in phytosterols appear interesting despite limitations in their use; similarly, precautions of usage should accompany the consumption of products enriched with omega 3, sweeteners.... These attractive appearing and "gustatively correct" foods of the future will have more and more pronounced health claims. But alimentary innovation, relying on this basis in order to conquer new sections of the market, risks causing new nutritional imbalances. The practitioner must therefore remain sensible with nutritional advice and take account of economic and regional aspects by adapting it for each patient.
Arch
Mal
Coeur Vaiss 2003 Sep
PMID:[From today's foods to those of the future]. 1465 48
Plasminogen activator inhibitor-1 (PAI-1), is a serpin whose major function is to negate plasminogen activation and impair fibrinolysis. It occurs in plasma and tissues. Studies in genetically modified mice indicate that PAI-1 might be involved in thrombosis, vascular healing and atherosclerosis although contradictory findings have been obtained in the latter two processes. Differences between results depend on the types and the lengths of the models and underline the fact that besides its role in regulating fibrinolysis, PAI-1 plays a role in several cellular processes independent of plasminogen activation. In patients, high plasma PAI-1 levels worsen the prognosis of myocardial infarction in the acute phase and have been considered as a risk factor for coronary heart disease. The predictive capacity of PAI-1 is mainly related to several metabolic covariates which constitute the
metabolic syndrome
(MS). This syndrome is associated with increased cardiovascular morbidity and mortality and is becoming one of the major health problems as its prevalence is growing rapidly. Accelerated atherothrombotic process in the MS is attributed not only to metabolic abnormalities but also to a specific inflammatory state which leads to increased plasma PAI-1 levels. Modifying PAI-1 expression by PAI-1 inhibitors may open a new field of research and may reveal the true role of PAI-1 in atherosclerotic and insulin resistance processes.
Arch
Mal
Coeur Vaiss 2004 Jun
PMID:Contribution of PAI-1 in cardiovascular pathology. 1528 42
Among the major developments of the year 2004 in the knowledge of hypertension, a special part should be dedicated to the venue in Paris of the Fourteenth meeting of the European Society of Hypertension last June. Beside major progress observed in basic science, namely signaling pathways involved in the regulation of smooth muscle tone, growth and inflammation, at the cross-road of hypertension, diabetes, and
metabolic syndrome
, large clinical trials have afforded strong evidence for the usefulness of lowering blood pressure in various diseases associated with hypertension. Despite these advances, the percentage of treated hypertensive patients who reach the BP goal (<140/90 mmHg) is too low (about 30%). Thus urges the need for adapting therapeutic strategies. The ESH meeting gave the opportunity to gather a large body of evidence for a better therapeutic approach, in order to control BP in a larger number of hypertensive patients.
Arch
Mal
Coeur Vaiss 2005 Jan
PMID:[The best of hypertension in 2004]. 1571 63
It is difficult to summarize in a few pages the wealth of information appeared during the year 2005 in the field of epidemiology and cardiovascular prevention. The general epidemiological data on the evolutionary tendencies of coronary mortality and morbidity make it possible to underline the effectiveness of the control of the great risk factors within the framework of the primary prevention. Although lipids and diabetes have still this year held the front of the scene through many trials, this analysis is also focused on smoking, subject more and more tackled in the cardiologic journals, and to which a larger attention should be paid in our daily practice. The Paris Prospective Study I brought new data concerning the early identification of the subjects at risk of sudden death, starting from the analysis of the evolution of heart rate profile during and after exercise. Is the concept of
metabolic syndrome
a phenomenon of mode or does it constitute in itself an autonomous prognostic factor beyond the risk related to the plurality of the factors which define it? The cardiologist will have to be interested more and more in the living conditions of his patients and in particular with the environmental factors such as the air pollution, who seems to have a considerable impact on the incidence of the acute coronary events. Lastly, the ADMA (asymmetric dimethylarginine), seems a possible new marker of cardiovascular risk, but its real prognostic interest remains to be defined.
Arch
Mal
Coeur Vaiss 2006 Jan
PMID:[The best of epidemiology and cardiovascular prevention in 2005]. 1647 64
Although the year 2005 has reinforced the therapeutic advances of 2004, with confirmation of certain concepts, the 'coxib affair' has continued to provoke arguments between pharmaceutical companies, licensing agencies as well as patients, some of whom have amalgamated into consumer groups to reject en masse placing any responsibility on the prescribers in favour of an attack on the drug licensing process itself. Among the cardiovascular drugs that will soon be licensed, only ivabradine in stable angina, and remodulin in primary pulmonary arterial hypertension are new. The therapeutic advances in 2005 regarding platelet aggregation and blood coagulation have been significant, in the human, scientific and commercial context, while hypertension has not been ignored. Another new development is the ever more precise notion of the
metabolic syndrome
, a target of choice for the pharmaceutical industry. The potential range of applications has been widened to include obesity, hypertension, diabetes, HDL cholesterol... The licensing authorities find themselves facing a hurdle to overcome, with novel combinations of drugs (ACE inhibitors, calcium blockers/statins, statins/aspirin, ARA2/calcium blockers...).
Arch
Mal
Coeur Vaiss 2006 Jan
PMID:[The best of clinical cardiovascular pharmacology in 2005]. 1647 71
Metabolic syndrome
is public health problem. The characteristic feature is an association between factors contributing to increased cardiovascular risk. Several definitions have been proposed from 1998 to 2005. All proposed definitions take into consideration insulin resistance and its corollary hyperglycemia, overweight, hypertriglyceridemia, and LDL-cholesterol lowering. The most widely used definitions are proposed by the World Health Organization (WHO) and the American "Cholesterol" program (NCEP-ATpIII). The prevalence of
metabolic syndrome
varies by geographic region as a function of the chosen definition, the study methodology, the selection criteria, the age and gender of the study population, and the period of the study. Prevalence is higher in the United States than Europe and increases with age. A growing number of adolescents appear to meet the criteria of
metabolic syndrome
. Irrespective of the definition retained,
metabolic syndrome
is associated with increased cardiovascular risk and increased risk of type II diabetes. Sound evidence is however lacking on whether the risk is greater than that of taking into account each individual factor. Several points remain to be clarified concerning the underlying mechanisms. Visceral adipose tissue appears to be a key element in the process via anomalous function related to obesity and insulin resistance. Management is based mainly on reduction of body weight and regular physical activity. Drugs may be necessary to correct for the dyslipidemia, normalize blood glucose and reduce blood pressure.
J
Mal
Vasc 2006 Sep
PMID:[Metabolic syndrome]. 1708 87
The TROPHY study was designed to show the feasibility of pharmacological prevention of hypertension with respect to the group of patients with "prehypertension" as defined by the JNC VII recommendations. This clinical trial compared candesartan 16 mg/day with placebo and the result at 4 years was a reduction in the relative risk of developing hypertension of 15.6%. The antihypertensive drug delayed the onset of hypertension in a mainly overweight masculine population. Staessen, Zhu and O'Brien's groups suggest measuring an index of arterial rigidity obtained from ambulatory blood pressure monitoring: the ambulatory arterial stiffness index (AASI). This is calculated as [1- slope of systolic/diastolic pressure]. The reference values for AASI vary with age from 0.50 to 0.70. The CAFE study, a spin-off of the ASCOT trial, showed that the central blood pressure decreased more than the peripheral blood pressure with the association amlodipine-perindopril as compared with atenolol and a thiazide diuretic. The capacity of an antihypertensive drug or an association of antihypertensives to decrease the central blood pressure could be a pertinent factor of evaluation to be taken into account in the interpretation of clinical trials. The study of the Italian cohort PAMELA showed a progressive increase in cardiovascular and global mortality with respect to the findings of increased blood pressure by one, two or three methods of measurement (at the office, at home, ambulatory) compared with patients declared normotensive by the same methods. This registry confirmed the implication of masked hypertension on cardiovascular prognosis and also showed that "white coat" hypertension was not completely benign. The "3 cities" study is a French epidemiological study of persons over 65 years of age. The control of the blood pressure of the treated elderly hypertensives was 57% in men and 70% in women when the cut-off was 160/95 mmHg and 31% for all patients in a cut-off level of 140/90 mmHg. Lafontan et al. are studying the mobilisation of fat induced by exercise, resistant to betablockers therapy and attributed to natriuretic peptides. This metabolic pathway could be of relevance in the
metabolic syndrome
and in cardiac failure. Renin inhibitors, such as aliskiren, are being developed. The outlook is the possible use of these drugs with ACE inhibitors or angiotensin II inhibitors, taking into account the risk/benefit ratio.
Arch
Mal
Coeur Vaiss 2007 Jan
PMID:[The best of hypertension in 2006]. 1740 64
Genetically hypertensive rats of the Lyon strain (LH) associate high blood pressure (BP), exaggerated salt-sensitivity, and a
metabolic syndrome
made of overweight together with increased plasma lipids and insulin/glucose ratio. A genetic mapping study in a large population of F2 rats derived from a cross between hypertensive (LH) and normotensive rats (LN) showed the existence, on chromosome 17, of two clusters of Quantitative Traits Loci (QTLs). The first one was associated to morphological parameters whereas the second influenced blood pressure and plasma lipids level. In order to determine the functional importance of this QTLs, we generated a consomic strain LH-17BN in which the LH chromosome 17 has been fully substituted by a normotensive Brown Norway (BN) one. These LH-17BN, as well as LH and BN male rats of the parental strain were phenotyped. This included radio telemetric measurement of BP during normal and elevated salt intake (1% and then 2% in the drinking water) as well as the determination of morphological, metabolic (triglycerides, cholesterol) and renal (creatinine clearance, proteinuria) parameters. LH-17BN, compared to LH rats, exhibited significant decreases in body weight and blood pressure. Renal functions are improved (decreased of proteinuria). Finally, plasma triglycerides were reduced and reach the level observed in BN rats. In conclusion, the present work demonstrates that, in our model, chromosome 17 contains genes which influence morphology, blood pressure, renal function, and lipid metabolism. Interestingly, chromosome 17 almost completely explains the spontaneous hypertriglyceridemia observed in Lyon Hypertensive rats.
Arch
Mal
Coeur Vaiss 2007 Aug
PMID:[Importance of chromosome 17 in genetically hypertensive rats of the Lyon strain (LH): study of a consomic strain]. 1792 82
The object of this study was to compare the management of uncontrolled hypertensives (BP > 140/90 mmHg) by general practitioners with respect to the presence or absence of overweight (BMI > or =25 Kg/m2). A 2/1 stratification allowed comparison of 4080 patients who were overweight and 1951 patients with a normal body weight (normal BMI < 25 Kg/m2). The BP of patients who were overweight (> or =25 Kg/m2) was slightly higher than those with a normal BMI (161 +/- 12 mmHg vs. 159 +/- 12 mmHg, p < 0.001). The presence of a
metabolic syndrome
(43% vs. 7%, ATPIII criteria) was, logically, commoner in the patients overweight. However, the practitioners only recognised the presence of a
metabolic syndrome
in 65% of the overweight patients (28% true positives and 37% true negatives). The practitioners fixed their target value of systolic BP at 136.5 +/- 5.6 mmHg, in accordance with the recent recommendations of the Health Authorities. The targets were judged to be difficult to obtain in 18% of the overweight group and in 5% of patients with normal body weights. This optimism contrasted with the prescriptions, especially in the overweight patients, 46% of whom were treated by monotherapy and who remained for 44% on monotherapy at the end of the consultation. This descriptive study confirms the lack of awareness of the
metabolic syndrome
in overweight patients and identifies barriers to effective management of the hypertension of these high risk patients.
Arch
Mal
Coeur Vaiss 2006 Dec
PMID:[Management of hypertension and obesity: the observatory of management of uncontrolled hypertensives with respect to the presence or absence of overweight (PHYSIObs)]. 1894 21
Sleep duration has gradually diminished during the last decade while obesity and type 2 diabetes have become epidemics. Experimental sleep curtailment leads to increased appetite, hormonal disturbances and, especially, insulin resistance. Numerous epidemiological studies have therefore examined whether habitual short sleep is associated with obesity and type 2 diabetes. A large majority of cross-sectional studies have confirmed an association between short, and also long sleep duration and obesity in adults more than in the elderly. Short sleep is strongly associated to obesity in children and adolescents. Prospective studies, including studies in children, are not conclusive with regard to the effect of short sleep on the incidence of obesity. Both short and long sleep durations are associated with diabetes, but only short sleep duration seems predictive of future diabetes. Insomnia seems to be a strong contributor to short sleep duration but the association of insomnia with obesity is not clear. Insomnia is associated with type 2 diabetes and also predictive of a higher incidence. Other studies have shown that short sleep duration and insomnia are associated with, and sometime predictive of, other components of the
metabolic syndrome
, especially hypertension and the risk of coronary disease. The treatment of short sleep duration and insomnia with regard to their effects on the
metabolic syndrome
merits further study.
Rev
Mal
Respir 2015 Dec
PMID:[Sleep duration and metabolism]. 2660 59
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